{"reporting_entity_name": "GIIC_TPA","reporting_entity_type": "GIIC_Geisinger Indemnity Insurance Company","last_updated_on": "2026-10-07","version": "2.0","provider_references": [ {"provider_group_id":2102536176,"network_name":[],"provider_groups":[{"npi":[1063945707,1144755091,1164526588,1235664186,1265537674,1285167916,1346344769,1407813603,1427165125,1538693825,1689107328,1700084944,1730158981,1922009620,1922425651,1972038826,1972613305],"tin":{"type":"ein","value":"820912090","business_name":"UPMC Memorial"}}]} ], "in_network" : [ {"negotiation_arrangement":"ffs","name":"ICD-2FC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FC31","description":"ICD-2FC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFED1","description":"ICD-GFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hip midline cath insert kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5523","description":"Hip midline cath insert kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repl leath cuff kafo-afo cal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4110","description":"Repl leath cuff kafo-afo cal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXF1","description":"ICD-JFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJC1","description":"ICD-BHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Warfarin or another FDA-approved anticoagulant not prescribed_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9928","description":"Warfarin or another FDA-approved anticoagulant not prescribed_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALF1","description":"ICD-CALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA5A","description":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0908T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","description":"CPT-0908T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOD0","description":"ICD-OHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant hormone pellet(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11980","description":"Implant hormone pellet(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCB0","description":"ICD-EGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive mastoid surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69530","description":"Extensive mastoid surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL5B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA5D","description":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTE0","description":"ICD-EHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thyroid imaging w/blood flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78013","description":"Thyroid imaging w/blood flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69642","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHB0","description":"ICD-MBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infrared therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97026","description":"Infrared therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOF1","description":"ICD-OJOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18F","description":"Special Care Low _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low extemity neur not perfor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8405","description":"Low extemity neur not perfor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAD0","description":"ICD-NGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVE1","description":"ICD-OGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECF0","description":"ICD-OECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKC0","description":"ICD-GFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX53","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELB1","description":"ICD-EELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB211","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFB0","description":"ICD-JEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOE0","description":"ICD-HHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMF0","description":"ICD-KDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCA0","description":"ICD-CDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEME1","description":"ICD-CEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBB0","description":"ICD-OJBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAA1","description":"ICD-CHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4EA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EA21","description":"ICD-4EA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGED1","description":"ICD-GGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27435","description":"Incision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQA1","description":"ICD-CAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHA0","description":"ICD-JHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIC1","description":"ICD-FFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAF1","description":"ICD-FDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTA1","description":"ICD-ICTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPA0","description":"ICD-GCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML05","description":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD205","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELC0","description":"ICD-CELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47125","description":"Partial removal of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9275","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","description":"HCPCS-J9275","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBD1","description":"ICD-OBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCA0","description":"ICD-MLCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC126","description":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX3B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOF0","description":"ICD-GEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYE1","description":"ICD-OCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng leg ped plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4031","description":"Cast sup lng leg ped plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ONC PAN-TUM DNA&RNA GNRJ SEQ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0211U","description":"ONC PAN-TUM DNA&RNA GNRJ SEQ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m pentetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9539","description":"Tc99m pentetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Moveable patient lift system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0639","description":"Moveable patient lift system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPA0","description":"ICD-NJPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ext h rate sz 15-30 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0383T","description":"Ext h rate sz 15-30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Factor ix complex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7194","description":"Factor ix complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epicord_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4187","description":"Epicord_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRC0","description":"ICD-DHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dark field examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87166","description":"Dark field examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of amikacin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80150","description":"Assay of amikacin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Targeted case management","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1017","description":"Targeted case management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr ventral hern init reduc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49560","description":"Rpr ventral hern init reduc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUD0","description":"ICD-JHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suture small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44603","description":"Suture small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEC0","description":"ICD-MKEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00851","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00851","description":"CPT-00851","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gluc monitor purchase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1030","description":"Gluc monitor purchase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Monitor_ Cardiac_ Including Intracardiac Lead And All System Components (Implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1833","description":"Monitor_ Cardiac_ Including Intracardiac Lead And All System Components (Implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSC1","description":"ICD-OKSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUB0","description":"ICD-MDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA31","description":"Default_ /30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comp screen mammogram add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77052","description":"Comp screen mammogram add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEE0","description":"ICD-GGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cranial electrotherapy stimulation (CES) system supplies and accessories_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4596","description":"Cranial electrotherapy stimulation (CES) system supplies and accessories_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVC1","description":"ICD-BFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENF0","description":"ICD-NENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8A","description":"High Rehab _ ADL Index 0-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antibody; Zika virus_ IgM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86794","description":"Antibody; Zika virus_ IgM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLD0","description":"ICD-GBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59841","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial mastectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19301","description":"Partial mastectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA211","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9289","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","description":"HCPCS-J9289","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Residential Habilitation 4-8 Supp 1:1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0103","description":"Residential Habilitation 4-8 Supp 1:1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBA1","description":"ICD-FEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC23B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Penile vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93981","description":"Penile vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Axicabtage neciloleucel_ up to 200 million autologous anti-CD19 CAR T Cells_ including leukapheresis and dose preparation procedures_ per infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2041","description":"Axicabtage neciloleucel_ up to 200 million autologous anti-CD19 CAR T Cells_ including leukapheresis and dose preparation procedures_ per infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient recorded spirometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94015","description":"Patient recorded spirometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB3B","description":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8C","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABA1","description":"ICD-OABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML51","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEE0","description":"ICD-FHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIE1","description":"ICD-NHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of pharyngeal walls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42892","description":"Revision of pharyngeal walls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML12","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD22B","description":"Clinically Complex _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUD0","description":"ICD-GIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTE1","description":"ICD-CFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCE1","description":"ICD-JBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDB1","description":"ICD-MFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHC0","description":"ICD-MJHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOC0","description":"ICD-OAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBE0","description":"ICD-GGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISF1","description":"ICD-CISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMA0","description":"ICD-OEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esrd demo bundle level i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9013","description":"Esrd demo bundle level i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIA1","description":"ICD-OFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of heart lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33120","description":"Removal of heart lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special stains group 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88312","description":"Special stains group 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBF1","description":"ICD-FDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99459","description":"Pelvic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRF0","description":"ICD-DIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJB1","description":"ICD-GEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAC0","description":"ICD-ECAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANA1","description":"ICD-JANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stationary o2 contents_ gas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0441","description":"Stationary o2 contents_ gas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFME0","description":"ICD-CFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Speech screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5362","description":"Speech screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E3200","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","description":"HCPCS-E3200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXA1","description":"ICD-CDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inject for spine disk x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62291","description":"Inject for spine disk x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54322","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients not on any kidney or kidney-pancreas transplant waitlist or is not in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1267","description":"Patients not on any kidney or kidney-pancreas transplant waitlist or is not in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEE0","description":"ICD-IIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of bursa of foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28001","description":"Drainage of bursa of foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGD0","description":"ICD-FIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRB1","description":"ICD-GCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHF1","description":"ICD-CFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKB0","description":"ICD-FEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth spine cord surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67051","description":"Anesth spine cord surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1395","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","description":"HCPCS-M1395","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSC1","description":"ICD-LBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic analysis_ programming_ and verification of an auditory osseointegrated sound processor_ any type; each additional 15 minutes (List separately in addition to code fo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92623","description":"Diagnostic analysis_ programming_ and verification of an auditory osseointegrated sound processor_ any type; each additional 15 minutes (List separately in addition to code fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-Invasive Calculation And Analysis Of Central Arterial Pressure Waveforms With Interpretation And Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0311T","description":"Non-Invasive Calculation And Analysis Of Central Arterial Pressure Waveforms With Interpretation And Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNE1","description":"ICD-GBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHB0","description":"ICD-GGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enteral ng tubing w/o stylet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4082","description":"Enteral ng tubing w/o stylet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGA1","description":"ICD-CDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mass spectrometry qual/quan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83789","description":"Mass spectrometry qual/quan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUE0","description":"ICD-EFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTC0","description":"ICD-MDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTE1","description":"ICD-NCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETA1","description":"ICD-KETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHD0","description":"ICD-IGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVC0","description":"ICD-JHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAA0","description":"ICD-FBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTB0","description":"ICD-KCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGF1","description":"ICD-CFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPD0","description":"ICD-FEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q0238","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","description":"HCPCS-Q0238","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADF0","description":"ICD-OADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc disc tx choices","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9399","description":"Doc disc tx choices","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXB0","description":"ICD-CHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXC0","description":"ICD-GAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Uppr gi scope w/submuc inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43236","description":"Uppr gi scope w/submuc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUA0","description":"ICD-OLUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGD1","description":"ICD-OCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1103","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1103","description":"CDT-D1103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTB0","description":"ICD-JCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXC0","description":"ICD-CBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA1B","description":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHC0","description":"ICD-GHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDC1","description":"ICD-JDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMD0","description":"ICD-JFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBF0","description":"ICD-NDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair prosth valve clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33496","description":"Repair prosth valve clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLB0","description":"ICD-OGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27814","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC23B","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4BB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BB21","description":"ICD-4BB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQA0","description":"ICD-KFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap ins device for rt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49327","description":"Lap ins device for rt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chromatogram assay sugars","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84375","description":"Chromatogram assay sugars","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEC1","description":"ICD-ABEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHC1","description":"ICD-FEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconst lwr jaw w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21193","description":"Reconst lwr jaw w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMC0","description":"ICD-MKMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWD1","description":"ICD-GIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCC1","description":"ICD-OJCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTE0","description":"ICD-MHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKB1","description":"ICD-NFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANC1","description":"ICD-KANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISE1","description":"ICD-CISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA5C","description":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIB1","description":"ICD-CHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace afo soft interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4392","description":"Replace afo soft interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0123U","description":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQD1","description":"ICD-GCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lancet device each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4258","description":"Lancet device each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8B","description":"Low Rehab_ ADL Index 0-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Construction of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57291","description":"Construction of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWA0","description":"ICD-OBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQF1","description":"ICD-HIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYE1","description":"ICD-CDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray guide intestinal tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74355","description":"X-ray guide intestinal tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB0D","description":"Low Rehab_ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disp fee inhal drugs/90 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0514","description":"Disp fee inhal drugs/90 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVE0","description":"ICD-NBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31080","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pet image w/ct skull-thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78815","description":"Pet image w/ct skull-thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEC0","description":"ICD-IAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDE1","description":"ICD-EHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHD0","description":"ICD-CBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diphtheria antitoxin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90296","description":"Diphtheria antitoxin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prosth retina receive&gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0100T","description":"Prosth retina receive&gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEC0","description":"ICD-CFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of vitamin k","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84597","description":"Assay of vitamin k","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0568U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","description":"CPT-0568U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOF1","description":"ICD-DEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA54","description":"Very High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1423","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","description":"HCPCS-M1423","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYA0","description":"ICD-GDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ levoleucovorin_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9043","description":"Injection_ levoleucovorin_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eye exam new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92002","description":"Eye exam new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAME1","description":"ICD-KAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPB0","description":"ICD-BFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEA1","description":"ICD-BGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJF0","description":"ICD-OCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOA0","description":"ICD-KEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCD0","description":"ICD-NHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMC1","description":"ICD-OFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAD0","description":"ICD-FFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUC1","description":"ICD-GGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx ovarian recurrence","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9116","description":"Onc dx ovarian recurrence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATD1","description":"ICD-KATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE121","description":"Clinically Complex _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGD1","description":"ICD-OJGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mammo assess hghlymalig doc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3345F","description":"Mammo assess hghlymalig doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perc d-e cor stent ather s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9602","description":"Perc d-e cor stent ather s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIB1","description":"ICD-MBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJF1","description":"ICD-CHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBA1","description":"ICD-EDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45905","description":"Dilation of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nonstnd lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0581","description":"Nonstnd lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Below elbow switch control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6930","description":"Below elbow switch control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCF0","description":"ICD-NLCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove wrist joint implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25449","description":"Remove wrist joint implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRA1","description":"ICD-KGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Counseling_ individual_ by department of veterans affairs chaplain services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9002","description":"Counseling_ individual_ by department of veterans affairs chaplain services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWD1","description":"ICD-OIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEA0","description":"ICD-IFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prothrombin complex concentrate (human)_ kcentra_ per i.u. of factor ix activity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7168","description":"Prothrombin complex concentrate (human)_ kcentra_ per i.u. of factor ix activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDC0","description":"ICD-GDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITC1","description":"ICD-NITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit new","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99203","description":"Office/outpatient visit new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0407","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0407","description":"CDT-D0407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"W/c wdth 20-23 in seat frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2340","description":"W/c wdth 20-23 in seat frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext b9+marg >4.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11406","description":"Exc tr-ext b9+marg >4.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice/home hlth_ place nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5009","description":"Hospice/home hlth_ place nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise bladder/drain ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51045","description":"Incise bladder/drain ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJE1","description":"ICD-CBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; includes set-up_ patient training_ configuration o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0533T","description":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; includes set-up_ patient training_ configuration o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Med txmnt options rvwd w/pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4325F","description":"Med txmnt options rvwd w/pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of upper arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24900","description":"Amputation of upper arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGF0","description":"ICD-OAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1003","description":"HCPCS-A1003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDB1","description":"ICD-GGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQB0","description":"ICD-OAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBC0","description":"ICD-NGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Services for high intensity clinical services associated with the initial engagement and outreach of beneficiaries assigned to the sip component of the pcf model (do not bill","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2020","description":"Services for high intensity clinical services associated with the initial engagement and outreach of beneficiaries assigned to the sip component of the pcf model (do not bill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARE1","description":"ICD-CARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML50","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKA0","description":"ICD-OAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cd4+ cell percentage <15%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3497F","description":"Cd4+ cell percentage <15%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPF1","description":"ICD-JDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Relocation Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ With Connection To Existing Dual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0681T","description":"Relocation Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ With Connection To Existing Dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALA0","description":"ICD-NALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB211","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUC0","description":"ICD-KAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEE0","description":"ICD-MDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foot foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28190","description":"Removal of foot foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of existing tract_ percutaneous_ for an endourologic procedure including imaging guidance (eg_ ultrasound and/or fluoroscopy) and all associated radiological supervis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50437","description":"Dilation of existing tract_ percutaneous_ for an endourologic procedure including imaging guidance (eg_ ultrasound and/or fluoroscopy) and all associated radiological supervis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient is not on a statin therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9797","description":"Patient is not on a statin therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1JA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JA31","description":"ICD-1JA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown 3/4 cast based metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6781","description":"Crown 3/4 cast based metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise ulnar nerve at wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64719","description":"Revise ulnar nerve at wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWA0","description":"ICD-KEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Centruroides immune f(ab)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0716","description":"Centruroides immune f(ab)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUE1","description":"ICD-IFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove nasal foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30300","description":"Remove nasal foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27640","description":"Partial removal of tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Postop follow-up visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99024","description":"Postop follow-up visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPD1","description":"ICD-CCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1111","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFD1","description":"ICD-NBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWD0","description":"ICD-KDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESF1","description":"ICD-LESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open/perq place stent 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37236","description":"Open/perq place stent 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKA0","description":"ICD-ODKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abscess imaging whole body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78806","description":"Abscess imaging whole body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted preventive service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99429","description":"Unlisted preventive service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATF1","description":"ICD-CATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophageal recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93616","description":"Esophageal recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB1B","description":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cannabinoids natural","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80349","description":"Cannabinoids natural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBA1","description":"ICD-MEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJC0","description":"ICD-KEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of manganese","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83785","description":"Assay of manganese","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal/revision of cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29705","description":"Removal/revision of cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"R-T Spctrl Alys Prst8 Tiss Fluorescenc Spctrscpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0443T","description":"R-T Spctrl Alys Prst8 Tiss Fluorescenc Spctrscpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHE1","description":"ICD-CGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA32","description":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amnio-Maxx or Amnio Maxx Lite_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4239","description":"Amnio-Maxx or Amnio Maxx Lite_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHID1","description":"ICD-EHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGD0","description":"ICD-BIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Memory goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9169","description":"Memory goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJD0","description":"ICD-KIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWF1","description":"ICD-PJWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKE0","description":"ICD-BFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAB1","description":"ICD-GIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDB0","description":"ICD-FDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTA1","description":"ICD-JGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98015","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","description":"CPT-98015","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEB0","description":"ICD-AAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Frame typ sock interscap-tho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6690","description":"Frame typ sock interscap-tho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQF0","description":"ICD-DHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sps elbow device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1801","description":"Sps elbow device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid organ)_ targeted genomic sequence analysis_ formalin-fixed paraffin-embedded (FFPE) tumor tissue_ DNA analysis_ 84 or more genes_ interrogation for sequence va","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0334U","description":"Oncology (solid organ)_ targeted genomic sequence analysis_ formalin-fixed paraffin-embedded (FFPE) tumor tissue_ DNA analysis_ 84 or more genes_ interrogation for sequence va","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHD0","description":"ICD-BEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAC1","description":"ICD-CIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYA1","description":"ICD-PAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foam drg >16<=48 sq in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6213","description":"Foam drg >16<=48 sq in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYD0","description":"ICD-PHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nerve palsy fascial graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15840","description":"Nerve palsy fascial graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOD0","description":"ICD-PAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLD0","description":"ICD-GDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAC0","description":"ICD-IAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUD1","description":"ICD-FEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWB0","description":"ICD-OBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Warming card for nwt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0232","description":"Warming card for nwt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLC0","description":"ICD-BCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBB0","description":"ICD-JGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biliary endoscopy thru skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47554","description":"Biliary endoscopy thru skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Metaproterenol comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7667","description":"Metaproterenol comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk_ Breasts_ Scalp_ Arms_ And/Or Legs; 50 Cc Or Less Injectate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15771","description":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk_ Breasts_ Scalp_ Arms_ And/Or Legs; 50 Cc Or Less Injectate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antinuclear antibodies (ana)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86039","description":"Antinuclear antibodies (ana)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parotid duct diversion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42510","description":"Parotid duct diversion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incis 1 vertebral seg cerv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22210","description":"Incis 1 vertebral seg cerv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHC1","description":"ICD-FCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYC1","description":"ICD-DDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ aicd_ endo dual coil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1895","description":"Lead_ aicd_ endo dual coil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0901","description":"HCPCS-A0901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Platelet survival","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78191","description":"Platelet survival","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth nose/sinus surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16076","description":"Anesth nose/sinus surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Composite drsg > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6205","description":"Composite drsg > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart-vein defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33732","description":"Repair heart-vein defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB117","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N block inj sciatic sng","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64445","description":"N block inj sciatic sng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKC0","description":"ICD-KHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC1B","description":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHA0","description":"ICD-FCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tx/proph/dg addl seq iv inf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96367","description":"Tx/proph/dg addl seq iv inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp aortofemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35647","description":"Art byp aortofemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ko single upright pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1843","description":"Ko single upright pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHA0","description":"ICD-FEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Needle biopsy of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47000","description":"Needle biopsy of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eeg cerebral death only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95824","description":"Eeg cerebral death only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eeg 41-60 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95812","description":"Eeg 41-60 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of endocrine hormone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84235","description":"Assay of endocrine hormone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKF1","description":"ICD-JDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"repair resin partial denture base_ mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5611","description":"repair resin partial denture base_ mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lifestyle mod 2 or 3 stage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0341","description":"Lifestyle mod 2 or 3 stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD141","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTF0","description":"ICD-NFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPA1","description":"ICD-NLPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXA0","description":"ICD-CIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVF1","description":"ICD-FHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYA0","description":"ICD-PBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQD1","description":"ICD-CHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBF1","description":"ICD-BEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQB1","description":"ICD-PJQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFF0","description":"ICD-CAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAF0","description":"ICD-FCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28D","description":"Special Care Low _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nebulizer reservoir bottle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7009","description":"Nebulizer reservoir bottle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coch imp ext proc/contr rplc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8619","description":"Coch imp ext proc/contr rplc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCID1","description":"ICD-CCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Maxilla open reduct compound","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7710","description":"Maxilla open reduct compound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIND1","description":"ICD-CIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIB0","description":"ICD-EAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIB0","description":"ICD-KBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBC1","description":"ICD-KIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cntct lens hydrophil extend","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2523","description":"Cntct lens hydrophil extend","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reset dislocated jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21485","description":"Reset dislocated jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2AB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AB31","description":"ICD-2AB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat skull fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62005","description":"Treat skull fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJF1","description":"ICD-CCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATB1","description":"ICD-GATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCD1","description":"ICD-CDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHB0","description":"ICD-AEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA111","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAA1","description":"ICD-JAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUB1","description":"ICD-FGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1607","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1607","description":"HCPCS-C1607","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N block inj intercost sng","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64420","description":"N block inj intercost sng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor <26.15 & Age >84.5_ without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0108","description":"Stroke with Motor <26.15 & Age >84.5_ without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mtms by pharm addl 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99607","description":"Mtms by pharm addl 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHE1","description":"ICD-OFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove kidney open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50220","description":"Remove kidney open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFA1","description":"ICD-KFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Strapping of elbow or wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29260","description":"Strapping of elbow or wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKC1","description":"ICD-NHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEC0","description":"ICD-EEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE25C","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hysteroscopy dx sep proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58555","description":"Hysteroscopy dx sep proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25120","description":"Removal of forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision graft extremity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35903","description":"Excision graft extremity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1081T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1081T","description":"CPT-1081T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC25D","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ldr prostate brachy comp rat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0458","description":"Ldr prostate brachy comp rat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA201","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBB1","description":"ICD-GGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWC1","description":"ICD-DBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26392","description":"Repair/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay carbamazepine total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80156","description":"Assay carbamazepine total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Position back cush wd>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2614","description":"Position back cush wd>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enterovirus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86658","description":"Enterovirus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMA1","description":"ICD-EAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAC1","description":"ICD-GIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap paraesoph her rpr w/mesh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43282","description":"Lap paraesoph her rpr w/mesh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD256","description":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIC0","description":"ICD-JIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFD1","description":"ICD-KBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37298","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","description":"CPT-37298","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUB1","description":"ICD-AHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRF0","description":"ICD-PCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct lwr extremity w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73702","description":"Ct lwr extremity w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWC0","description":"ICD-KEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXE0","description":"ICD-JBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Postop dsg cast chg elb dis/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6382","description":"Postop dsg cast chg elb dis/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRE1","description":"ICD-DIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKB1","description":"ICD-CHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQF1","description":"ICD-HFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of esophagus pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43135","description":"Removal of esophagus pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUC1","description":"ICD-NHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAB0","description":"ICD-NGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt recvd no inhal anesthic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4555F","description":"Pt recvd no inhal anesthic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHB0","description":"ICD-IDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAA1","description":"ICD-JDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGID0","description":"ICD-NGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMB0","description":"ICD-AIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GC21","description":"ICD-3GC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc mel cnr stg 0 - iic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8944","description":"Ajcc mel cnr stg 0 - iic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHE0","description":"ICD-KCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ allopurinol sodium_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0206","description":"Injection_ allopurinol sodium_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inpt/ed teleconsult50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0426","description":"Inpt/ed teleconsult50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53200","description":"Biopsy of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKB0","description":"ICD-OCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv)_ includes: hiv risk assessment (initial or continued","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0013","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv)_ includes: hiv risk assessment (initial or continued","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYB0","description":"ICD-CBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKF0","description":"ICD-KDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; system_ including pulse generat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33278","description":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; system_ including pulse generat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIF0","description":"ICD-KFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBE1","description":"ICD-AIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00873","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00873","description":"CPT-00873","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLC0","description":"ICD-MLLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWC1","description":"ICD-HEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQF1","description":"ICD-KGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove/insert drug implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11983","description":"Remove/insert drug implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1107T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1107T","description":"CPT-1107T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCB1","description":"ICD-MJCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRD0","description":"ICD-CDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hep b scrng docd as done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3513F","description":"Hep b scrng docd as done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor x stuart-power","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85260","description":"Clot factor x stuart-power","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTD1","description":"ICD-GBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDB1","description":"ICD-NCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPE0","description":"ICD-BDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUA0","description":"ICD-GEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ccnd1/Igh (T(11;14)) (Eg_ Mantle Cell Lymphoma) Translocation Analysis_ Major Breakpoint_ Qualitative And Quantitative_ If Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81168","description":"Ccnd1/Igh (T(11;14)) (Eg_ Mantle Cell Lymphoma) Translocation Analysis_ Major Breakpoint_ Qualitative And Quantitative_ If Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25445","description":"Reconstruct wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXE0","description":"ICD-OHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prev visit new age 12-17","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99384","description":"Prev visit new age 12-17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antibody_ severe acute respiratory system coronavirus 2 (SARS CoV-2) (Coronavirus disease [COVID-19])","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86769","description":"Antibody_ severe acute respiratory system coronavirus 2 (SARS CoV-2) (Coronavirus disease [COVID-19])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB154","description":"Special Care Low _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ins cath abd/l-ext art addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36248","description":"Ins cath abd/l-ext art addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0560","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","description":"HCPCS-G0560","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTE1","description":"ICD-GGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWE1","description":"ICD-KHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEA0","description":"ICD-JCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB33","description":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Conn tiss_ non-human","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1763","description":"Conn tiss_ non-human","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDA1","description":"ICD-OGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88005","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDE0","description":"ICD-OBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA53","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKD1","description":"ICD-NDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELD1","description":"ICD-FELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXC1","description":"ICD-GBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Redo compl cardiac anomaly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33622","description":"Redo compl cardiac anomaly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Genetic counsel 15 mins","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0265","description":"Genetic counsel 15 mins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDE1","description":"ICD-OKDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSD1","description":"ICD-KDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGF0","description":"ICD-OCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE260","description":"Clinically Complex _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML16","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRD1","description":"ICD-ODRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ aicd_ non sing/dual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1896","description":"Lead_ aicd_ non sing/dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYA1","description":"ICD-PIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67906","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fo nontorsion joint cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3935","description":"Fo nontorsion joint cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUD0","description":"ICD-FAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52285","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMA1","description":"ICD-MCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ elranatamab-bcmm_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1323","description":"Injection_ elranatamab-bcmm_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCD0","description":"ICD-OHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMD0","description":"ICD-FDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARD1","description":"ICD-KARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARC1","description":"ICD-PARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQC1","description":"ICD-GCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sterile gauze > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6404","description":"Sterile gauze > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/o cont_ lwr ext","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8913","description":"Mra w/o cont_ lwr ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ efbemalenograstim alfa-vuxw_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9361","description":"Injection_ efbemalenograstim alfa-vuxw_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flex/ext wrist w/wo friction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6621","description":"Flex/ext wrist w/wo friction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQB0","description":"ICD-LCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGE0","description":"ICD-OEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUF0","description":"ICD-OIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBC0","description":"ICD-FBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMF1","description":"ICD-OLMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEF1","description":"ICD-FIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJD0","description":"ICD-OFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALB0","description":"ICD-KALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA5A","description":"Default_ /PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTB0","description":"ICD-KFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETC0","description":"ICD-FETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0543","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","description":"HCPCS-G0543","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRE0","description":"ICD-DCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWE1","description":"ICD-OIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAID1","description":"ICD-GAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKA0","description":"ICD-NJKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDF1","description":"ICD-EIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA21B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Water pressure mattress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0187","description":"Water pressure mattress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNF1","description":"ICD-KHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAA0","description":"ICD-OLAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBC0","description":"ICD-NBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18X","description":"Special Care High _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trans shoe caliper plate new","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3610","description":"Trans shoe caliper plate new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCC1","description":"ICD-IHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst incl t/o complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58291","description":"Vag hyst incl t/o complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA145","description":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAC1","description":"ICD-OBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRC1","description":"ICD-PCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00542","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00542","description":"CPT-00542","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC141","description":"Special Care Low _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHE1","description":"ICD-OJHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMA0","description":"ICD-GAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Er and ip hosp <2 in 12 mos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9521","description":"Er and ip hosp <2 in 12 mos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9612","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","description":"HCPCS-A9612","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 BIVALENT 25 MCG/0.25 ML ADDL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0144A","description":"IMM ADMN SARSCOV2 BIVALENT 25 MCG/0.25 ML ADDL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Upgrade of pacemaker system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33214","description":"Upgrade of pacemaker system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tx/pro/dx inj same drug adon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96376","description":"Tx/pro/dx inj same drug adon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0260U","description":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVC1","description":"ICD-JBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETC1","description":"ICD-CETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLF1","description":"ICD-GCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert picvad cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36570","description":"Insert picvad cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBB0","description":"ICD-GDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAE0","description":"ICD-NDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABA1","description":"ICD-KABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ONC MTC MRNA XPRSN ALYS 108","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0208U","description":"ONC MTC MRNA XPRSN ALYS 108","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUD1","description":"ICD-EHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQB1","description":"ICD-PIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB23","description":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Icm device eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93290","description":"Icm device eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0805","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0805","description":"HCPCS-A0805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q0520","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0520","description":"HCPCS-Q0520","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert tandem cuff","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53444","description":"Insert tandem cuff","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYA0","description":"ICD-PCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl ctr cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33985","description":"Ecmo/ecls rmvl ctr cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Carmustine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9050","description":"Carmustine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC231","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIC1","description":"ICD-NFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE15A","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGB1","description":"ICD-JGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASC1","description":"ICD-OASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA24C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXA1","description":"ICD-JHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJF0","description":"ICD-GDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOB1","description":"ICD-CEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTD1","description":"ICD-FDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHF1","description":"ICD-MKHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITD0","description":"ICD-EITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWC0","description":"ICD-OAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOD1","description":"ICD-HAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC110","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ BICROS_ behind the ear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5220","description":"Hearing aid_ BICROS_ behind the ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGE1","description":"ICD-OKGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neox 100 or Clarix 100_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4156","description":"Neox 100 or Clarix 100_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFC0","description":"ICD-GHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXE0","description":"ICD-OCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB160","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAC0","description":"ICD-FEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIF0","description":"ICD-NGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test 4 limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95864","description":"Muscle test 4 limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of bile duct cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47715","description":"Excision of bile duct cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMB1","description":"ICD-JHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBE0","description":"ICD-MGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPC1","description":"ICD-BHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKF1","description":"ICD-ODKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIND0","description":"ICD-OIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36557","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTD0","description":"ICD-GFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTF0","description":"ICD-MFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31605","description":"Incision of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGE1","description":"ICD-NBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aortic dysfunction/dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81410","description":"Aortic dysfunction/dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB12A","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEC1","description":"ICD-BFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient pressure wrap with adjustable straps_ above knee_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6585","description":"Gradient pressure wrap with adjustable straps_ above knee_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGE0","description":"ICD-FBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFE0","description":"ICD-OCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAB0","description":"ICD-MGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKE0","description":"ICD-NHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEB0","description":"ICD-MHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nontherm electromgntc device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0761","description":"Nontherm electromgntc device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRF1","description":"ICD-GHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSD0","description":"ICD-LDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implantable access syst perc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4301","description":"Implantable access syst perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEA0","description":"ICD-OAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHF1","description":"ICD-BAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUA1","description":"ICD-AHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remis 12m not phq-9 score <5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9510","description":"Remis 12m not phq-9 score <5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKC1","description":"ICD-KBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA141","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVD0","description":"ICD-JCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPE1","description":"ICD-OHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCB1","description":"ICD-IBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTC0","description":"ICD-JBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hx injec drug use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9450","description":"Hx injec drug use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJE0","description":"ICD-OHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCB1","description":"ICD-BDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA23","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1052T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1052T","description":"CPT-1052T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB10D","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of sternum separation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21750","description":"Repair of sternum separation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUB1","description":"ICD-MKUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2DB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DB11","description":"ICD-2DB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat pelvic ring fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27216","description":"Treat pelvic ring fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of psa free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84154","description":"Assay of psa free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCME0","description":"ICD-NCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chylmd pneum dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87486","description":"Chylmd pneum dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous vertebroplasty_ one vertebral body_ unilateral or bilateral injection; cervical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2360","description":"Percutaneous vertebroplasty_ one vertebral body_ unilateral or bilateral injection; cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWB0","description":"ICD-KHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOB0","description":"ICD-GBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0505","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0505","description":"HCPCS-C0505","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHND0","description":"ICD-FHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0988T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","description":"CPT-0988T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1LC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LC21","description":"ICD-1LC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Path rprt w/ pt pn cat et al","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3267F","description":"Path rprt w/ pt pn cat et al","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTA0","description":"ICD-MJTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMA1","description":"ICD-BEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compress burn mask face/neck","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6513","description":"Compress burn mask face/neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ald fm/dm system_ monaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5281","description":"Ald fm/dm system_ monaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCF0","description":"ICD-AFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Carbonic anhydrase VI (CA VI)_ parotid specific/secretory protein (PSP) and salivary protein (SP1) IgG_ IgM_ and IgA antibodies_ enzyme-linked immunosorbent assay (ELISA)_ sem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0472U","description":"Carbonic anhydrase VI (CA VI)_ parotid specific/secretory protein (PSP) and salivary protein (SP1) IgG_ IgM_ and IgA antibodies_ enzyme-linked immunosorbent assay (ELISA)_ sem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pros sock single ply ak","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8480","description":"Pros sock single ply ak","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Initial visit for episode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0525F","description":"Initial visit for episode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAE0","description":"ICD-BEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMF1","description":"ICD-OEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJE0","description":"ICD-OIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1757","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1757","description":"HCPCS-J1757","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNF0","description":"ICD-JGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diag laparo separate proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49320","description":"Diag laparo separate proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5144","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","description":"HCPCS-Q5144","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD22C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVA0","description":"ICD-CAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home Adaptations (>$6_000)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0141","description":"Home Adaptations (>$6_000)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Conform band s w >=5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6447","description":"Conform band s w >=5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFE0","description":"ICD-OGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0928T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","description":"CPT-0928T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPF1","description":"ICD-JEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWF0","description":"ICD-HGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVA1","description":"ICD-GAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Habil prevoc waiver per hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2015","description":"Habil prevoc waiver per hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESE0","description":"ICD-LESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Photopheresis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36522","description":"Photopheresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88020","description":"Autopsy (necropsy) complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB16","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth procedure on mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17051","description":"Anesth procedure on mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ivf canc a aspir case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4020","description":"Ivf canc a aspir case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAD1","description":"ICD-MDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYE1","description":"ICD-LEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJA0","description":"ICD-GFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3405","description":"HCPCS-J3405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBE0","description":"ICD-FFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD12A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole lauroxil_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1942","description":"Injection_ aripiprazole lauroxil_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUD0","description":"ICD-FDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25545","description":"Treat fracture of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBA0","description":"ICD-KCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBD0","description":"ICD-IFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHA1","description":"ICD-KIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAD1","description":"ICD-MJAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant spinal canal cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62351","description":"Implant spinal canal cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYB0","description":"ICD-KAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUA0","description":"ICD-NEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGF0","description":"ICD-GHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray spleen/liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75810","description":"Vein x-ray spleen/liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWD0","description":"ICD-KEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA13","description":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJC1","description":"ICD-OBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Correction eyelid w/implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67912","description":"Correction eyelid w/implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Bladder Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1075","description":"Radiation Therapy For Bladder Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIF0","description":"ICD-FCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAE0","description":"ICD-MIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSE0","description":"ICD-DGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELD1","description":"ICD-KELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excellagen_ 0.1 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4149","description":"Excellagen_ 0.1 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWB1","description":"ICD-CGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dyspnea not screened","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3452F","description":"Dyspnea not screened","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFB1","description":"ICD-OKFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBE0","description":"ICD-BBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCC0","description":"ICD-FHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTA1","description":"ICD-MKTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Advncd care plan addl 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99498","description":"Advncd care plan addl 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBD1","description":"ICD-MDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1DA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DA21","description":"ICD-1DA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Upper extremity medical tubing/lines enclosure or covering device_ restricts elbow range of motion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0711","description":"Upper extremity medical tubing/lines enclosure or covering device_ restricts elbow range of motion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVA0","description":"ICD-JDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGF1","description":"ICD-CBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepcidin-25_ Enzyme-Linked Immunosorbent Assay (Elisa)_ Serum Or Plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0251U","description":"Hepcidin-25_ Enzyme-Linked Immunosorbent Assay (Elisa)_ Serum Or Plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ire abltj 1+tum organ perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0600T","description":"Ire abltj 1+tum organ perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCE0","description":"ICD-MGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMD1","description":"ICD-IGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHD1","description":"ICD-OJHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWF1","description":"ICD-KFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXC0","description":"ICD-BBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transesoph doppl cardiac mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9157","description":"Transesoph doppl cardiac mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAD0","description":"ICD-KBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stationary liquid 02","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0439","description":"Stationary liquid 02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYD1","description":"ICD-OHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWE0","description":"ICD-CBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed semi-electr w/o mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0261","description":"Hosp bed semi-electr w/o mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mastoid surgery revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69601","description":"Mastoid surgery revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tympanometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92567","description":"Tympanometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVC0","description":"ICD-FCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYB0","description":"ICD-CIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOB0","description":"ICD-LGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"C motor evoked lwr limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95929","description":"C motor evoked lwr limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMD0","description":"ICD-MAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54530","description":"Removal of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJF0","description":"ICD-JEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0501","description":"HCPCS-A0501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQD1","description":"ICD-LHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE13A","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Residual limb support system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1020","description":"Residual limb support system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNE0","description":"ICD-KDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIA1","description":"ICD-JHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5150","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","description":"HCPCS-Q5150","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal endoscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31231","description":"Nasal endoscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEF1","description":"ICD-OJEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBA0","description":"ICD-BGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHD0","description":"ICD-AFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Molecular Fluorescent Imaging Of Suspicious Nevus; Each Additional Lesion (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0701T","description":"Molecular Fluorescent Imaging Of Suspicious Nevus; Each Additional Lesion (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGC1","description":"ICD-NKGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAE0","description":"ICD-FIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leukocyte assessment fecal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89055","description":"Leukocyte assessment fecal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hep c genotype prior to med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9207","description":"Hep c genotype prior to med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEC1","description":"ICD-JFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEF0","description":"ICD-BFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJD0","description":"ICD-CEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm 2.6-5.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12052","description":"Intmd rpr face/mm 2.6-5.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC5B","description":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen supplies regulator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1353","description":"Oxygen supplies regulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWC1","description":"ICD-DIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJB1","description":"ICD-GHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMA1","description":"ICD-GCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Synthetic resorbable wound dressing_ sterile_ pad size 16 sq in or less_ without adhesive border_ each dressing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6460","description":"Synthetic resorbable wound dressing_ sterile_ pad size 16 sq in or less_ without adhesive border_ each dressing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPF1","description":"ICD-CIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Complete wheel lock assembly","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2206","description":"Complete wheel lock assembly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDB0","description":"ICD-EGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHD0","description":"ICD-GBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOA0","description":"ICD-GHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording and disconnection per patient encounter_ leadless pacemaker system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0391T","description":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording and disconnection per patient encounter_ leadless pacemaker system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLE0","description":"ICD-NJLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDB0","description":"ICD-BEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSE1","description":"ICD-HBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUA1","description":"ICD-GDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWD1","description":"ICD-HAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5877","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5877","description":"CDT-D5877","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFA1","description":"ICD-CHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61522","description":"Removal of brain abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant ureter in bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50800","description":"Implant ureter in bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVD0","description":"ICD-KIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N block inj pudendal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64430","description":"N block inj pudendal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76519","description":"Echo exam of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pres/absn hmrhg/lesion docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3110F","description":"Pres/absn hmrhg/lesion docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRB1","description":"ICD-HCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anacaulase-bcdb_ 8.8% gel_ 1 gm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7353","description":"Anacaulase-bcdb_ 8.8% gel_ 1 gm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE20B","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Phlebotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99195","description":"Phlebotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rbc_ frz/deg/wsh_ l/r_ irrad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9057","description":"Rbc_ frz/deg/wsh_ l/r_ irrad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBD0","description":"ICD-EHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD201","description":"Clinically Complex _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA1B","description":"High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA22C","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of spleen partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38101","description":"Removal of spleen partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQD1","description":"ICD-GHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCD0","description":"ICD-JCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALF0","description":"ICD-CALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rebuild eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69637","description":"Rebuild eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of skull defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62140","description":"Repair of skull defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD145","description":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFD0","description":"ICD-OAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE117","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Matristem micromatrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4118","description":"Matristem micromatrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gc chl syp documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9228","description":"Gc chl syp documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSE0","description":"ICD-CHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESB0","description":"ICD-PESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental suture wound to 5 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7911","description":"Dental suture wound to 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAD1","description":"ICD-KFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOC1","description":"ICD-GIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVE1","description":"ICD-JAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMC1","description":"ICD-BAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUE0","description":"ICD-MGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1375","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","description":"HCPCS-M1375","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJED1","description":"ICD-NJED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Re-Cement Or Re-Bond Fixed Retainer - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8699","description":"Re-Cement Or Re-Bond Fixed Retainer - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPF1","description":"ICD-BCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise spine eltrd perq aray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63663","description":"Revise spine eltrd perq aray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of etiocholanolone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82696","description":"Assay of etiocholanolone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKB0","description":"ICD-KEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFA0","description":"ICD-FFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging_ breast_ without contrast material; unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77046","description":"Magnetic resonance imaging_ breast_ without contrast material; unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMD1","description":"ICD-BEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELA0","description":"ICD-MELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEC0","description":"ICD-ADEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA124","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRF0","description":"ICD-DCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g._ ulcerative colitis_ crohn_s disease)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1182","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g._ ulcerative colitis_ crohn_s disease)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEB1","description":"ICD-MGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLD0","description":"ICD-KDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27507","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEE0","description":"ICD-MJEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX5B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0407","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0407","description":"HCPCS-B0407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat scapula fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23585","description":"Treat scapula fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of biotinidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82261","description":"Assay of biotinidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lvef not performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8396","description":"Lvef not performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUB1","description":"ICD-IFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bilateral hip_ knee_ ankle_ foot device_ powered_ includes pelvic component_ single or double upright(s)_ knee joints any type_ with or without ankle joints any type_ includes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1007","description":"Bilateral hip_ knee_ ankle_ foot device_ powered_ includes pelvic component_ single or double upright(s)_ knee joints any type_ with or without ankle joints any type_ includes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elbow arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29838","description":"Elbow arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKA0","description":"ICD-FIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX25","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSA0","description":"ICD-GBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVD0","description":"ICD-NBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Whlchr stand fxd arm ft rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1130","description":"Whlchr stand fxd arm ft rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHD1","description":"ICD-MHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBD0","description":"ICD-FBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inject spine cerv/thoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62310","description":"Inject spine cerv/thoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wedging of clubfoot cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29750","description":"Wedging of clubfoot cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDF0","description":"ICD-CGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHME0","description":"ICD-IHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Omeza Collagen Matrix_ per 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2014","description":"Omeza Collagen Matrix_ per 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOC1","description":"ICD-CIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray of brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70015","description":"Contrast x-ray of brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC34","description":"Medium Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Denture reln part maxil lab","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5760","description":"Denture reln part maxil lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE14A","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDF1","description":"ICD-JEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHF1","description":"ICD-JEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCD0","description":"ICD-BFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGA0","description":"ICD-OLGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Same day nb discharge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99463","description":"Same day nb discharge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or removal and replacement of intracardiac ischemia monitoring system including imaging supervision and interpretatio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9750","description":"Insertion or removal and replacement of intracardiac ischemia monitoring system including imaging supervision and interpretatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Continuous Home Care - A flat per hourly rate before area wage adjustment for intensive home nursing care delivered by personnel when the need for such care exceeds 8 hours","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0603","description":"Continuous Home Care - A flat per hourly rate before area wage adjustment for intensive home nursing care delivered by personnel when the need for such care exceeds 8 hours","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation that neoplasm detected is only diagnosed as traditional serrated adenoma_ sessile serrated polyp_ or sessile serrated adenoma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9934","description":"Documentation that neoplasm detected is only diagnosed as traditional serrated adenoma_ sessile serrated polyp_ or sessile serrated adenoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPF1","description":"ICD-FIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYE0","description":"ICD-PHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"In111 pentetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9548","description":"In111 pentetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medicaid certified community behavioral health clinic services_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1041","description":"Medicaid certified community behavioral health clinic services_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIF0","description":"ICD-EEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIED0","description":"ICD-IIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","description":"HCPCS-M1502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXB1","description":"ICD-JHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFC0","description":"ICD-NIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap mobil splenic fl add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44213","description":"Lap mobil splenic fl add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCE0","description":"ICD-NJCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory syncytial virus_ monoclonal antibody_ seasonal dose; 1 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90381","description":"Respiratory syncytial virus_ monoclonal antibody_ seasonal dose; 1 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWA1","description":"ICD-OLWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUC0","description":"ICD-CHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J8541","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","description":"HCPCS-J8541","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MyOwn skin_ includes harvesting and preparation procedures_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4226","description":"MyOwn skin_ includes harvesting and preparation procedures_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEE0","description":"ICD-EBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCB0","description":"ICD-MKCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKD1","description":"ICD-GHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt no ref otolo no spec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8568","description":"Pt no ref otolo no spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPC1","description":"ICD-NHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEC0","description":"ICD-MJEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBB1","description":"ICD-OEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37262","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","description":"CPT-37262","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tetanus ig im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90389","description":"Tetanus ig im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove bladder/revise tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51595","description":"Remove bladder/revise tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"5% dextrose in lac ringers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7121","description":"5% dextrose in lac ringers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brca1&2 185&5385&6174 var","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81212","description":"Brca1&2 185&5385&6174 var","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87811","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGE1","description":"ICD-FGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJD0","description":"ICD-FCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHD0","description":"ICD-EAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILB0","description":"ICD-JILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trichomonas vaginalis amplif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87661","description":"Trichomonas vaginalis amplif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ingest challenge addl 60 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95079","description":"Ingest challenge addl 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXD0","description":"ICD-GFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFD0","description":"ICD-NHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPE0","description":"ICD-CHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML5A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aneurysm pressure sens study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93982","description":"Aneurysm pressure sens study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYC0","description":"ICD-OJYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXD0","description":"ICD-NFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTD0","description":"ICD-KFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ detection of 8 autoantibodies (ARF 6_ NKX3-1_ 5_-UTR-BMI1_ CEP 164_ 3_-UTR-Ropporin_ Desmocollin_ AURKAIP-1_ CSNK2A2)_ multiplexed immunoassay and flow cy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0021U","description":"Oncology (prostate)_ detection of 8 autoantibodies (ARF 6_ NKX3-1_ 5_-UTR-BMI1_ CEP 164_ 3_-UTR-Ropporin_ Desmocollin_ AURKAIP-1_ CSNK2A2)_ multiplexed immunoassay and flow cy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMD0","description":"ICD-FCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB14D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQE0","description":"ICD-CAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXD1","description":"ICD-FBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33010","description":"Drainage of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMF1","description":"ICD-CAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSD0","description":"ICD-PJSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release wrist/forearm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25295","description":"Release wrist/forearm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKA0","description":"ICD-OKKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQB0","description":"ICD-OJQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGE0","description":"ICD-NEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRC1","description":"ICD-OHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pertuzumab_ trastuzumab_ and hyaluronidase-zzxf_ per 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9316","description":"Injection_ pertuzumab_ trastuzumab_ and hyaluronidase-zzxf_ per 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L1006","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","description":"HCPCS-L1006","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRE1","description":"ICD-PFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPC1","description":"ICD-NIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYA0","description":"ICD-GGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHA0","description":"ICD-MHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGF1","description":"ICD-NDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8E","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls daily mgmt artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33949","description":"Ecmo/ecls daily mgmt artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRF0","description":"ICD-PKRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB135","description":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJF1","description":"ICD-JAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALD0","description":"ICD-CALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ acute myeloid leukemia_ myelodysplastic syndrome_ and myeloproliferative neoplasms_ DNA analysis_ 23 genes_ interrogation for sequenc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0171U","description":"Targeted genomic sequence analysis panel_ acute myeloid leukemia_ myelodysplastic syndrome_ and myeloproliferative neoplasms_ DNA analysis_ 23 genes_ interrogation for sequenc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35304","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWA1","description":"ICD-DFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBA0","description":"ICD-FHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6005","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant spine infusion pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62361","description":"Implant spine infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC14A","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNC0","description":"ICD-GDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No trnsfr from anesth to cc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0582F","description":"No trnsfr from anesth to cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise submaxillary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42440","description":"Excise submaxillary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interferon alfa-2a inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9213","description":"Interferon alfa-2a inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for intraoral procedures_ including biopsy; radical surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0126U","description":"Anesthesia for intraoral procedures_ including biopsy; radical surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRD0","description":"ICD-PCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE244","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auricular replacement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5927","description":"Auricular replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release of lower leg tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27681","description":"Release of lower leg tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDC0","description":"ICD-CIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mst rcnt hbb < 10g/dl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8973","description":"Mst rcnt hbb < 10g/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopy of bowel pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44385","description":"Endoscopy of bowel pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extension per extension per","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2760","description":"Extension per extension per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYA0","description":"ICD-HGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEE0","description":"ICD-BAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFE1","description":"ICD-OFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSF0","description":"ICD-GCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLB0","description":"ICD-NGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENA0","description":"ICD-BENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocolld drg >16<=48 w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6235","description":"Hydrocolld drg >16<=48 w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc forearm tum deep < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25076","description":"Exc forearm tum deep < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pfizer-BioNTech Covid-19 vaccine administration tris-sucrose pediatric - first dose (SARSCOV2 COVID-19 VAC mRNA 10mcg/0.2mL tris-sucrose IM DOSE 1)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1713","description":"Pfizer-BioNTech Covid-19 vaccine administration tris-sucrose pediatric - first dose (SARSCOV2 COVID-19 VAC mRNA 10mcg/0.2mL tris-sucrose IM DOSE 1)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDE0","description":"ICD-OHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31577","description":"Remove foreign body larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3IB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IB21","description":"ICD-3IB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45315","description":"Proctosigmoidoscopy removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVE1","description":"ICD-JCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat ulnar fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24685","description":"Treat ulnar fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEF0","description":"ICD-JBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQE0","description":"ICD-OHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0492U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","description":"CPT-0492U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA55","description":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB12","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt falls assess-docd le1/yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1101F","description":"Pt falls assess-docd le1/yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOE1","description":"ICD-KFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB144","description":"Clinically Complex _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc visit unspecified nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9055","description":"Onc visit unspecified nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXF0","description":"ICD-CIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo guidance radiotherapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76965","description":"Echo guidance radiotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDB1","description":"ICD-JDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eye photodynamic ther add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67225","description":"Eye photodynamic ther add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVA1","description":"ICD-NLVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ringers lactate infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7120","description":"Ringers lactate infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artery transpose/endovas taa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33889","description":"Artery transpose/endovas taa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA34","description":"Medium Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29870","description":"Knee arthroscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGA1","description":"ICD-CCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOF0","description":"ICD-GAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIC0","description":"ICD-FIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBA0","description":"ICD-IEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lipid panel doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3011F","description":"Lipid panel doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEE0","description":"ICD-OJEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMC1","description":"ICD-NIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat heel fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28415","description":"Treat heel fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compres burn garment_ noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6512","description":"Compres burn garment_ noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQD0","description":"ICD-PCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDF1","description":"ICD-CIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vagina wall partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57106","description":"Remove vagina wall partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD130","description":"Clinically Complex _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI abdomen w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74182","description":"MRI abdomen w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8F","description":"Medium Rehab _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC15","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enrollment**","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0009","description":"Enrollment**","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEA0","description":"ICD-KGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27445","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILD0","description":"ICD-CILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj >24 hr in ed gcs <15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9532","description":"Inj >24 hr in ed gcs <15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surg redct fibrous tuberosit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7972","description":"Surg redct fibrous tuberosit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYC0","description":"ICD-PLYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRB0","description":"ICD-HBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELB0","description":"ICD-KELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISC0","description":"ICD-LISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRC1","description":"ICD-DGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp axillary-femoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35621","description":"Art byp axillary-femoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sclerotx fluid collection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49185","description":"Sclerotx fluid collection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCB0","description":"ICD-ICCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA3A","description":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXF0","description":"ICD-NKXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect femur/knee tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27365","description":"Resect femur/knee tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1306","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0619U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","description":"CPT-0619U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSC0","description":"ICD-DCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIF0","description":"ICD-JAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp4 hd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0879","description":"Pwc gp4 hd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAND1","description":"ICD-BAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2AA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AA21","description":"ICD-2AA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJA0","description":"ICD-JAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEC0","description":"ICD-JHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N block inj trigeminal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64400","description":"N block inj trigeminal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of hip joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27054","description":"Removal of hip joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33710","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLED1","description":"ICD-OLED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSA1","description":"ICD-CGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Caster fork replacement only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2226","description":"Caster fork replacement only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFND1","description":"ICD-NFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Holotranscobalamin_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0103T","description":"Holotranscobalamin_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTF0","description":"ICD-CBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDF1","description":"ICD-KFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIF1","description":"ICD-CBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFD1","description":"ICD-KEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytogenetics 10-30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88273","description":"Cytogenetics 10-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig med check","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8430","description":"Pt inelig med check","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWD1","description":"ICD-DBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIE0","description":"ICD-FBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCND1","description":"ICD-NCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Capecitabine_ oral_ 150 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8520","description":"Capecitabine_ oral_ 150 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Subs episode for condition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1128F","description":"Subs episode for condition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDF0","description":"ICD-KDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin exo frict swg & st","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5712","description":"Knee-shin exo frict swg & st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0901","description":"HCPCS-C0901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mdd mild","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3088F","description":"Mdd mild","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eye image valid to dx rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2026F","description":"Eye image valid to dx rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHF0","description":"ICD-OBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDD1","description":"ICD-OKDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of pharyngeal walls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42894","description":"Revision of pharyngeal walls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDE0","description":"ICD-JEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXD1","description":"ICD-KHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHD1","description":"ICD-NFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBE1","description":"ICD-OIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIF1","description":"ICD-CFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCE0","description":"ICD-ICCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYE0","description":"ICD-HCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap ing hernia repair recur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49651","description":"Lap ing hernia repair recur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACF1","description":"ICD-KACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA2C","description":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orbital replacement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5928","description":"Orbital replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged iv inf_ req pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8957","description":"Prolonged iv inf_ req pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elbow disart myoelectronic c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6945","description":"Elbow disart myoelectronic c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIB1","description":"ICD-IEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy snare les remv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43217","description":"Esophagoscopy snare les remv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIF1","description":"ICD-IEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64742","description":"Incision of facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB51","description":"Low Rehab_ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; Without Contrast_ Followed By Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0638T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; Without Contrast_ Followed By Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUB1","description":"ICD-BFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism (adverse drug reactions and drug response)_ buccal specimen_ gene-drug interactions_ variant analysis of 33 genes_ including deletion/duplication analysis of C","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0438U","description":"Drug metabolism (adverse drug reactions and drug response)_ buccal specimen_ gene-drug interactions_ variant analysis of 33 genes_ including deletion/duplication analysis of C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXE0","description":"ICD-CEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct maxilla segment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7947","description":"Reconstruct maxilla segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KC21","description":"ICD-2KC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAD1","description":"ICD-AFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ustekinumab_ for intravenous injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9487","description":"Ustekinumab_ for intravenous injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJB1","description":"ICD-CIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8F","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENE1","description":"ICD-OENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHB1","description":"ICD-MDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDA0","description":"ICD-MLDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUF1","description":"ICD-NBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKF0","description":"ICD-KFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPB0","description":"ICD-CBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Add pwr tiller","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0984","description":"Add pwr tiller","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of small bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74251","description":"X-ray exam of small bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCB0","description":"ICD-BFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1068T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1068T","description":"CPT-1068T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Generator_ neurostimulator (implantable)_ non-rechargeable_ with implantable stimulation lead and external paired stimulation controller","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1827","description":"Generator_ neurostimulator (implantable)_ non-rechargeable_ with implantable stimulation lead and external paired stimulation controller","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB246","description":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWB0","description":"ICD-OKWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADA1","description":"ICD-CADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHC0","description":"ICD-GGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQE1","description":"ICD-OJQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQE1","description":"ICD-OGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMA0","description":"ICD-IAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct upper jaw bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21206","description":"Reconstruct upper jaw bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD15C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJA1","description":"ICD-KCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMC0","description":"ICD-OAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy thigh soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27324","description":"Biopsy thigh soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FB21","description":"ICD-1FB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVE0","description":"ICD-BDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Conductive garment for tens/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0731","description":"Conductive garment for tens/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOE1","description":"ICD-CFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMA1","description":"ICD-EIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medical Physics Dose Evaluation For Radiation Exposure That Exceeds Institutional Review Threshold_ Including Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76145","description":"Medical Physics Dose Evaluation For Radiation Exposure That Exceeds Institutional Review Threshold_ Including Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKA0","description":"ICD-NBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTB0","description":"ICD-KGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fludarabine phosphate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9185","description":"Fludarabine phosphate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQB1","description":"ICD-DAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28515","description":"Treatment of toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWF1","description":"ICD-DAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCA1","description":"ICD-GCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of breast implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19328","description":"Removal of breast implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBND1","description":"ICD-NBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aminolevulinic acid hcl for topical administration_ 10% gel_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7345","description":"Aminolevulinic acid hcl for topical administration_ 10% gel_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKC0","description":"ICD-NJKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pre-tibial shell molded to p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2340","description":"Pre-tibial shell molded to p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62326","description":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Omegaven_ 10 Grams Lipids","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4187","description":"Omegaven_ 10 Grams Lipids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bekesy audiometry screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92560","description":"Bekesy audiometry screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRF0","description":"ICD-LCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPE1","description":"ICD-CEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mr guidance for needle place","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77021","description":"Mr guidance for needle place","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWB1","description":"ICD-DIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTD0","description":"ICD-IFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35321","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Analgesics non-opioid 6/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80331","description":"Analgesics non-opioid 6/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Penicillin g procaine inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2510","description":"Penicillin g procaine inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of ankle ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27695","description":"Repair of ankle ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWE0","description":"ICD-DAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMC1","description":"ICD-OHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTB0","description":"ICD-CHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFA1","description":"ICD-NBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC30","description":"Ultra High Rehab _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10121","description":"Remove foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYD1","description":"ICD-LDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patient_s 13th birthday","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1163","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patient_s 13th birthday","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXA1","description":"ICD-KGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLC0","description":"ICD-NCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enterectomy cong add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44128","description":"Enterectomy cong add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBF1","description":"ICD-OCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBB0","description":"ICD-NBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystourethro cut ejacul duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52402","description":"Cystourethro cut ejacul duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMC1","description":"ICD-GAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCB1","description":"ICD-KCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEB1","description":"ICD-EDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical path gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88300","description":"Surgical path gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXD1","description":"ICD-NJXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD255","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Individual who did not fill at least two prescriptions for any antipsychotic medication or did not have a pdc of 0.8 or greater","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9370","description":"Individual who did not fill at least two prescriptions for any antipsychotic medication or did not have a pdc of 0.8 or greater","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHD1","description":"ICD-FIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ bin_ bte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5253","description":"Hearing aid_ prog_ bin_ bte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair spinal fluid leakage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63707","description":"Repair spinal fluid leakage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFC1","description":"ICD-FCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPF1","description":"ICD-CGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Isoproterenol non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7658","description":"Isoproterenol non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair prosthesis per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7520","description":"Repair prosthesis per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair windpipe opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31614","description":"Repair windpipe opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATE0","description":"ICD-GATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Real-time pressure-sensing epidural guidance system (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0777T","description":"Real-time pressure-sensing epidural guidance system (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEA0","description":"ICD-CGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA23D","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBF0","description":"ICD-OBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENF1","description":"ICD-JENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTF0","description":"ICD-BFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic seq analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81450","description":"Targeted genomic seq analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7528","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","description":"HCPCS-J7528","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft axill/fem/fem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35533","description":"Art byp grft axill/fem/fem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAD1","description":"ICD-NIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ocrelizumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2350","description":"Injection_ ocrelizumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shock absorber for man w/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1015","description":"Shock absorber for man w/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABE0","description":"ICD-NABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of urethra lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53235","description":"Removal of urethra lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18G","description":"Clinically Complex _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCC0","description":"ICD-NGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAC0","description":"ICD-BDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aortic aneurysm<5cm diam ct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9001F","description":"Aortic aneurysm<5cm diam ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dx bronchoscope/lavage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31624","description":"Dx bronchoscope/lavage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrivalent (ccIIV4)_ derived from cell cultures_ subunit_ preservative and antibiotic free_ 0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90674","description":"Influenza virus vaccine_ quadrivalent (ccIIV4)_ derived from cell cultures_ subunit_ preservative and antibiotic free_ 0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CROM GNOTYP CD55 EXONS 1-10","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0182U","description":"CROM GNOTYP CD55 EXONS 1-10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIED1","description":"ICD-IIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBD1","description":"ICD-CBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVD0","description":"ICD-BEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75736","description":"Artery x-rays pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGF1","description":"ICD-FIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSB0","description":"ICD-LDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDB0","description":"ICD-GIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBA0","description":"ICD-FIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFA0","description":"ICD-FDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilate urethra stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53601","description":"Dilate urethra stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVD0","description":"ICD-CCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-27458","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","description":"CPT-27458","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTE1","description":"ICD-KCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Near-infrared dual imaging (ie_ simultaneous reflective and trans-illuminated light) of meibomian glands_ unilateral or bilateral_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0507T","description":"Near-infrared dual imaging (ie_ simultaneous reflective and trans-illuminated light) of meibomian glands_ unilateral or bilateral_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC25B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPA1","description":"ICD-NEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye muscle w/suture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67334","description":"Revise eye muscle w/suture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disposable sensor_ cgm sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9276","description":"Disposable sensor_ cgm sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMA0","description":"ICD-FEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Arm supp att to wc rancho ty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2627","description":"Arm supp att to wc rancho ty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEE1","description":"ICD-BCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA1B","description":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIE0","description":"ICD-KFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVE0","description":"ICD-OKVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX44","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epoetin beta_ esrd use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9972","description":"Epoetin beta_ esrd use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFC0","description":"ICD-OIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biofeedback Training_ Perineal Muscles_ Anorectal Or Urethral Sphincter_ Including Emg And/Or Manometry_ When Performed; Each Additional 15 Minutes Of One-On-One Physician Or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90913","description":"Biofeedback Training_ Perineal Muscles_ Anorectal Or Urethral Sphincter_ Including Emg And/Or Manometry_ When Performed; Each Additional 15 Minutes Of One-On-One Physician Or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Peripheral vascular rehab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93668","description":"Peripheral vascular rehab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAF0","description":"ICD-KBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove bladder/revise tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51590","description":"Remove bladder/revise tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADF0","description":"ICD-AADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRB1","description":"ICD-PJRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27745","description":"Reinforce tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXF1","description":"ICD-BEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0305","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0305","description":"HCPCS-C0305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rbc irradiated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9038","description":"Rbc irradiated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00820","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00820","description":"CPT-00820","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol/drug screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0049","description":"Alcohol/drug screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTA0","description":"ICD-GDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sewho airplan desig abdu pos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3960","description":"Sewho airplan desig abdu pos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGC0","description":"ICD-JDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trnscth renal symp denrv unl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0338T","description":"Trnscth renal symp denrv unl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWF0","description":"ICD-OKWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj testostero enanthate 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3121","description":"Inj testostero enanthate 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA15","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYC0","description":"ICD-LFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAA0","description":"ICD-GCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of shoulder blade","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73010","description":"X-ray exam of shoulder blade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fuse pancreas and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48548","description":"Fuse pancreas and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEA0","description":"ICD-JDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKF0","description":"ICD-JIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glasses bicros hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5230","description":"Glasses bicros hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of phenobarbital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80184","description":"Assay of phenobarbital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fda approved prescription drug_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)_ not otherwise classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0799","description":"Fda approved prescription drug_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)_ not otherwise classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hip arthro w/femoroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29914","description":"Hip arthro w/femoroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB150","description":"Special Care Low _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00534","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00534","description":"CPT-00534","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI brain w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70557","description":"MRI brain w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat knuckle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26705","description":"Treat knuckle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQA1","description":"ICD-DGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Irrig drug delivery device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96523","description":"Irrig drug delivery device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37280","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","description":"CPT-37280","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQE0","description":"ICD-DFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suction pump_ home model_ portable or stationary_ electric_ any type_ for use with external urine management system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2001","description":"Suction pump_ home model_ portable or stationary_ electric_ any type_ for use with external urine management system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQD0","description":"ICD-OFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dtap-ipv vaccine 4-6 yrs im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90696","description":"Dtap-ipv vaccine 4-6 yrs im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism_ Qualified Tool Not Otherwise Specified_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1011","description":"Clinical Decision Support Mechanism_ Qualified Tool Not Otherwise Specified_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCF1","description":"ICD-CCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ini phq9 >9 not assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9396","description":"Ini phq9 >9 not assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILE1","description":"ICD-GILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSB0","description":"ICD-DGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYF1","description":"ICD-HEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABB1","description":"ICD-BABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEF1","description":"ICD-ODEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQB0","description":"ICD-LEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRD1","description":"ICD-OGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEF1","description":"ICD-GDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bendamustine hydrochloride_ (Belrapzo)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9036","description":"Injection_ bendamustine hydrochloride_ (Belrapzo)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25274","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUC1","description":"ICD-IDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis g dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87526","description":"Hepatitis g dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEF0","description":"ICD-EAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (autism spectrum disorder ASD) RNA next-generation sequencing saliva algorithmic analysis and results reported as predictive probability of ASD diagnosis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0170U","description":"Neurology (autism spectrum disorder ASD) RNA next-generation sequencing saliva algorithmic analysis and results reported as predictive probability of ASD diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospital discharge day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99238","description":"Hospital discharge day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYC0","description":"ICD-CEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVA0","description":"ICD-FIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD117","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elevat legrst up hangr brack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0047","description":"Elevat legrst up hangr brack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBE1","description":"ICD-OGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of ruptured spleen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38115","description":"Repair of ruptured spleen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sodium fluoride f-18","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9580","description":"Sodium fluoride f-18","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIC0","description":"ICD-NEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA30","description":"Medium Rehab _ ADL Index 0-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ carboxydextran-coated superparamagnetic iron oxide_ per study dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9697","description":"Injection_ carboxydextran-coated superparamagnetic iron oxide_ per study dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMA1","description":"ICD-ECMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIF1","description":"ICD-IFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDD1","description":"ICD-BEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCF0","description":"ICD-NBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coll-e-Derm_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4193","description":"Coll-e-Derm_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iliac revasc w/stent add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37223","description":"Iliac revasc w/stent add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transurethral Ablation Of Malignant Prostate Tissue By High-Energy Water Vapor Thermotherapy_ Including Intraoperative Imaging And Needle Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0582T","description":"Transurethral Ablation Of Malignant Prostate Tissue By High-Energy Water Vapor Thermotherapy_ Including Intraoperative Imaging And Needle Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nepuitant 300 mg and palonosetron 0.5 mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9978","description":"Nepuitant 300 mg and palonosetron 0.5 mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tendon transfer with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26492","description":"Tendon transfer with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNC0","description":"ICD-OLNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYC1","description":"ICD-PKYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYA0","description":"ICD-KBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADD0","description":"ICD-BADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospital call","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9420","description":"Hospital call","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE113","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35286","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9313","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9313","description":"HCPCS-C9313","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPC1","description":"ICD-OKPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDA1","description":"ICD-ICDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFC1","description":"ICD-BGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medical food oral 100% nutr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9433","description":"Medical food oral 100% nutr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAF1","description":"ICD-BIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft hepatorenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35535","description":"Art byp grft hepatorenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEF1","description":"ICD-MEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEE0","description":"ICD-KBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gauze >16<=48 no w/sal w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6223","description":"Gauze >16<=48 no w/sal w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLC0","description":"ICD-GHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood smear interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85060","description":"Blood smear interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUF0","description":"ICD-MIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOC0","description":"ICD-PDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fem urinary collect dev cup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4327","description":"Fem urinary collect dev cup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Identify sperm tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89264","description":"Identify sperm tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRC1","description":"ICD-PGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of figure eight","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29049","description":"Application of figure eight","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQA1","description":"ICD-PLQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAD1","description":"ICD-GDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tis trnfr s/a/l 10.1-30 sqcm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14021","description":"Tis trnfr s/a/l 10.1-30 sqcm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNF1","description":"ICD-JHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at six months as demonstrate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1023","description":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at six months as demonstrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXC0","description":"ICD-JDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMC1","description":"ICD-BIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWA0","description":"ICD-GFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29850","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTE1","description":"ICD-IFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRE0","description":"ICD-PDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove limb nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64782","description":"Remove limb nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc of non tobacco user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9275","description":"Doc of non tobacco user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCB1","description":"ICD-MHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPE0","description":"ICD-OAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDC0","description":"ICD-MBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hocm 150-199mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9959","description":"Hocm 150-199mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9730","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJA1","description":"ICD-CDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDE0","description":"ICD-EEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Presc opiates >6 wks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9577","description":"Presc opiates >6 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHE1","description":"ICD-EBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOE0","description":"ICD-LBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLB0","description":"ICD-BGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ crizanlizumab-tmca_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0791","description":"Injection_ crizanlizumab-tmca_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transplant palm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26485","description":"Transplant palm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB0C","description":"High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator_ dual lead system_ with insertion of pacing electrode_ cardiac venous system_ for","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7540","description":"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator_ dual lead system_ with insertion of pacing electrode_ cardiac venous system_ for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWB0","description":"ICD-HHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cavopulmonary shunting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33768","description":"Cavopulmonary shunting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTF1","description":"ICD-KDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablation Pros Tr Hifu Incl I Guid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9747","description":"Ablation Pros Tr Hifu Incl I Guid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Follow-up angiography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75898","description":"Follow-up angiography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPD0","description":"ICD-GAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDF0","description":"ICD-JIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES225","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPD0","description":"ICD-OGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUF0","description":"ICD-BHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (lung)_ flow cytometry_ sputum_ 5 markers (meso-tetra [4-carboxyphenyl] porphyrin [TCPP]_ CD206_ CD66b_ CD3_ CD19)_ algorithm reported as likelihood of lung cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0406U","description":"Oncology (lung)_ flow cytometry_ sputum_ 5 markers (meso-tetra [4-carboxyphenyl] porphyrin [TCPP]_ CD206_ CD66b_ CD3_ CD19)_ algorithm reported as likelihood of lung cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMD1","description":"ICD-FIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Retreat root canal anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3346","description":"Retreat root canal anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEA1","description":"ICD-EIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35311","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKA1","description":"ICD-BAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Graphite crucible for preparation of Technetium Tc 99m-labeled carbon aerosol_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9506","description":"Graphite crucible for preparation of Technetium Tc 99m-labeled carbon aerosol_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter Tricuspid Valve Repair_ Percutaneous Approach; Initial Prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0569T","description":"Transcatheter Tricuspid Valve Repair_ Percutaneous Approach; Initial Prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVC0","description":"ICD-NCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAD1","description":"ICD-EBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHD1","description":"ICD-EBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leads any type vad_ rep only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0487","description":"Leads any type vad_ rep only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB54","description":"Medium Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE12C","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGA0","description":"ICD-KBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQC0","description":"ICD-CGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient_ who has a reactive hcv antibody test_ and has a follow up hcv viral test that detected hcv viremia_ has hcv treatment initiated within 3 months of the reactive hcv an","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1228","description":"Patient_ who has a reactive hcv antibody test_ and has a follow up hcv viral test that detected hcv viremia_ has hcv treatment initiated within 3 months of the reactive hcv an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; not otherwise specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0129U","description":"Anesthesia for intracranial procedures; not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Syphilis test_ non-treponemal antibody_ immunoassay_ qualitative (RPR)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0065U","description":"Syphilis test_ non-treponemal antibody_ immunoassay_ qualitative (RPR)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUC0","description":"ICD-BAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDF0","description":"ICD-KGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDE1","description":"ICD-NJDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTA0","description":"ICD-NLTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAC0","description":"ICD-JCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD15D","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCA0","description":"ICD-KDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYE0","description":"ICD-KFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE12D","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCC1","description":"ICD-CCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mh clubhouse svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2031","description":"Mh clubhouse svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx vert fx w/o manj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22310","description":"Closed tx vert fx w/o manj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKC0","description":"ICD-GBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIF1","description":"ICD-KFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHA1","description":"ICD-BAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEA0","description":"ICD-OJEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYD0","description":"ICD-PBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVE1","description":"ICD-FEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0965T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","description":"CPT-0965T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB06","description":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFF0","description":"ICD-OFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17108","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adjunctive procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9999","description":"Adjunctive procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Targeted Sequence Analysis (Eg_ 4 Oncology)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81352","description":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Targeted Sequence Analysis (Eg_ 4 Oncology)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABA0","description":"ICD-KABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"PermeaDer B_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2016","description":"PermeaDer B_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYF0","description":"ICD-LAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sutimlimab-jome_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1302","description":"Injection_ sutimlimab-jome_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydration status assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2018F","description":"Hydration status assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLE0","description":"ICD-MJLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair rectum-vagina fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57305","description":"Repair rectum-vagina fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMB1","description":"ICD-OIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHC0","description":"ICD-JAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSF0","description":"ICD-ODSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFC0","description":"ICD-OCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Derm autograft t/a/l add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15131","description":"Derm autograft t/a/l add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Focusing on women_s health mips value pathway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1366","description":"Focusing on women_s health mips value pathway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALF1","description":"ICD-BALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMB1","description":"ICD-MEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA45","description":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBE1","description":"ICD-ECBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Succinycholine chloride inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0330","description":"Succinycholine chloride inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILD1","description":"ICD-BILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJD0","description":"ICD-GAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGA1","description":"ICD-GDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18G","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIID1","description":"ICD-CIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Temple bone implant revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69717","description":"Temple bone implant revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEB0","description":"ICD-KBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGC0","description":"ICD-GBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKB1","description":"ICD-OAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRB1","description":"ICD-DCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA60","description":"Ultra High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXE0","description":"ICD-GIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSC0","description":"ICD-PDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infusion insulin pump needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4231","description":"Infusion insulin pump needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0537","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","description":"HCPCS-G0537","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Smear wet mount saline/ink","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87210","description":"Smear wet mount saline/ink","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOB1","description":"ICD-DHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLA0","description":"ICD-NFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLB1","description":"ICD-MCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lngleg cylndr ped p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4035","description":"Cast sup lngleg cylndr ped p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0502","description":"HCPCS-A0502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI for tissue ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77022","description":"MRI for tissue ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC235","description":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABB1","description":"ICD-GABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRA0","description":"ICD-GIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTD1","description":"ICD-JCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LB31","description":"ICD-4LB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDA0","description":"ICD-BHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFD0","description":"ICD-JFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE116","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEC0","description":"ICD-MDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35231","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAE1","description":"ICD-IHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA03","description":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCF0","description":"ICD-GGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIC1","description":"ICD-NIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESC1","description":"ICD-CESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOD0","description":"ICD-KCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGC0","description":"ICD-KGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRD1","description":"ICD-CCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Absorp drg <= 16 suc pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0744","description":"Absorp drg <= 16 suc pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid check one ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92592","description":"Hearing aid check one ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Re-Cement Or Re-Bond Unilateral Space Maintainer - Per Quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1553","description":"Re-Cement Or Re-Bond Unilateral Space Maintainer - Per Quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWA0","description":"ICD-HFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSB0","description":"ICD-KFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Persist asthma medicine ctrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4015F","description":"Persist asthma medicine ctrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Isoproterenol comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7660","description":"Isoproterenol comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Triamcinolone comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7684","description":"Triamcinolone comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug scrn quan levetiracetam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80177","description":"Drug scrn quan levetiracetam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATD0","description":"ICD-KATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHD1","description":"ICD-GCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fluconazole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1450","description":"Fluconazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJA0","description":"ICD-FBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEA0","description":"ICD-IBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAC0","description":"ICD-MGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cult skin grft t/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15150","description":"Cult skin grft t/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9154","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","description":"HCPCS-A9154","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol wipes per box","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4245","description":"Alcohol wipes per box","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNE0","description":"ICD-GDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tubing used w suction pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7002","description":"Tubing used w suction pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9616","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","description":"HCPCS-A9616","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSC1","description":"ICD-CGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50722","description":"Release of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reas no adhere pos air pres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8854","description":"Reas no adhere pos air pres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYD0","description":"ICD-OJYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of thymus gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60521","description":"Removal of thymus gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMC0","description":"ICD-BEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngotomy (thyrotomy_ laryngofissure)_ with removal of tumor or laryngocele_ cordectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31300","description":"Laryngotomy (thyrotomy_ laryngofissure)_ with removal of tumor or laryngocele_ cordectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILE1","description":"ICD-CILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compre dental tx adolescent","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8080","description":"Compre dental tx adolescent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAB1","description":"ICD-MJAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSF1","description":"ICD-DFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE13C","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJB1","description":"ICD-JFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXC1","description":"ICD-JIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFD1","description":"ICD-GCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGF1","description":"ICD-BFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esrd serv 1 vst p mo 12-19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90959","description":"Esrd serv 1 vst p mo 12-19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE131","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGD0","description":"ICD-CCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXC0","description":"ICD-NLXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Synthetic sheepskin pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0188","description":"Synthetic sheepskin pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ob us < 14 wks single fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76801","description":"Ob us < 14 wks single fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Palliative Care Services Provided To Patient Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9988","description":"Palliative Care Services Provided To Patient Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOF0","description":"ICD-PEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAA0","description":"ICD-NDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Asthma education","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9441","description":"Asthma education","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFE1","description":"ICD-OGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAE1","description":"ICD-KFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ chest; 2 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71046","description":"Radiologic examination_ chest; 2 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pierce skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61150","description":"Pierce skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUE0","description":"ICD-NEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXD0","description":"ICD-OLXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary arterial angiography_ unilateral (List se","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93569","description":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary arterial angiography_ unilateral (List se","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOF1","description":"ICD-PGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lso flexion control custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0634","description":"Lso flexion control custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVE1","description":"ICD-GFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nephrology (diabetic chronic kidney disease [CKD])_ multiplex electrochemiluminescent immunoassay (ECLIA) of soluble tumor necrosis factor receptor 1 (sTNFR1)_ soluble tumor n","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0407U","description":"Nephrology (diabetic chronic kidney disease [CKD])_ multiplex electrochemiluminescent immunoassay (ECLIA) of soluble tumor necrosis factor receptor 1 (sTNFR1)_ soluble tumor n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cygnus_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4170","description":"Cygnus_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18G","description":"Special Care High _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psych disorders assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3700F","description":"Psych disorders assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML41","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUB0","description":"ICD-AIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients Received Both The 13-Valent Pneumococcal Conjugate Vaccine And The 23-Valent Pneumococcal Polysaccharide Vaccine At Least 12 Months Apart_ With The First Occurrence A","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2157","description":"Patients Received Both The 13-Valent Pneumococcal Conjugate Vaccine And The 23-Valent Pneumococcal Polysaccharide Vaccine At Least 12 Months Apart_ With The First Occurrence A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Symes ankle w/o (sach) foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5703","description":"Symes ankle w/o (sach) foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHF0","description":"ICD-NCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect metatarsal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28173","description":"Resect metatarsal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOE1","description":"ICD-PLOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N block inj facial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64402","description":"N block inj facial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDF1","description":"ICD-IGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX30","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVA1","description":"ICD-CBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDE0","description":"ICD-NDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMD0","description":"ICD-MCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSD1","description":"ICD-GDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTC0","description":"ICD-JHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETC1","description":"ICD-BETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOA1","description":"ICD-DAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous ablation therapy of incompetent vein_ extremity_ inclusive of all imaging guidance and monitoring_ percutaneous_ mechanochemical; subsequent vein(s) treated in a si","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36474","description":"Endovenous ablation therapy of incompetent vein_ extremity_ inclusive of all imaging guidance and monitoring_ percutaneous_ mechanochemical; subsequent vein(s) treated in a si","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD225","description":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Baclofen intrathecal trial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0476","description":"Baclofen intrathecal trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFC0","description":"ICD-CDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFND1","description":"ICD-FFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWE1","description":"ICD-GIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDC1","description":"ICD-JHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCD0","description":"ICD-OCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYD1","description":"ICD-PKYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1033","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","description":"HCPCS-E1033","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert picc cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36569","description":"Insert picc cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCB1","description":"ICD-ODCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCE1","description":"ICD-AFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ear microscopy examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92504","description":"Ear microscopy examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amifostine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0207","description":"Amifostine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0481U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","description":"CPT-0481U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36218","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOB1","description":"ICD-LHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAC1","description":"ICD-MEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMA1","description":"ICD-FBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dexamethasone comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7637","description":"Dexamethasone comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prepare donor lung double","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32856","description":"Prepare donor lung double","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEA0","description":"ICD-AFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCD1","description":"ICD-MHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral - occlusal radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0706","description":"Intraoral - occlusal radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA24","description":"Low Rehab_ ADL Index 0-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGB1","description":"ICD-KBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUA0","description":"ICD-BDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening barbiturates","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80345","description":"Drug screening barbiturates","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC4D","description":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYD1","description":"ICD-LAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1400","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","description":"HCPCS-M1400","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPD1","description":"ICD-JIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heart tmr w/other procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33141","description":"Heart tmr w/other procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrcp talk b/4 antiv txmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4159F","description":"Contrcp talk b/4 antiv txmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB01","description":"Ultra High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDB0","description":"ICD-CBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33770","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQD1","description":"ICD-CCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCF0","description":"ICD-OHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAB1","description":"ICD-MLAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMF1","description":"ICD-KDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA101","description":"Clinically Complex _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rsv mab im 50mg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90378","description":"Rsv mab im 50mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWA1","description":"ICD-OFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBA0","description":"ICD-MHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADD0","description":"ICD-FADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXD1","description":"ICD-FGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period_ (e.g._ patient declined_ other patient reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1202","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period_ (e.g._ patient declined_ other patient reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUE1","description":"ICD-FGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dronabinol 2.5mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0167","description":"Dronabinol 2.5mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIC0","description":"ICD-IGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELD0","description":"ICD-KELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain ovary abscess percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58822","description":"Drain ovary abscess percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-surg tx root canal obs","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3331","description":"Non-surg tx root canal obs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0801T","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67840","description":"Remove eyelid lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOD0","description":"ICD-CCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDB1","description":"ICD-FEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"In-home respite care_ 4-hour unit_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0529","description":"In-home respite care_ 4-hour unit_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEB1","description":"ICD-GDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Air pressure pad for mattres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0197","description":"Air pressure pad for mattres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIE0","description":"ICD-AGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJB0","description":"ICD-BEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgraft xt_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4269","description":"Surgraft xt_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0904T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","description":"CPT-0904T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Limited dental tx adolescent","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8030","description":"Limited dental tx adolescent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cranial bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21182","description":"Reconstruct cranial bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBC1","description":"ICD-NCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AA11","description":"ICD-3AA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were in hospice at any time during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1022","description":"Patients who were in hospice at any time during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOE0","description":"ICD-CDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBA0","description":"ICD-JHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX33","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lenticular lens_ bifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2221","description":"Lenticular lens_ bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAE0","description":"ICD-OLAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit picc insert no supp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5522","description":"Hit picc insert no supp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove ext hem groups 2+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46250","description":"Remove ext hem groups 2+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHE0","description":"ICD-NDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L8720","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8720","description":"HCPCS-L8720","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lambswool sheepskin pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0189","description":"Lambswool sheepskin pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMA1","description":"ICD-NLMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE141","description":"Clinically Complex _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC246","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dschrg med/current med merge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1111F","description":"Dschrg med/current med merge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGD0","description":"ICD-GFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQC1","description":"ICD-HHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of hydroxyapatite regeneration medicament - per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2991","description":"Application of hydroxyapatite regeneration medicament - per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bifoc prscp lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0506","description":"Bifoc prscp lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUC0","description":"ICD-EFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIF0","description":"ICD-KBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28I","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNE0","description":"ICD-BFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kafo dbl solid stirrup band/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2020","description":"Kafo dbl solid stirrup band/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Screen cerv/vag thin layer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0123","description":"Screen cerv/vag thin layer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ht hem horm inj diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9537","description":"Ht hem horm inj diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIF0","description":"ICD-CBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trim skin lesions 2 to 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11056","description":"Trim skin lesions 2 to 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis_ interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95251","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis_ interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMD1","description":"ICD-IAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHE1","description":"ICD-EDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTF1","description":"ICD-IBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27372","description":"Removal of foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDF0","description":"ICD-AHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFD1","description":"ICD-NJFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transplant forearm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25312","description":"Transplant forearm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht arm splint plst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4021","description":"Cast sup sht arm splint plst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18H","description":"Special Care High _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEED1","description":"ICD-AEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD21A","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYB1","description":"ICD-OHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBB1","description":"ICD-KCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of orbit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21256","description":"Reconstruction of orbit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEB0","description":"ICD-MDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","description":"HCPCS-Q4403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIC0","description":"ICD-NIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIA1","description":"ICD-NCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFE0","description":"ICD-OEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneumococcal conjugate vaccine_ 20 valent (PCV20)_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90677","description":"Pneumococcal conjugate vaccine_ 20 valent (PCV20)_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore/repair chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32110","description":"Explore/repair chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOF0","description":"ICD-GIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJA1","description":"ICD-CCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth kidney transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86851","description":"Anesth kidney transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFC1","description":"ICD-OKFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33413","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAD1","description":"ICD-IHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJF0","description":"ICD-OHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQB1","description":"ICD-LBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43310","description":"Repair of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt alive 3 mos post proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9540","description":"Pt alive 3 mos post proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medical home_ maintenance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0281","description":"Medical home_ maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFB1","description":"ICD-KEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clot inhibit prot s total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85305","description":"Clot inhibit prot s total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMB0","description":"ICD-GFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Strapping of chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29200","description":"Strapping of chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6003","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBF0","description":"ICD-OLBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastrointestinal repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43361","description":"Gastrointestinal repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52290","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIE1","description":"ICD-JGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWA0","description":"ICD-KDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hh respiratory thrpy in eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5180","description":"Hh respiratory thrpy in eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCC0","description":"ICD-CCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB11A","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medrsn no pt category","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9292","description":"Medrsn no pt category","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cpap full face mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7030","description":"Cpap full face mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Battery elec/combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0496","description":"Battery elec/combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0204","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0204","description":"HCPCS-C0204","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYF1","description":"ICD-GBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMD0","description":"ICD-AEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBE1","description":"ICD-EHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGE1","description":"ICD-KAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD104","description":"Clinically Complex _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXE1","description":"ICD-GHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q9997","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","description":"HCPCS-Q9997","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraop kinetic balnce sensr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0396T","description":"Intraop kinetic balnce sensr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC30","description":"Very High Rehab _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPD0","description":"ICD-NCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEF0","description":"ICD-KEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of heart lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33542","description":"Removal of heart lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not have the retina attached after 6 months following only one surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9377","description":"Patient did not have the retina attached after 6 months following only one surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUD1","description":"ICD-EGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFA0","description":"ICD-OHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apnea monitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0618","description":"Apnea monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAE0","description":"ICD-EIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE260","description":"Special Care Low _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELD0","description":"ICD-IELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diazepam injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3360","description":"Diazepam injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood split unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9011","description":"Blood split unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDC0","description":"ICD-EGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUE1","description":"ICD-FFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc no daily aspirin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9278","description":"Doc no daily aspirin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal neck/armpit lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38555","description":"Removal neck/armpit lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Scanning Analysis With Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93243","description":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Scanning Analysis With Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFA0","description":"ICD-FCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA ESCHERICHIA COLI 0157","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87335","description":"IAAD IA ESCHERICHIA COLI 0157","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNB0","description":"ICD-CBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15937","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUE1","description":"ICD-CDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of arm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24320","description":"Repair of arm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray aorta leg arteries","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75630","description":"X-ray aorta leg arteries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bortezomib_ (dr. reddy_s)_ not therapeutically equivalent to j9041_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9046","description":"Injection_ bortezomib_ (dr. reddy_s)_ not therapeutically equivalent to j9041_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of midfoot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28800","description":"Amputation of midfoot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elevate footrest articulate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0053","description":"Elevate footrest articulate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA224","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCD1","description":"ICD-JDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEE1","description":"ICD-CDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAC0","description":"ICD-JGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTF1","description":"ICD-JCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interferon gamma 1-b inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9216","description":"Interferon gamma 1-b inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEA0","description":"ICD-OLEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aztreonam_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0073","description":"Injection_ aztreonam_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCE0","description":"ICD-FFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5913","description":"Nasal prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFED0","description":"ICD-KFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIF0","description":"ICD-MHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exam of vulva w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56820","description":"Exam of vulva w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth repair of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94851","description":"Anesth repair of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKND1","description":"ICD-NKND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUD1","description":"ICD-ODUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood typing rbc antigens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86905","description":"Blood typing rbc antigens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRD0","description":"ICD-LBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYA1","description":"ICD-CFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKA0","description":"ICD-BAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUD0","description":"ICD-FHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine osmolality","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83935","description":"Assay of urine osmolality","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB10","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4411","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","description":"HCPCS-Q4411","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prolong e&m/psyctx serv o/p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99355","description":"Prolong e&m/psyctx serv o/p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21260","description":"Revise eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ coagulation factor ix (recombinant)_ ixinity_ 1 i.u.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7213","description":"Injection_ coagulation factor ix (recombinant)_ ixinity_ 1 i.u.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFB0","description":"ICD-BGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB20B","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVE1","description":"ICD-BHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49617","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIE1","description":"ICD-MJIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct orbit/ear/fossa w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70480","description":"Ct orbit/ear/fossa w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ag detection polyval if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87300","description":"Ag detection polyval if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking thighlngth 40-50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6535","description":"Gc stocking thighlngth 40-50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBA1","description":"ICD-FGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHA1","description":"ICD-IEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUC0","description":"ICD-JBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHC1","description":"ICD-FBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lengthen radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25391","description":"Lengthen radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMF0","description":"ICD-GBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRA0","description":"ICD-KIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1028T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1028T","description":"CPT-1028T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE211","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHB0","description":"ICD-NHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unspecified oral anti-emetic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0181","description":"Unspecified oral anti-emetic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation stating the patient has an active diagnosis of depression or has diagnosed bipolar disorder_ therefore screening or follow-up not required","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9717","description":"Documentation stating the patient has an active diagnosis of depression or has diagnosed bipolar disorder_ therefore screening or follow-up not required","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAC1","description":"ICD-NGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6013","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neuromatrix nerve cuff_ cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9355","description":"Neuromatrix nerve cuff_ cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N block other peripheral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64450","description":"N block other peripheral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0801","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0801","description":"HCPCS-C0801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for special stain_ including interpretation and report_ histochemical stain on frozen tissue block (List separately in addition to code","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0758T","description":"Digitization of glass microscope slides for special stain_ including interpretation and report_ histochemical stain on frozen tissue block (List separately in addition to code","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTB1","description":"ICD-ODTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Palonosetron hcl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2469","description":"Palonosetron hcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXE1","description":"ICD-NGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2IB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IB11","description":"ICD-2IB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAA0","description":"ICD-CIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJD1","description":"ICD-KGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEC0","description":"ICD-OAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBE0","description":"ICD-GEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L1653","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","description":"HCPCS-L1653","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASF1","description":"ICD-CASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCF0","description":"ICD-FBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis access system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1881","description":"Dialysis access system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Meals for clinical trial par","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9996","description":"Meals for clinical trial par","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3IA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IA21","description":"ICD-3IA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Device(S) Supply With Scheduled (Eg_ Daily)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98977","description":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Device(S) Supply With Scheduled (Eg_ Daily)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBF0","description":"ICD-GIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFF0","description":"ICD-KHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALB0","description":"ICD-NALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXF0","description":"ICD-OCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOE0","description":"ICD-GEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVB0","description":"ICD-CAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALF0","description":"ICD-NALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision breast lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19125","description":"Excision breast lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGB0","description":"ICD-NJGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPC1","description":"ICD-OAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hgb lvl 11-12.9 g/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3280F","description":"Hgb lvl 11-12.9 g/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIME1","description":"ICD-JIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0627U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","description":"CPT-0627U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repl batt silver oxide 3 v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0602","description":"Repl batt silver oxide 3 v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGB1","description":"ICD-GFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA135","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFED1","description":"ICD-KFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHC0","description":"ICD-NBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEA1","description":"ICD-CFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAD0","description":"ICD-BGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain appendix abscess open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44900","description":"Drain appendix abscess open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ligate/strip long leg vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37722","description":"Ligate/strip long leg vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA256","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEC0","description":"ICD-FGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJD1","description":"ICD-JHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDF0","description":"ICD-NFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX32","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gammagraft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4111","description":"Gammagraft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXA1","description":"ICD-KCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone marrow aspirate &biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0364","description":"Bone marrow aspirate &biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tap block uni by infusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64487","description":"Tap block uni by infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGA0","description":"ICD-CGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWE1","description":"ICD-HCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl ctr cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33986","description":"Ecmo/ecls rmvl ctr cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMA1","description":"ICD-CAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB23","description":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPF1","description":"ICD-FEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCB0","description":"ICD-MJCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Afo plastic molded w/ankle j","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1970","description":"Afo plastic molded w/ankle j","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE140","description":"Special Care High _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYA1","description":"ICD-DGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vc lesion scope/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31546","description":"Remove vc lesion scope/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA140","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31580","description":"Revision of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUE1","description":"ICD-EHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALF0","description":"ICD-EALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIB0","description":"ICD-JBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKB0","description":"ICD-JCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of fb reaction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7540","description":"Removal of fb reaction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTE0","description":"ICD-ABTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apc gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81201","description":"Apc gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUF1","description":"ICD-FAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMC0","description":"ICD-CGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES34C","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDF0","description":"ICD-OLDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIC0","description":"ICD-KBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dentistry Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0067","description":"Dentistry Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore chest free adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32124","description":"Explore chest free adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parainfluenza ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87279","description":"Parainfluenza ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWB1","description":"ICD-LFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of lactic acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83605","description":"Assay of lactic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tracheo-esophagoplasty cong","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43314","description":"Tracheo-esophagoplasty cong","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLD1","description":"ICD-OGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sc ther infusion addl hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96370","description":"Sc ther infusion addl hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0551U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0551U","description":"CPT-0551U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPC1","description":"ICD-OFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTE0","description":"ICD-FCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Temozolomide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8700","description":"Temozolomide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23600","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRB1","description":"ICD-PHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWE0","description":"ICD-KDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCB1","description":"ICD-MBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB160","description":"Special Care High _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC245","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQE0","description":"ICD-OAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1301","description":"HCPCS-B1301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDED1","description":"ICD-BDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDC1","description":"ICD-KIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01941","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","description":"CPT-01941","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prq card angio/athrect addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92925","description":"Prq card angio/athrect addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQD1","description":"ICD-HHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDC1","description":"ICD-IDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Melatonin levels test_ sleep study_ 7 or 9 sample melatonin profile (cortisol optional)_ enzyme-linked immunosorbent assay (ELISA)_ saliva_ screening/preliminary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0462U","description":"Melatonin levels test_ sleep study_ 7 or 9 sample melatonin profile (cortisol optional)_ enzyme-linked immunosorbent assay (ELISA)_ saliva_ screening/preliminary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLD1","description":"ICD-MDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGB1","description":"ICD-BCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of one of the following medical reason(s) for not achieving at least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degree","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9772","description":"Documentation of one of the following medical reason(s) for not achieving at least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degree","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD206","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rectal sensation test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91120","description":"Rectal sensation test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; HIV-1 antigen(s)_ with HIV-1 and HIV-2 antibodies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87806","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; HIV-1 antigen(s)_ with HIV-1 and HIV-2 antibodies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLC1","description":"ICD-NLLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise lower leg tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27686","description":"Revise lower leg tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML21","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0027","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSB1","description":"ICD-HFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sr89 strontium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9600","description":"Sr89 strontium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWE0","description":"ICD-PBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAF0","description":"ICD-ACAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Personalized_ anterior and lateral interbody cage (implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1831","description":"Personalized_ anterior and lateral interbody cage (implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES201","description":"Extensive Services _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pelvis contents","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58240","description":"Removal of pelvis contents","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fracture frame attachmnts pe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0947","description":"Fracture frame attachmnts pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWE0","description":"ICD-LGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kcentra_ per i.u.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9132","description":"Kcentra_ per i.u.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1440","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","description":"HCPCS-M1440","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cessj therapy cath removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37214","description":"Cessj therapy cath removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"K flow/funct image w/drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78708","description":"K flow/funct image w/drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGC0","description":"ICD-OEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Deb bone 20 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11044","description":"Deb bone 20 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Provisional splint extracoro","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4321","description":"Provisional splint extracoro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKC0","description":"ICD-KDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bridge porcelain base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6241","description":"Bridge porcelain base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFA0","description":"ICD-GHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCA0","description":"ICD-IHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of hydrocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55060","description":"Repair of hydrocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient received adjuvant treatment course including both chemotherapy and her2-targeted therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2206","description":"Patient received adjuvant treatment course including both chemotherapy and her2-targeted therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61538","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cnslng chldbrng women epi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4340F","description":"Cnslng chldbrng women epi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAB1","description":"ICD-CIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insrt/redo spine n generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63685","description":"Insrt/redo spine n generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTB0","description":"ICD-MCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEB0","description":"ICD-ICEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Internal nerve revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64727","description":"Internal nerve revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ teclistamab-cqyv_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9380","description":"Injection_ teclistamab-cqyv_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIF0","description":"ICD-BCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAF0","description":"ICD-CBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate cancer)_ analysis of all prostate-specific antigen (PSA) structural isoforms by phase separation and immunoassay_ plasma_ algorithm reports risk of cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0359U","description":"Oncology (prostate cancer)_ analysis of all prostate-specific antigen (PSA) structural isoforms by phase separation and immunoassay_ plasma_ algorithm reports risk of cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M0235","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","description":"HCPCS-M0235","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJC1","description":"ICD-JAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion_ sotrovimab_ includes infusion and post administration monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0247","description":"Intravenous infusion_ sotrovimab_ includes infusion and post administration monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUD0","description":"ICD-EDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHC1","description":"ICD-EGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0675","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","description":"HCPCS-J0675","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D6180","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D6180","description":"CDT-D6180","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1807","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","description":"HCPCS-J1807","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINC1","description":"ICD-NINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLD0","description":"ICD-JDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1144","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBD0","description":"ICD-ACBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSC1","description":"ICD-LCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKE0","description":"ICD-FBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove wrist joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26130","description":"Remove wrist joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Placement of a custom removable clear plastic temporary aesthetic appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9939","description":"Placement of a custom removable clear plastic temporary aesthetic appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Detect agnt mult dna direc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87800","description":"Detect agnt mult dna direc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aor ane >=6.0 cm max diam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9599","description":"Aor ane >=6.0 cm max diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEA1","description":"ICD-MGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB13C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Liver disease_ analysis of 3 biomarkers (hyaluronic acid [ha]_ procollagen iii amino terminal peptide [piiinp]_ tissue inhibitor of metalloproteinase 1 [timp-1])_ using immuno","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0014M","description":"Liver disease_ analysis of 3 biomarkers (hyaluronic acid [ha]_ procollagen iii amino terminal peptide [piiinp]_ tissue inhibitor of metalloproteinase 1 [timp-1])_ using immuno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter intracoronary infusion of supersaturated oxygen in conjunction w/percutaneous coronary revascularization during acute myocardial infarction_ including catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0659T","description":"Transcatheter intracoronary infusion of supersaturated oxygen in conjunction w/percutaneous coronary revascularization during acute myocardial infarction_ including catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOF0","description":"ICD-PHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of pulmonary valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33470","description":"Revision of pulmonary valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWC1","description":"ICD-OCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens_ intraocular (new tech)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1780","description":"Lens_ intraocular (new tech)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXF0","description":"ICD-NGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKE1","description":"ICD-KGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHE1","description":"ICD-OAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGC1","description":"ICD-OEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Us exam infant hips dynamic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76885","description":"Us exam infant hips dynamic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE134","description":"Special Care Low _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACE0","description":"ICD-GACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cryosurgery anal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46916","description":"Cryosurgery anal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lactate (ld) (ldh) enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83615","description":"Lactate (ld) (ldh) enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC120","description":"Reduced Physical Function _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPD1","description":"ICD-NLPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVF1","description":"ICD-CBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUE0","description":"ICD-AHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIF0","description":"ICD-EFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIF1","description":"ICD-MIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOE0","description":"ICD-GBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNA0","description":"ICD-ODNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemodener muscle larynx emg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64617","description":"Chemodener muscle larynx emg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB20D","description":"Special Care High _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75880","description":"Vein x-ray eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Custom fabricate w/c cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2609","description":"Custom fabricate w/c cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOE0","description":"ICD-PFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHF0","description":"ICD-ADHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB24A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6100","description":"Removal of implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYD1","description":"ICD-CAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBF1","description":"ICD-JEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMA0","description":"ICD-AGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ non-str_ ha_ p-103","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2635","description":"Brachytx_ non-str_ ha_ p-103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTC1","description":"ICD-MJTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLE1","description":"ICD-EDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anidulafungin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0348","description":"Anidulafungin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAA0","description":"ICD-FIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay carboxyhb quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82375","description":"Assay carboxyhb quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Analyze sp inf pump w/reprog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62368","description":"Analyze sp inf pump w/reprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score ue pt no elg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8669","description":"Fun stat score ue pt no elg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inc for vagus n elect impl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64568","description":"Inc for vagus n elect impl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IC31","description":"ICD-1IC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDE0","description":"ICD-AFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWD1","description":"ICD-CGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSF0","description":"ICD-LDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHF0","description":"ICD-AEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCE0","description":"ICD-JDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDD0","description":"ICD-OBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAD0","description":"ICD-JBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoe lifts elevation heel /i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3334","description":"Shoe lifts elevation heel /i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESC1","description":"ICD-HESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAC1","description":"ICD-NLAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27248","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQD0","description":"ICD-OLQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx pancreatc p r1/r2 no","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9106","description":"Onc dx pancreatc p r1/r2 no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI w/o fol w/cont_ brst_ un","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8905","description":"MRI w/o fol w/cont_ brst_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECB0","description":"ICD-MECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYD0","description":"ICD-HAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/lesion removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45385","description":"Colonoscopy w/lesion removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65273","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIB1","description":"ICD-IDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rad resect hand tumor 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26118","description":"Rad resect hand tumor 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aoe intent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9465","description":"Aoe intent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFA1","description":"ICD-CCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Av fuse uppr arm basilic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36819","description":"Av fuse uppr arm basilic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPF0","description":"ICD-OFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pontic-indirect resin based","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6205","description":"Pontic-indirect resin based","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB30","description":"Very High Rehab _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Addition to lower extremity prosthesis_ endoskeletal_ knee disarticulation_ above knee_ hip disarticulation_ positional rotation unit_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5926","description":"Addition to lower extremity prosthesis_ endoskeletal_ knee disarticulation_ above knee_ hip disarticulation_ positional rotation unit_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKE1","description":"ICD-BFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instrumenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97550","description":"Caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instrumenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIND1","description":"ICD-FIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVA1","description":"ICD-GGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ vedolizumab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3380","description":"Injection_ vedolizumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB12C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ready gradient glove","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8427","description":"Ready gradient glove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-38228","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","description":"CPT-38228","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA256","description":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBME1","description":"ICD-MBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIE0","description":"ICD-OEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBD1","description":"ICD-AFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLC1","description":"ICD-ICLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1201","description":"HCPCS-A1201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD20A","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ hips_ bilateral_ minimum of two views of each hip_ including anteroposterior view of pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73520","description":"Radiologic examination_ hips_ bilateral_ minimum of two views of each hip_ including anteroposterior view of pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Preventive behavior change_ online/electronic structured intensive program for prevention of diabetes using a standardized diabetes prevention program curriculum_ provided to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0488T","description":"Preventive behavior change_ online/electronic structured intensive program for prevention of diabetes using a standardized diabetes prevention program curriculum_ provided to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2DA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DA31","description":"ICD-2DA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUF1","description":"ICD-FBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17272","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAF0","description":"ICD-BBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hhc lis nurse train ea 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0164","description":"Hhc lis nurse train ea 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC131","description":"Clinically Complex _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAA1","description":"ICD-CAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of kidney/ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50400","description":"Revision of kidney/ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vent mgmt inpat subq day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94003","description":"Vent mgmt inpat subq day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of sternum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21620","description":"Partial removal of sternum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Legionella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86713","description":"Legionella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEND0","description":"ICD-JEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening tramadol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80373","description":"Drug screening tramadol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE230","description":"Clinically Complex _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj follitropin beta 75 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0128","description":"Inj follitropin beta 75 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orthodontic treatment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8690","description":"Orthodontic treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB156","description":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIF1","description":"ICD-OCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Review/report bp recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93790","description":"Review/report bp recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJC0","description":"ICD-BBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sperm antibody test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89325","description":"Sperm antibody test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBE0","description":"ICD-JDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTD1","description":"ICD-AFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBB0","description":"ICD-OLBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUF0","description":"ICD-BCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1383","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","description":"HCPCS-M1383","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJB1","description":"ICD-NBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGD1","description":"ICD-NLGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAA1","description":"ICD-OEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKF1","description":"ICD-CDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"O2 contents liquid lb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8121","description":"O2 contents liquid lb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFB0","description":"ICD-KFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incontinence supply","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4335","description":"Incontinence supply","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDE1","description":"ICD-MBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Right Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone; Normal Native Connection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93593","description":"Right Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone; Normal Native Connection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDB1","description":"ICD-FCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIF1","description":"ICD-OLIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEB1","description":"ICD-JEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLF0","description":"ICD-GDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRA1","description":"ICD-PHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diast bp 80-89 mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3079F","description":"Diast bp 80-89 mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc cur meds by prov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8427","description":"Doc cur meds by prov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Youth size brief/diaper","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4533","description":"Youth size brief/diaper","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tis trnfr any 30.1-60 sq cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14301","description":"Tis trnfr any 30.1-60 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA112","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJD0","description":"ICD-FAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inject sacroiliac joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27096","description":"Inject sacroiliac joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36582","description":"Replace tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILF1","description":"ICD-CILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove brain electrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61535","description":"Remove brain electrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary Disease (Idiopathic Pulmonary Fibrosis [Ipf])_ Mrna_ Gene Expression Analysis Of 190 Genes_ Utilizing Transbronchial Biopsies_ Diagnostic Algorithm Reported As Categ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81554","description":"Pulmonary Disease (Idiopathic Pulmonary Fibrosis [Ipf])_ Mrna_ Gene Expression Analysis Of 190 Genes_ Utilizing Transbronchial Biopsies_ Diagnostic Algorithm Reported As Categ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOB1","description":"ICD-KDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0305","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0305","description":"HCPCS-A0305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal sinus therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30210","description":"Nasal sinus therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ef ped complete soy based","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4159","description":"Ef ped complete soy based","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYD0","description":"ICD-OCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious Disease_ Bacterial Vaginosis_ Quantitative Real-Time Amplification Of Rna Markers For Atopobium Vaginae_ Gardnerella Vaginalis_ And Lactobacillus Species_ Utilizing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81513","description":"Infectious Disease_ Bacterial Vaginosis_ Quantitative Real-Time Amplification Of Rna Markers For Atopobium Vaginae_ Gardnerella Vaginalis_ And Lactobacillus Species_ Utilizing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of achilles tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27605","description":"Incision of achilles tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient identified as tobacco user did not receive tobacco cessation intervention (counseling and/or pharmacotherapy)_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9908","description":"Patient identified as tobacco user did not receive tobacco cessation intervention (counseling and/or pharmacotherapy)_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBC1","description":"ICD-GFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVD0","description":"ICD-JBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eptifibatide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1327","description":"Eptifibatide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHB0","description":"ICD-CGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of chloramphenicol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82415","description":"Assay of chloramphenicol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHME1","description":"ICD-MHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIC0","description":"ICD-IHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVB1","description":"ICD-FGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKA0","description":"ICD-KGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release spinal cord lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63200","description":"Release spinal cord lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGC1","description":"ICD-BCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD225","description":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKF0","description":"ICD-CIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPC1","description":"ICD-OJPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVA1","description":"ICD-OHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADE0","description":"ICD-OADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE106","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCC0","description":"ICD-MLCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABD0","description":"ICD-MABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRE0","description":"ICD-OKRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBE1","description":"ICD-EDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Phq-scr >9 doc in 12m time","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9572","description":"Phq-scr >9 doc in 12m time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUE1","description":"ICD-KIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVC1","description":"ICD-CDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAD0","description":"ICD-KDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATB0","description":"ICD-NATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pov group 1 vhd 451-600 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0802","description":"Pov group 1 vhd 451-600 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUB1","description":"ICD-CIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB5D","description":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKC1","description":"ICD-NCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGND0","description":"ICD-CGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXD0","description":"ICD-OBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUF1","description":"ICD-IHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1200","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB0B","description":"Low Rehab_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cyp2c19 gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81225","description":"Cyp2c19 gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Advancing Care For Heart Disease Mips Value Pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0055","description":"Advancing Care For Heart Disease Mips Value Pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEB0","description":"ICD-OIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auditory function 60 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92620","description":"Auditory function 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialysat sol fld vol > 249cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4720","description":"Dialysat sol fld vol > 249cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc brstcncr stage 3 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3378F","description":"Ajcc brstcncr stage 3 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANC0","description":"ICD-JANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELE1","description":"ICD-EELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUD0","description":"ICD-OHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVA0","description":"ICD-KHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAF0","description":"ICD-FFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEND0","description":"ICD-KEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Whfo_ rigid w/o joints","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3808","description":"Whfo_ rigid w/o joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC130","description":"Special Care High _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVC0","description":"ICD-KIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fluorescent antibody screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86255","description":"Fluorescent antibody screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPB0","description":"ICD-BHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_ risk adj_ maintenance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9005","description":"Mccd_ risk adj_ maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release of foot tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28226","description":"Release of foot tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lo sag ri an/pos pnl pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0642","description":"Lo sag ri an/pos pnl pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elastase_ Pancreatic (El-1)_ Fecal; Quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82653","description":"Elastase_ Pancreatic (El-1)_ Fecal; Quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDA0","description":"ICD-JFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDD0","description":"ICD-IGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBF0","description":"ICD-BDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVC0","description":"ICD-GEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXA0","description":"ICD-KIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIC1","description":"ICD-GIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of forearm cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29075","description":"Application of forearm cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC24","description":"Very High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJC1","description":"ICD-CBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJE0","description":"ICD-OFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGB1","description":"ICD-OKGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA35","description":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYA0","description":"ICD-PEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMB1","description":"ICD-MIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPC0","description":"ICD-BBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUC1","description":"ICD-BFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMD1","description":"ICD-OHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVB1","description":"ICD-KGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXA0","description":"ICD-OHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWF0","description":"ICD-HEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rituximab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9312","description":"Injection_ rituximab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJF0","description":"ICD-JCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hypoxia response curve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94450","description":"Hypoxia response curve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chimeric antigen receptor T-cell (CAR-T) therapy; receipt and preparation of CAR-T cells for administration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0539T","description":"Chimeric antigen receptor T-cell (CAR-T) therapy; receipt and preparation of CAR-T cells for administration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDF0","description":"ICD-GFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDE1","description":"ICD-AGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0567","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","description":"HCPCS-G0567","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3FB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FB31","description":"ICD-3FB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hocm 250-299mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9961","description":"Hocm 250-299mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Test for porphobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84106","description":"Test for porphobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIE1","description":"ICD-IDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIA0","description":"ICD-AGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal surg noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2409","description":"Fetal surg noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture spleen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35112","description":"Repair artery rupture spleen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of osteocalcin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83937","description":"Assay of osteocalcin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVF1","description":"ICD-GGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; second physician or other qualifie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0821T","description":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; second physician or other qualifie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYC0","description":"ICD-HFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL4B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMD1","description":"ICD-GGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADB0","description":"ICD-KADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28576","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0507U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","description":"CPT-0507U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX2A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26434","description":"Repair/graft finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMB1","description":"ICD-IAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIF1","description":"ICD-GEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of mastoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70120","description":"X-ray exam of mastoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDA0","description":"ICD-FFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of spleen total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38102","description":"Removal of spleen total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01958","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01958","description":"CPT-01958","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc antibio not given","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4042F","description":"Doc antibio not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt screened for depression","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1220F","description":"Pt screened for depression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDD0","description":"ICD-IBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1466","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","description":"HCPCS-M1466","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67901","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hand/finger surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26989","description":"Hand/finger surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYD0","description":"ICD-PFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Part hand myo exclu term dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6026","description":"Part hand myo exclu term dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bcr/abl1 gene minor bp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81207","description":"Bcr/abl1 gene minor bp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hip clevis type 2 posit jnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2570","description":"Hip clevis type 2 posit jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Herpes simplex nes antbdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86694","description":"Herpes simplex nes antbdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML54","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHE0","description":"ICD-NLHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLF1","description":"ICD-AGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Complement/function activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86161","description":"Complement/function activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFF0","description":"ICD-OHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCC1","description":"ICD-MCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDA1","description":"ICD-EDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILC0","description":"ICD-AILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEF0","description":"ICD-OAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA2D","description":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDE0","description":"ICD-ECDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNC1","description":"ICD-OFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFD1","description":"ICD-FDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBA1","description":"ICD-EEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACID0","description":"ICD-ACID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGD0","description":"ICD-NGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRA0","description":"ICD-PDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUA1","description":"ICD-MBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bx of cervix w/scope leep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57460","description":"Bx of cervix w/scope leep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis c ab test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86803","description":"Hepatitis c ab test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4228","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4228","description":"HCPCS-A4228","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCA1","description":"ICD-KGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTA1","description":"ICD-AHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKA1","description":"ICD-BHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFE0","description":"ICD-JHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Red blood cell antigen typing_ DNA_ genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes (Versitiā„¢ Red Cell Genotyping Panel)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0282U","description":"Red blood cell antigen typing_ DNA_ genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes (Versitiā„¢ Red Cell Genotyping Panel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISE1","description":"ICD-PISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sperm procure init visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4030","description":"Sperm procure init visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64656","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","description":"CPT-64656","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOB0","description":"ICD-GEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEC1","description":"ICD-OHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD135","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXD0","description":"ICD-JEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHE1","description":"ICD-OCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skn splt a-grft fac/nck/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15120","description":"Skn splt a-grft fac/nck/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3HC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HC11","description":"ICD-3HC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8X","description":"Very High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDE0","description":"ICD-JCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXA1","description":"ICD-BFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic interventions that focus on cognitive function (eg_ attention_ memory_ reasoning_ executive function_ problem solving_ and/or pragmatic functioning) and compensato","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97127","description":"Therapeutic interventions that focus on cognitive function (eg_ attention_ memory_ reasoning_ executive function_ problem solving_ and/or pragmatic functioning) and compensato","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMF1","description":"ICD-NHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELA1","description":"ICD-BELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31238","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIF0","description":"ICD-IAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETB1","description":"ICD-EETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAC1","description":"ICD-GFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJD0","description":"ICD-CHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE155","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDB1","description":"ICD-EFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPB0","description":"ICD-BCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect face/scalp tum < 2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21015","description":"Resect face/scalp tum < 2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDF0","description":"ICD-KFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFND0","description":"ICD-CFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hsv dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87528","description":"Hsv dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Porcelain Fused To Predominatly Base Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6082","description":"Implant Supported Crown - Porcelain Fused To Predominatly Base Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALE0","description":"ICD-GALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chylmd trach dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87492","description":"Chylmd trach dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mesna injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9209","description":"Mesna injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACA1","description":"ICD-BACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGA0","description":"ICD-OCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABF0","description":"ICD-OABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUD1","description":"ICD-ABUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNA1","description":"ICD-OCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPA1","description":"ICD-JEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Corneal tissue processing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2785","description":"Corneal tissue processing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLB1","description":"ICD-BCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Xenon xe-129 hyperpolarized gas_ diagnostic_ per study dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9150","description":"Xenon xe-129 hyperpolarized gas_ diagnostic_ per study dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOB0","description":"ICD-CEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRD1","description":"ICD-HGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00162","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00162","description":"CPT-00162","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vestibular rehab per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9476","description":"Vestibular rehab per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1216","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOC1","description":"ICD-CGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIF1","description":"ICD-KIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal foreign body mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40804","description":"Removal foreign body mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEB1","description":"ICD-JHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVB0","description":"ICD-FHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52260","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAA1","description":"ICD-EEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGC1","description":"ICD-NDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release/revise ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50725","description":"Release/revise ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trapezius sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1070","description":"Trapezius sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging without contrast_ breast; bilateral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8907","description":"Magnetic resonance imaging without contrast_ breast; bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHF1","description":"ICD-FFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/o cont_ pelvis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8919","description":"Mra w/o cont_ pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIB0","description":"ICD-IAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc Lung 5 Clinical Risk Factors Alg Prblty Mal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0080U","description":"Onc Lung 5 Clinical Risk Factors Alg Prblty Mal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUB1","description":"ICD-NBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive care for joint replacement model_ home visit for patient assemssment performed by clinical staff for an individual not considered homebound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9490","description":"Comprehensive care for joint replacement model_ home visit for patient assemssment performed by clinical staff for an individual not considered homebound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release palm contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26121","description":"Release palm contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCD1","description":"ICD-MFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFB0","description":"ICD-FCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTE0","description":"ICD-BHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ full leg and foot_ padded_ for nighttime use_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6527","description":"Gradient compression garment_ full leg and foot_ padded_ for nighttime use_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBF1","description":"ICD-IBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVD0","description":"ICD-JFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIC0","description":"ICD-OLIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-86581","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","description":"CPT-86581","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAF1","description":"ICD-BBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYF0","description":"ICD-CDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAB1","description":"ICD-MEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXD0","description":"ICD-FCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cyp2c9 gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81227","description":"Cyp2c9 gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAE0","description":"ICD-FCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair bowel opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44620","description":"Repair bowel opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Calcitrol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0169","description":"Calcitrol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCA0","description":"ICD-OFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fem/popl revasc w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37226","description":"Fem/popl revasc w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUC0","description":"ICD-BGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise ulnar nerve at elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64718","description":"Revise ulnar nerve at elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHB0","description":"ICD-FEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPA0","description":"ICD-OAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1902","description":"HCPCS-B1902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTD0","description":"ICD-NGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYE0","description":"ICD-OLYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Microslide consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88321","description":"Microslide consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Polycarb lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0580","description":"Polycarb lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB14B","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAE1","description":"ICD-MDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVB1","description":"ICD-JDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt education noc group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9446","description":"Pt education noc group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCA0","description":"ICD-MBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0704","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0704","description":"HCPCS-C0704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKC1","description":"ICD-OFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exoskeletal axial rotation u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5982","description":"Exoskeletal axial rotation u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWD1","description":"ICD-CAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0608","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","description":"HCPCS-J0608","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXA0","description":"ICD-FHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mh health assess by non-md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0031","description":"Mh health assess by non-md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAF0","description":"ICD-GBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRC0","description":"ICD-CHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGC0","description":"ICD-NBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRD0","description":"ICD-CGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWE1","description":"ICD-KCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB5D","description":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDD0","description":"ICD-GCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC236","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal) screening_ quantitative real-time target and signal amplification of 8 RNA markers (GAPDH_ SMAD4_ ACY1_ AREG_ CDH1_ KRAS_ TNFRSF10B_ EGLN2) and fecal hem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0421U","description":"Oncology (colorectal) screening_ quantitative real-time target and signal amplification of 8 RNA markers (GAPDH_ SMAD4_ ACY1_ AREG_ CDH1_ KRAS_ TNFRSF10B_ EGLN2) and fecal hem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No rh-immunoglobulin order","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8811","description":"No rh-immunoglobulin order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAA0","description":"ICD-CDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIE1","description":"ICD-EHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPC0","description":"ICD-OEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydromorphone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1170","description":"Hydromorphone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX34","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Methylprednisolone 40 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1030","description":"Methylprednisolone 40 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Granulocytes_ pheresis unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9050","description":"Granulocytes_ pheresis unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray head for orthodontia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70350","description":"X-ray head for orthodontia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUE0","description":"ICD-KAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76979","description":"Ultrasound_ targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUE0","description":"ICD-CFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL50","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ coagulation Factor Xa (recombinant)_ inactivated (Andexxa)_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9041","description":"Injection_ coagulation Factor Xa (recombinant)_ inactivated (Andexxa)_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOC0","description":"ICD-DAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dehydroepiandrosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82627","description":"Dehydroepiandrosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYE1","description":"ICD-OJYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reinsert ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65155","description":"Reinsert ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic casts","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0470","description":"Diagnostic casts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients receiving rrt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1199","description":"Patients receiving rrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIA0","description":"ICD-NGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ca screen;pelvic/breast exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0101","description":"Ca screen;pelvic/breast exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical repair of root resorption - premolar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3472","description":"Surgical repair of root resorption - premolar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Manual wc accessory_ handrim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2205","description":"Manual wc accessory_ handrim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADF0","description":"ICD-MADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUA1","description":"ICD-IAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBA1","description":"ICD-GFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1481","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","description":"HCPCS-M1481","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ tubular protective absorption padded layer_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6608","description":"Gradient compression bandaging supply_ tubular protective absorption padded layer_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRB0","description":"ICD-CDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEB0","description":"ICD-NGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEE0","description":"ICD-NHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Carry goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8985","description":"Carry goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1737","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1737","description":"HCPCS-C1737","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLF1","description":"ICD-IFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA36","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBD0","description":"ICD-FGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ margetuximab-cmkb_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9353","description":"Injection_ margetuximab-cmkb_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of lower eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15820","description":"Revision of lower eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHE1","description":"ICD-NJHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCA1","description":"ICD-GFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENB1","description":"ICD-CENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUE1","description":"ICD-BFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWC0","description":"ICD-OGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFC0","description":"ICD-KBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ins cath abd/l-ext art 2nd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36246","description":"Ins cath abd/l-ext art 2nd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of ureter & kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50750","description":"Fusion of ureter & kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Indium in-111 pentetreotide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9572","description":"Indium in-111 pentetreotide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat ulnar fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24675","description":"Treat ulnar fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGF1","description":"ICD-CIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICC0","description":"ICD-BICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0520U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","description":"CPT-0520U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICA1","description":"ICD-IICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl perph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33969","description":"Ecmo/ecls rmvl perph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGD0","description":"ICD-GHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADE0","description":"ICD-NADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIB0","description":"ICD-GDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE251","description":"Clinically Complex _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGF1","description":"ICD-GBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJF0","description":"ICD-GCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB10B","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOA1","description":"ICD-LGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ciliary endoscopic ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66711","description":"Ciliary endoscopic ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ CROS_ in the ear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5170","description":"Hearing aid_ CROS_ in the ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gingivectomy/plasty rest","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4212","description":"Gingivectomy/plasty rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYF1","description":"ICD-LCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEB0","description":"ICD-BCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1376","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","description":"HCPCS-M1376","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBF1","description":"ICD-OFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX41","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAF1","description":"ICD-NGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lo flex l1-below l5 pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0625","description":"Lo flex l1-below l5 pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEE0","description":"ICD-OFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJD0","description":"ICD-KDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder_ initial 15-29 minutes_ provided remotely by hospital staff who are licensed to","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7900","description":"Service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder_ initial 15-29 minutes_ provided remotely by hospital staff who are licensed to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adjust bone fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20693","description":"Adjust bone fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0545U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","description":"CPT-0545U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFE1","description":"ICD-GHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERD0","description":"ICD-PERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENA0","description":"ICD-CENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ehrlichia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86666","description":"Ehrlichia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr rem hernia init reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49550","description":"Rpr rem hernia init reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFC0","description":"ICD-NLFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace high roll cuff","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4060","description":"Replace high roll cuff","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDD1","description":"ICD-NLDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8C","description":"Low Rehab_ ADL Index 0-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1401","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1401","description":"CDT-D1401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNA1","description":"ICD-JGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDB0","description":"ICD-NLDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEF0","description":"ICD-MBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray of ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73615","description":"Contrast x-ray of ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXB1","description":"ICD-NAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMF0","description":"ICD-KBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUF1","description":"ICD-ODUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compression form shoe insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5510","description":"Compression form shoe insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAA1","description":"ICD-IHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTF0","description":"ICD-KHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foam/fabric leg strap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5114","description":"Foam/fabric leg strap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93316","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJF1","description":"ICD-FGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXB0","description":"ICD-OAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX54","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSE1","description":"ICD-KFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC15D","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGF0","description":"ICD-NLGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFB0","description":"ICD-JGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cid transmit coil and cable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8629","description":"Cid transmit coil and cable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGE1","description":"ICD-FBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLE0","description":"ICD-OGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTE1","description":"ICD-JHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCF1","description":"ICD-CDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWF1","description":"ICD-CFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHD0","description":"ICD-BDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUE1","description":"ICD-CEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD217","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWC1","description":"ICD-GIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27827","description":"Treat lower leg fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDD1","description":"ICD-GFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ther/proph/diag inj sc/im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96372","description":"Ther/proph/diag inj sc/im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAD1","description":"ICD-ACAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPB0","description":"ICD-NLPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML2C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJA0","description":"ICD-KEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth sitting procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60451","description":"Anesth sitting procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJF1","description":"ICD-KBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28320","description":"Repair of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUA0","description":"ICD-CAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTB0","description":"ICD-JDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Corneal transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65730","description":"Corneal transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHE0","description":"ICD-BEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHD1","description":"ICD-MLHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHC1","description":"ICD-JAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGC1","description":"ICD-OBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHB1","description":"ICD-OCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intracardiac ecg (ice)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93662","description":"Intracardiac ecg (ice)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITE1","description":"ICD-IITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA12C","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTE0","description":"ICD-CBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABC1","description":"ICD-NABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVC0","description":"ICD-CBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of unstable kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27420","description":"Revision of unstable kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0938T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","description":"CPT-0938T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ethinyl estradiol and etonogestrel 0.015 mg_ 0.12 mg per 24hours; monthly vaginal ring_ ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7295","description":"Ethinyl estradiol and etonogestrel 0.015 mg_ 0.12 mg per 24hours; monthly vaginal ring_ ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAC0","description":"ICD-NBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thromboplastin inhibition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85705","description":"Thromboplastin inhibition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIE0","description":"ICD-EGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair nose to lip fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42260","description":"Repair nose to lip fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKB0","description":"ICD-CBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insulin (fiasp)_ per 5 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1812","description":"Insulin (fiasp)_ per 5 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOC1","description":"ICD-LEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who died from cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9852","description":"Patients who died from cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insemination of oocytes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89268","description":"Insemination of oocytes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Evidence-based therapy was prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1227","description":"Evidence-based therapy was prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD235","description":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Massage therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97124","description":"Massage therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIF0","description":"ICD-NFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychiatric symp absent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1183F","description":"Neuropsychiatric symp absent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBB1","description":"ICD-CGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSF0","description":"ICD-OKSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBC0","description":"ICD-OBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL4C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJA0","description":"ICD-NBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC225","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDE1","description":"ICD-AHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPE0","description":"ICD-KCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCE0","description":"ICD-IHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-15018","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","description":"CPT-15018","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTA1","description":"ICD-CBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit periton dialysis diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9339","description":"Hit periton dialysis diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/w resect addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32667","description":"Thoracoscopy w/w resect addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bmi is documented as being outside of normal parameters_ follow-up plan is not completed for documented medical reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1286","description":"Bmi is documented as being outside of normal parameters_ follow-up plan is not completed for documented medical reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Varus/valgus strap padded/li","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2270","description":"Varus/valgus strap padded/li","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove ear canal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69145","description":"Remove ear canal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFE1","description":"ICD-KDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEA1","description":"ICD-GEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral administration ki","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4224","description":"Parenteral administration ki","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHE0","description":"ICD-BCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of percutaneous electrode array_ peripheral nerve_ with integrated neurostimulator_ including imaging guidance_ when performed; initial electrode arra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64596","description":"Insertion or replacement of percutaneous electrode array_ peripheral nerve_ with integrated neurostimulator_ including imaging guidance_ when performed; initial electrode arra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL44","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vasc embolize/occlude organ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37243","description":"Vasc embolize/occlude organ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transab esoph hiat hern rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43332","description":"Transab esoph hiat hern rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL2D","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTE1","description":"ICD-AHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSF0","description":"ICD-HCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES13B","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL55","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Left hrt cath w/ventrclgrphy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93452","description":"Left hrt cath w/ventrclgrphy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sealant_ pulmonary_ liquid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2615","description":"Sealant_ pulmonary_ liquid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOE1","description":"ICD-LFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEF0","description":"ICD-NHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHB1","description":"ICD-OIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQC1","description":"ICD-KHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of tricuspid valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33460","description":"Revision of tricuspid valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADE0","description":"ICD-MADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Head/extremity control inter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2328","description":"Head/extremity control inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen probe used w oximeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4606","description":"Oxygen probe used w oximeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLC0","description":"ICD-JDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEA0","description":"ICD-IDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cbt each addl hour","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94645","description":"Cbt each addl hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21450","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGC0","description":"ICD-JCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Staph a dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87640","description":"Staph a dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx rectal t3 n0 no prog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9091","description":"Onc dx rectal t3 n0 no prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDE0","description":"ICD-KFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTF0","description":"ICD-OBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRA0","description":"ICD-KGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Venipuncture home/snf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9529","description":"Venipuncture home/snf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDE0","description":"ICD-NFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILF1","description":"ICD-NILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSC0","description":"ICD-HBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX4C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00524","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00524","description":"CPT-00524","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPE0","description":"ICD-JDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB217","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENA1","description":"ICD-JENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA55","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTB1","description":"ICD-BCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB11C","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVF1","description":"ICD-JDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of orbit (transcranial approach); with biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61332","description":"Exploration of orbit (transcranial approach); with biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACA1","description":"ICD-AACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADC1","description":"ICD-IADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB244","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAB1","description":"ICD-AEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDB0","description":"ICD-GBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneumococcal vaccine admin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8864","description":"Pneumococcal vaccine admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQB0","description":"ICD-GAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAE1","description":"ICD-OIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUB1","description":"ICD-FIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGC1","description":"ICD-CGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8004","description":"HCPCS-C8004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOD0","description":"ICD-CHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYC0","description":"ICD-KFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEE0","description":"ICD-ABEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of quinidine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80194","description":"Assay of quinidine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score ue not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8670","description":"Fun stat score ue not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJB1","description":"ICD-OJJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAA1","description":"ICD-CIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB111","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18H","description":"Special Care Low _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE145","description":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLB1","description":"ICD-NGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOE0","description":"ICD-PEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIF0","description":"ICD-AFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOE1","description":"ICD-HIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy remove lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46612","description":"Anoscopy remove lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cryoablate prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55873","description":"Cryoablate prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colchicine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0760","description":"Colchicine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSF0","description":"ICD-OJSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor X_ (human)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7175","description":"Injection_ Factor X_ (human)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLF0","description":"ICD-IDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair heavy duty fixed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1295","description":"Wheelchair heavy duty fixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSB0","description":"ICD-LCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHB1","description":"ICD-EEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSE0","description":"ICD-DDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5154","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","description":"HCPCS-Q5154","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBND1","description":"ICD-KBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUB1","description":"ICD-IDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC110","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQC0","description":"ICD-LDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove shoulder blade lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23172","description":"Remove shoulder blade lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0989T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","description":"CPT-0989T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHB1","description":"ICD-NIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA53","description":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKB1","description":"ICD-OGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFE0","description":"ICD-GEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sensorineural acuity test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92575","description":"Sensorineural acuity test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHF0","description":"ICD-BAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefoperazone sod","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0021","description":"Injection_ cefoperazone sod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPB0","description":"ICD-NHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rig fram pelvic pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0468","description":"Tlso rig fram pelvic pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML43","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of tongue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41105","description":"Biopsy of tongue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOD0","description":"ICD-PFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB03","description":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove external ear partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69110","description":"Remove external ear partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27392","description":"Incision of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAE0","description":"ICD-AAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPD1","description":"ICD-FEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBD0","description":"ICD-IIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQE0","description":"ICD-KDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Below knee flex cover system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5962","description":"Below knee flex cover system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hzv vaccine live subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90736","description":"Hzv vaccine live subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYC1","description":"ICD-HEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMB1","description":"ICD-OBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-1antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86701","description":"Hiv-1antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transverse aortic arch graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33870","description":"Transverse aortic arch graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High mount flip-up footrest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0037","description":"High mount flip-up footrest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sewho airplane w/jnt(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3973","description":"Sewho airplane w/jnt(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8009","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8009","description":"HCPCS-C8009","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDA1","description":"ICD-CEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRF1","description":"ICD-DGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA4D","description":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01130","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01130","description":"CPT-01130","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Im b1 mrw cel ther cmpl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0263T","description":"Im b1 mrw cel ther cmpl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPC1","description":"ICD-CFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKA1","description":"ICD-JCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not respond to the question of patient felt heard and understood by this provider and team","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1239","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXB1","description":"ICD-OLXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fluorouracil injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9190","description":"Fluorouracil injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEC0","description":"ICD-MBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJF1","description":"ICD-GEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1399","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","description":"HCPCS-M1399","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth cardiac electrophys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53751","description":"Anesth cardiac electrophys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9309","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9309","description":"HCPCS-C9309","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMB1","description":"ICD-KBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp )to prevent human immunodeficiency virus (hiv)_ includes hiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0011","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp )to prevent human immunodeficiency virus (hiv)_ includes hiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE144","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQD1","description":"ICD-PFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mandibular part denture flex","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5226","description":"Mandibular part denture flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Online e/m by phys/qhp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99444","description":"Online e/m by phys/qhp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXE0","description":"ICD-JFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGA0","description":"ICD-GBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0523U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","description":"CPT-0523U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYC0","description":"ICD-OEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMC1","description":"ICD-CGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDF0","description":"ICD-BFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHF0","description":"ICD-IDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Afo tib fx cast molded to pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2108","description":"Afo tib fx cast molded to pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35371","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replantation digit complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20816","description":"Replantation digit complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No rx ace/arb therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8937","description":"No rx ace/arb therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXF1","description":"ICD-CDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ost skn barr convex <=4 sq i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4409","description":"Ost skn barr convex <=4 sq i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXF1","description":"ICD-CHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Influenza a ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87276","description":"Influenza a ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRA1","description":"ICD-HCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCID0","description":"ICD-OCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert tissue expander(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11960","description":"Insert tissue expander(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tamoxifen/ai prescribed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4179F","description":"Tamoxifen/ai prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETA0","description":"ICD-GETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCF0","description":"ICD-EFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEA1","description":"ICD-IEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assistive Technology","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0138","description":"Assistive Technology","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q0235","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","description":"HCPCS-Q0235","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOB0","description":"ICD-GDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML14","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Co2 breathing response curve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94400","description":"Co2 breathing response curve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hand muscle testing manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95832","description":"Hand muscle testing manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostoma stent/stud/bttn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7524","description":"Tracheostoma stent/stud/bttn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrical stimulator supplies (external) for use with implantable neurostimulator_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8678","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTF1","description":"ICD-FDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cantharidin for topical administration_ 0.7%_ single unit dose applicator (3.2 mg)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9164","description":"Cantharidin for topical administration_ 0.7%_ single unit dose applicator (3.2 mg)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis-periapical radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0389","description":"intraoral tomosynthesis-periapical radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMD0","description":"ICD-EAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDB1","description":"ICD-CFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEC1","description":"ICD-MKEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATA0","description":"ICD-GATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Histochemical stains add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88314","description":"Histochemical stains add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00756","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00756","description":"CPT-00756","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Botulinum antitoxin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90287","description":"Botulinum antitoxin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thorax stereo rad targetw/tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32701","description":"Thorax stereo rad targetw/tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTE0","description":"ICD-GBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD246","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC13B","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dentures adjust part maxill","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5421","description":"Dentures adjust part maxill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLF1","description":"ICD-AFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEE1","description":"ICD-BHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destroy l/s facet jnt addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64636","description":"Destroy l/s facet jnt addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00910","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00910","description":"CPT-00910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of palm bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26025","description":"Drainage of palm bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMA1","description":"ICD-OCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of vagus nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64760","description":"Incision of vagus nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRC0","description":"ICD-GBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with no clinical indications for imaging of the head","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1031","description":"Patients with no clinical indications for imaging of the head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA4A","description":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILB0","description":"ICD-MILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8G","description":"Very High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive (75 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiaryā€™s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2013","description":"Extensive (75 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiaryā€™s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLA0","description":"ICD-KBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMF0","description":"ICD-FDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTC0","description":"ICD-OJTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFC0","description":"ICD-BHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Miniature knee joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5826","description":"Miniature knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUF1","description":"ICD-BGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychi sympt 1+present","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1182F","description":"Neuropsychi sympt 1+present","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lab pathology consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80502","description":"Lab pathology consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTC1","description":"ICD-CDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"AmnioCoreTM_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4227","description":"AmnioCoreTM_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Analysis nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88356","description":"Analysis nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE113","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIC0","description":"ICD-AIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEC0","description":"ICD-GEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVF1","description":"ICD-GCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDF1","description":"ICD-OIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVB1","description":"ICD-CIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18A","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCF1","description":"ICD-NGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hip clevis/thrust bearing lo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2610","description":"Hip clevis/thrust bearing lo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB40","description":"High Rehab _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELB1","description":"ICD-FELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQA1","description":"ICD-LIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACE0","description":"ICD-FACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytotoxic antibody screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86808","description":"Cytotoxic antibody screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTC1","description":"ICD-ECTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOF0","description":"ICD-OCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology breast mrna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81519","description":"Oncology breast mrna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAC0","description":"ICD-BGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAE0","description":"ICD-NIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD241","description":"Clinically Complex _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair vessel defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33803","description":"Repair vessel defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBC0","description":"ICD-BDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy & polypectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44392","description":"Colonoscopy & polypectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC2B","description":"High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine vma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84585","description":"Assay of urine vma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRB0","description":"ICD-KHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUF0","description":"ICD-FIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTE0","description":"ICD-OGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMB0","description":"ICD-CFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"On Date Of Encounter_ Patient Is Not Able To Participate In Assessment Or Screening_ Including Non-Verbal Patients_ Delirious_ Severely Aphasic_ Severely Developmentally Delay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0037","description":"On Date Of Encounter_ Patient Is Not Able To Participate In Assessment Or Screening_ Including Non-Verbal Patients_ Delirious_ Severely Aphasic_ Severely Developmentally Delay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBD1","description":"ICD-IIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFE0","description":"ICD-FIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMB1","description":"ICD-JDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB03","description":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGE0","description":"ICD-ODGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFF0","description":"ICD-NLFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLF0","description":"ICD-OFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPA0","description":"ICD-NBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oral hygiene instruction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1330","description":"Oral hygiene instruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIC0","description":"ICD-BEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special anesthesia service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99100","description":"Special anesthesia service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGD1","description":"ICD-CAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1301","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXB0","description":"ICD-GAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1273","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINB0","description":"ICD-JINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUC0","description":"ICD-GAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGD1","description":"ICD-OHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPC1","description":"ICD-CBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drive belt power wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0098","description":"Drive belt power wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sialoendoscopy capt & interp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0371","description":"Sialoendoscopy capt & interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVC0","description":"ICD-OEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01270","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01270","description":"CPT-01270","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSE1","description":"ICD-CGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Take-Home Supply Of Nasal Naloxone; 2-Pack Of 8Mg Per 0.1 Ml Nasal Spray (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Additi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1028","description":"Take-Home Supply Of Nasal Naloxone; 2-Pack Of 8Mg Per 0.1 Ml Nasal Spray (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Additi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00142","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00142","description":"CPT-00142","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prq card stent w/angio 1 vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92928","description":"Prq card stent w/angio 1 vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXE1","description":"ICD-JAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Scr c/v cyto_ automated sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0147","description":"Scr c/v cyto_ automated sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB05","description":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB115","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0623T","description":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJE1","description":"ICD-JDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2034","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","description":"HCPCS-A2034","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iiv vaccine pandemic im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90668","description":"Iiv vaccine pandemic im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tooth splitting","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3920","description":"Tooth splitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOA0","description":"ICD-HEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHD1","description":"ICD-CDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFF0","description":"ICD-OGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydroxychloroquine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80220","description":"Hydroxychloroquine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRD0","description":"ICD-HIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove & treat brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61544","description":"Remove & treat brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7523","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNF0","description":"ICD-FFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Strapping of ankle and/or ft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29540","description":"Strapping of ankle and/or ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Methylphenidate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80360","description":"Methylphenidate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAME1","description":"ICD-AAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML26","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEA1","description":"ICD-EGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8C","description":"Medium Rehab _ ADL Index 0-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD11B","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE217","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRD1","description":"ICD-HIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Emergency Medicine Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4003","description":"Emergency Medicine Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQB0","description":"ICD-KFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA0D","description":"Ultra High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQB0","description":"ICD-CGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFE0","description":"ICD-KAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPA0","description":"ICD-OLPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFF1","description":"ICD-BDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBE1","description":"ICD-EIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYF1","description":"ICD-HGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSD1","description":"ICD-DBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1467","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","description":"HCPCS-M1467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dihydrotestosterone (DHT)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82642","description":"Dihydrotestosterone (DHT)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal kidney open complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50225","description":"Removal kidney open complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pre-op service lvrs 1-9 dos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0304","description":"Pre-op service lvrs 1-9 dos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens polycarb or equal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2784","description":"Lens polycarb or equal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replcmnt breast pump shield","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4284","description":"Replcmnt breast pump shield","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo guide for heart biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76932","description":"Echo guide for heart biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWB0","description":"ICD-LCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASA1","description":"ICD-LASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Closure of valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33602","description":"Closure of valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0041A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA41","description":"Default_ /60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endo ak/hip alignable system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5920","description":"Endo ak/hip alignable system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPE0","description":"ICD-OFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Germline disorders_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ whole blood_ report of specific gene rearrangement(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0012U","description":"Germline disorders_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ whole blood_ report of specific gene rearrangement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perc d-e cor revasc chro add","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9608","description":"Perc d-e cor revasc chro add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ko adj jnt pos r sup pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1832","description":"Ko adj jnt pos r sup pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who achieved a net increase in pam score of at least 6-points in a 6 to 12 month period (excellent)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1348","description":"Patients who achieved a net increase in pam score of at least 6-points in a 6 to 12 month period (excellent)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERF1","description":"ICD-DERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1163","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","description":"HCPCS-J1163","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYE0","description":"ICD-LGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMD1","description":"ICD-ICMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Med service out of office","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99056","description":"Med service out of office","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYF1","description":"ICD-KFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX3C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACE0","description":"ICD-CACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLE1","description":"ICD-MCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc back tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21932","description":"Exc back tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIE0","description":"ICD-BHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB22","description":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFA1","description":"ICD-NAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Packing strips_ non-impreg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6407","description":"Packing strips_ non-impreg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69727","description":"Removal_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA14","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colon ca scrn not hi rsk ind","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0121","description":"Colon ca scrn not hi rsk ind","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extracorp shockwv tx anesth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0102T","description":"Extracorp shockwv tx anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0574U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","description":"CPT-0574U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANB0","description":"ICD-JANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGD0","description":"ICD-OHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRB1","description":"ICD-DGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYF0","description":"ICD-PLYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBC1","description":"ICD-KCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28605","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perphenazine injeciton","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3310","description":"Perphenazine injeciton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ko dbl upright w/air pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1847","description":"Ko dbl upright w/air pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINC0","description":"ICD-CINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX1B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKB1","description":"ICD-JFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQE0","description":"ICD-DIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1214","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive (60 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0087","description":"Comprehensive (60 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat ankle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27840","description":"Treat ankle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Close mastoid fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69700","description":"Close mastoid fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suspension of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54620","description":"Suspension of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg 0.5cm<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11640","description":"Exc f/e/e/n/l mal+mrg 0.5cm<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXF1","description":"ICD-KAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIE1","description":"ICD-NEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL1B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIA1","description":"ICD-EIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMA0","description":"ICD-BDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Egd tube/cath insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43241","description":"Egd tube/cath insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVA1","description":"ICD-KCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUF1","description":"ICD-MBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of neck cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42810","description":"Excision of neck cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMF0","description":"ICD-CHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBD0","description":"ICD-GCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE24B","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCD1","description":"ICD-GHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICB1","description":"ICD-OICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLF1","description":"ICD-MCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADF0","description":"ICD-BADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAE0","description":"ICD-BFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATC0","description":"ICD-JATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8I","description":"Very High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMC0","description":"ICD-OLMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEE1","description":"ICD-NFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASE1","description":"ICD-LASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALE0","description":"ICD-OALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism (adverse drug reactions and drug response)_ targeted sequence analysis_ 20 gene variants and CYP2D6 deletion or duplication analysis with reported genotype and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0380U","description":"Drug metabolism (adverse drug reactions and drug response)_ targeted sequence analysis_ 20 gene variants and CYP2D6 deletion or duplication analysis with reported genotype and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome study additional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88289","description":"Chromosome study additional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect neck thorax tumor<5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21557","description":"Resect neck thorax tumor<5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJE1","description":"ICD-NIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pov group 1 hd 301-450 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0801","description":"Pov group 1 hd 301-450 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assistive technology assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97755","description":"Assistive technology assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODND1","description":"ICD-ODND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXB0","description":"ICD-NDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJA1","description":"ICD-BHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAF0","description":"ICD-JIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy trifocal 4.0/4.25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2305","description":"Lens sphcy trifocal 4.0/4.25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inpatient consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99253","description":"Inpatient consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNC1","description":"ICD-FGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj vocal cord bulking agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8607","description":"Inj vocal cord bulking agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99212","description":"Office/outpatient visit est","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQE1","description":"ICD-OAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEB1","description":"ICD-BGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDC0","description":"ICD-FDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJE1","description":"ICD-ODJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJF1","description":"ICD-OGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDD1","description":"ICD-AGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPA0","description":"ICD-NEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEF0","description":"ICD-OFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgraft_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4209","description":"Surgraft_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKD0","description":"ICD-JCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIME1","description":"ICD-NIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of pregnanetriol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84138","description":"Assay of pregnanetriol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKD0","description":"ICD-JIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Specialized Medical Equipment and Supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0137","description":"Specialized Medical Equipment and Supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAF1","description":"ICD-GEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rad exp time w/o fluor doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9501","description":"Rad exp time w/o fluor doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anes spine transthor w/vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62659","description":"Anes spine transthor w/vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breathing capacity test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94010","description":"Breathing capacity test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBB1","description":"ICD-BGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCF0","description":"ICD-EBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9488","description":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQD0","description":"ICD-LHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ezderm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4136","description":"Ezderm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACD1","description":"ICD-EACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVA0","description":"ICD-BGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBF1","description":"ICD-IEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDF1","description":"ICD-MGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"guided tissue regeneration - resorbable barrier_ per implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6106","description":"guided tissue regeneration - resorbable barrier_ per implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Other drugs/medicaments","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9630","description":"Other drugs/medicaments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial thyroid excision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60210","description":"Partial thyroid excision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQC0","description":"ICD-PAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKB1","description":"ICD-KIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEF0","description":"ICD-EBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Harvest vein for bypass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35500","description":"Harvest vein for bypass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSD1","description":"ICD-PHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKC1","description":"ICD-NGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGD1","description":"ICD-JCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBE0","description":"ICD-ADBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOC1","description":"ICD-CAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQF0","description":"ICD-LHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAID0","description":"ICD-AAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRD0","description":"ICD-OIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1389","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1389","description":"HCPCS-M1389","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Socket insert symes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5654","description":"Socket insert symes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of sutures or staples not requiring anesthesia (List separately in addition to E/M code)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15853","description":"Removal of sutures or staples not requiring anesthesia (List separately in addition to E/M code)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIF0","description":"ICD-NJIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Muscle-skin graft head/neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15732","description":"Muscle-skin graft head/neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRB1","description":"ICD-LGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRB0","description":"ICD-OCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Habil sup empl waiver/diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2018","description":"Habil sup empl waiver/diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUC0","description":"ICD-EHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUD0","description":"ICD-CIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJA1","description":"ICD-OHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKD0","description":"ICD-KCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYC1","description":"ICD-OKYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mometasone furoate sinus implant_ (sinuva)_ 10 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7402","description":"Mometasone furoate sinus implant_ (sinuva)_ 10 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (neoplasia)_ exome and transcriptome sequence analysis for sequence variants_ gene copy number amplifications and deletions_ gene rearrangements_ microsatellite insta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0329U","description":"Oncology (neoplasia)_ exome and transcriptome sequence analysis for sequence variants_ gene copy number amplifications and deletions_ gene rearrangements_ microsatellite insta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQC0","description":"ICD-KEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLE0","description":"ICD-MKLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iiv adjuvant vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90653","description":"Iiv adjuvant vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLA0","description":"ICD-CHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 22-24 under the MDPP Expanded Model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9885","description":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 22-24 under the MDPP Expanded Model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcyte_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4182","description":"Transcyte_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUE1","description":"ICD-GHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWF1","description":"ICD-HAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAD0","description":"ICD-FAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML17","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo proc uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58578","description":"Laparo proc uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKA0","description":"ICD-JAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mrs disc pain transmis data","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0610T","description":"Mrs disc pain transmis data","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKE0","description":"ICD-KAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABD0","description":"ICD-AABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrolyte panel this panel must include the following: carbon dioxide (82374) chloride (82435) potassium (84132) sodium (84295)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80051","description":"Electrolyte panel this panel must include the following: carbon dioxide (82374) chloride (82435) potassium (84132) sodium (84295)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc xdrl spine lesn scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63278","description":"Bx/exc xdrl spine lesn scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVC1","description":"ICD-FFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replantation thumb complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20827","description":"Replantation thumb complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCE0","description":"ICD-FDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAA0","description":"ICD-FGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFD0","description":"ICD-BIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Absolute quantitation of myocardial blood flow_ positron emission tomography (PET)_ rest and stress (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0482T","description":"Absolute quantitation of myocardial blood flow_ positron emission tomography (PET)_ rest and stress (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGE1","description":"ICD-JDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLB0","description":"ICD-EFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0503","description":"HCPCS-B0503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFD1","description":"ICD-BHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sewhfo airplane w/jnt(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3978","description":"Sewhfo airplane w/jnt(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Borrelia burgdorferi (Lyme disease)_ OspA protein evaluation_ urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0316U","description":"Borrelia burgdorferi (Lyme disease)_ OspA protein evaluation_ urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0164A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFE1","description":"ICD-JBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWF1","description":"ICD-CBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJC1","description":"ICD-BAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elbow disarticulation switch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6940","description":"Elbow disarticulation switch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1103T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1103T","description":"CPT-1103T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hhv-6 dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87531","description":"Hhv-6 dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ each additional single antibody stain procedure (List separately in addi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0761T","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ each additional single antibody stain procedure (List separately in addi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI lwr extremity w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73720","description":"MRI lwr extremity w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEF1","description":"ICD-MJEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98986","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","description":"CPT-98986","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRB0","description":"ICD-CCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insj/rplc nstim apnea stm ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0426T","description":"Insj/rplc nstim apnea stm ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARB1","description":"ICD-GARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE130","description":"Reduced Physical Function _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neg scrn dep symp by deptool","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3351F","description":"Neg scrn dep symp by deptool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair lower leg tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27676","description":"Repair lower leg tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65101","description":"Removal of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Subretinal injection of a pharmacologic agent_ including vitrectomy and 1 or more retinotomies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0810T","description":"Subretinal injection of a pharmacologic agent_ including vitrectomy and 1 or more retinotomies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHD0","description":"ICD-NLHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAF1","description":"ICD-MGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dicom format doc on rpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9340","description":"Dicom format doc on rpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRB0","description":"ICD-OKRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9687","description":"Hospice services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLE1","description":"ICD-FBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0733","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient identified as an unhealthy alcohol user received brief counseling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2200","description":"Patient identified as an unhealthy alcohol user received brief counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMD0","description":"ICD-CEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASD1","description":"ICD-LASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCE1","description":"ICD-MBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNE1","description":"ICD-KHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGC0","description":"ICD-CGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB52","description":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB105","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vasopneumatic device therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97016","description":"Vasopneumatic device therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUC1","description":"ICD-GAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aortic aneurysm 5-5.4cm diam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9002F","description":"Aortic aneurysm 5-5.4cm diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gr24 nonsealed leadacid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2362","description":"Gr24 nonsealed leadacid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pre-surg eye measures docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3073F","description":"Pre-surg eye measures docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTE0","description":"ICD-BFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc idrl spine lesn scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63283","description":"Bx/exc idrl spine lesn scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bls defibrillation supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0384","description":"Bls defibrillation supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27236","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX0A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBB0","description":"ICD-OHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX4D","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Principal illness navigation services_ additional 30 minutes per calendar month (list separately in addition to g0023)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0024","description":"Principal illness navigation services_ additional 30 minutes per calendar month (list separately in addition to g0023)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVF1","description":"ICD-CAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant spike protein nanoparticle_ saponin-based adjuvant_5mcg/0.5m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91304","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant spike protein nanoparticle_ saponin-based adjuvant_5mcg/0.5m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1327","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroejaculation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55870","description":"Electroejaculation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYD1","description":"ICD-HEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDE0","description":"ICD-OLDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65420","description":"Removal of eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reoperation carotid add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35390","description":"Reoperation carotid add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Init ak ischal plstr direct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5505","description":"Init ak ischal plstr direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJB0","description":"ICD-CBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Department of Veterans Affairs Whole Health Partner Services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9004","description":"Department of Veterans Affairs Whole Health Partner Services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Employment - Job Coaching 1:2 to 1:4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1734","description":"Employment - Job Coaching 1:2 to 1:4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc face tum deep 2 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21014","description":"Exc face tum deep 2 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cymetra injectable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4112","description":"Cymetra injectable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Family (Without The Patient Present)_ Face-To-Face; Initial 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96170","description":"Health Behavior Intervention_ Family (Without The Patient Present)_ Face-To-Face; Initial 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVD1","description":"ICD-OGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWD1","description":"ICD-ODWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Darbepoetin alfa_ esrd use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0882","description":"Darbepoetin alfa_ esrd use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBC0","description":"ICD-FDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antepartum manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59412","description":"Antepartum manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28D","description":"Special Care High _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTF1","description":"ICD-OJTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFED1","description":"ICD-FFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29806","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHF1","description":"ICD-OKHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLB1","description":"ICD-OLLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHB0","description":"ICD-MJHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABA0","description":"ICD-FABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nervous system nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78699","description":"Nervous system nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADF1","description":"ICD-GADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRF0","description":"ICD-GGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIE1","description":"ICD-BFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUB1","description":"ICD-FDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1138","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGID1","description":"ICD-KGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGE0","description":"ICD-FDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFF0","description":"ICD-GAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWF0","description":"ICD-PLWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFF1","description":"ICD-NCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFC1","description":"ICD-BIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30160","description":"Removal of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE13A","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tick-borne encephalitis virus vaccine_ inactivated; 0.25 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90626","description":"Tick-borne encephalitis virus vaccine_ inactivated; 0.25 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","description":"HCPCS-J2802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Myomectomy abdom method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58140","description":"Myomectomy abdom method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES205","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autologous adipose-derived regenerative cell therapy for scleroderma in the hands; multiple injections in one or both hands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0490T","description":"Autologous adipose-derived regenerative cell therapy for scleroderma in the hands; multiple injections in one or both hands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy face plate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4361","description":"Ostomy face plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGF0","description":"ICD-FCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain neck/chest lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21501","description":"Drain neck/chest lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHF0","description":"ICD-MGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0206","description":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKD1","description":"ICD-OBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj desmopressin acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2597","description":"Inj desmopressin acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSA1","description":"ICD-CDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE111","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Albuterol non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7611","description":"Albuterol non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBE1","description":"ICD-GBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA CRYPTOSPORIDIUM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87328","description":"IAAD IA CRYPTOSPORIDIUM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIA1","description":"ICD-MFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUE1","description":"ICD-FBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOF1","description":"ICD-LBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Breast Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1081","description":"Radiation Therapy For Breast Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of spinal herniation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63702","description":"Repair of spinal herniation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNB0","description":"ICD-OHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8G","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mercaptopurine 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0108","description":"Mercaptopurine 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion_ casirivimab and imdevimab includes infusion and post administration monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0243","description":"Intravenous infusion_ casirivimab and imdevimab includes infusion and post administration monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Follow up care plan mdd docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0545F","description":"Follow up care plan mdd docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHD0","description":"ICD-MEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD251","description":"Special Care Low _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAC1","description":"ICD-BDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIF1","description":"ICD-EFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit diuretic infus diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9361","description":"Hit diuretic infus diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artificial insemination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58322","description":"Artificial insemination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28F","description":"Special Care Low _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATF0","description":"ICD-MATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ischial bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27060","description":"Removal of ischial bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise excess skin fat pad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15838","description":"Excise excess skin fat pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIA0","description":"ICD-FEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection for ureter x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50690","description":"Injection for ureter x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove shoulder fb deep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23333","description":"Remove shoulder fb deep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHF0","description":"ICD-ABHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Methadone oral 5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0109","description":"Methadone oral 5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAD1","description":"ICD-BFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICF0","description":"ICD-GICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWF1","description":"ICD-CAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX4C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-P9027","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","description":"HCPCS-P9027","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSA1","description":"ICD-GFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53430","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lefort i-2 piece w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21142","description":"Lefort i-2 piece w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAA1","description":"ICD-IEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGB0","description":"ICD-JFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWA1","description":"ICD-PEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMF1","description":"ICD-IHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTF1","description":"ICD-EHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interdiscal perq aspir dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62267","description":"Interdiscal perq aspir dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB13","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endosteal implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6012","description":"Endosteal implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0595U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","description":"CPT-0595U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELB1","description":"ICD-JELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 vhd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0826","description":"Pwc gp 2 vhd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No eval riskk vte card prior","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9299","description":"No eval riskk vte card prior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA131","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIF1","description":"ICD-JFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVF1","description":"ICD-OCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialysate sol test kit_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4760","description":"Dialysate sol test kit_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35276","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No doc count of ct in 12mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9322","description":"No doc count of ct in 12mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBD0","description":"ICD-JGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCE0","description":"ICD-OCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFF1","description":"ICD-KFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE13D","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Image cath fluid colxn visc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49405","description":"Image cath fluid colxn visc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Airways surgical procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31899","description":"Airways surgical procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Screen pap by tech w md supv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P3000","description":"Screen pap by tech w md supv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGE1","description":"ICD-GGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foam drg > 48 sq in w/o brdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6211","description":"Foam drg > 48 sq in w/o brdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bladder & nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51575","description":"Removal of bladder & nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB52","description":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJD1","description":"ICD-NFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pozelimab-bbfg_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9376","description":"Injection_ pozelimab-bbfg_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove cartilage for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20912","description":"Remove cartilage for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB144","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Restorigin_ 1 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4192","description":"Restorigin_ 1 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4FB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FB31","description":"ICD-4FB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73020","description":"X-ray exam of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESD1","description":"ICD-CESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA260","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC230","description":"Special Care High _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert uteri tandem/ovoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57155","description":"Insert uteri tandem/ovoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETD0","description":"ICD-OETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB105","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNE0","description":"ICD-BGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRC1","description":"ICD-HHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Haloperidol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1630","description":"Haloperidol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYC1","description":"ICD-PEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ each multiplex antibody stain procedure (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0762T","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ each multiplex antibody stain procedure (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lipoprotein_ direct measurement; small dense LDL cholesterol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83722","description":"Lipoprotein_ direct measurement; small dense LDL cholesterol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMA0","description":"ICD-KCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFF1","description":"ICD-GBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTB1","description":"ICD-EHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQB0","description":"ICD-DGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Arthrodesis_ sacroiliac joint_ percutaneous_ with image guidance_ includes placement of intra-articular implant(s) (eg_ bone allograft[s]_ synthetic device[s])","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0775T","description":"Arthrodesis_ sacroiliac joint_ percutaneous_ with image guidance_ includes placement of intra-articular implant(s) (eg_ bone allograft[s]_ synthetic device[s])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60240","description":"Removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27830","description":"Treat lower leg dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Misc integral lens serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0590","description":"Misc integral lens serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who are counseled on connection with a csp and explicitly opt out","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1317","description":"Patients who are counseled on connection with a csp and explicitly opt out","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQE1","description":"ICD-KFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of calcium in urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82340","description":"Assay of calcium in urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3389","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","description":"HCPCS-J3389","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mammo assess negative docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3341F","description":"Mammo assess negative docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXF0","description":"ICD-FCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology (heart transplant)_ mRNA gene expression profiling by microarray of 1283 genes_ transplant biopsy tissue_ allograft rejection and injury algorithm reported as a pr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0087U","description":"Cardiology (heart transplant)_ mRNA gene expression profiling by microarray of 1283 genes_ transplant biopsy tissue_ allograft rejection and injury algorithm reported as a pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTB1","description":"ICD-NCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFF1","description":"ICD-FEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXF1","description":"ICD-NBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insulin dispos pen 3 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5571","description":"Insulin dispos pen 3 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISF0","description":"ICD-LISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cmv ig iv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90291","description":"Cmv ig iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAID0","description":"ICD-CAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wc planar back cush wd <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2620","description":"Wc planar back cush wd <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29883","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9942","description":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLC0","description":"ICD-ACLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQF0","description":"ICD-LDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB144","description":"Special Care High _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNC1","description":"ICD-OLNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy vagus nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43651","description":"Laparoscopy vagus nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMB0","description":"ICD-OBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOD0","description":"ICD-PBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVC0","description":"ICD-FBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJE0","description":"ICD-CGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDF1","description":"ICD-EDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKB1","description":"ICD-CIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQF1","description":"ICD-OIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Carrier screening for severe inherited conditions (eg_ cystic fibrosis_ spinal muscular atrophy_ beta hemoglobinopathies [including sickle cell disease]_ alpha thalassemia)_ r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0449U","description":"Carrier screening for severe inherited conditions (eg_ cystic fibrosis_ spinal muscular atrophy_ beta hemoglobinopathies [including sickle cell disease]_ alpha thalassemia)_ r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBF0","description":"ICD-FHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destroy lumb/sac facet jnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64635","description":"Destroy lumb/sac facet jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNF1","description":"ICD-JFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25455","description":"Revision of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESE1","description":"ICD-PESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ppps_ subseq visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0439","description":"Ppps_ subseq visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTB0","description":"ICD-NDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp aor-celiac-msn-renal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35631","description":"Art byp aor-celiac-msn-renal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breast adjuvant chemotherapy administered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9829","description":"Breast adjuvant chemotherapy administered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIC0","description":"ICD-GIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMC1","description":"ICD-OKMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57000","description":"Exploration of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht arm adult fbrgl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4010","description":"Cast sup sht arm adult fbrgl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44140","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Above knee cushion socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5648","description":"Above knee cushion socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIB1","description":"ICD-KAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Salivary gland function exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78232","description":"Salivary gland function exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFID1","description":"ICD-KFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDE0","description":"ICD-CEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHB0","description":"ICD-IEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMA1","description":"ICD-ICMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXA0","description":"ICD-OFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mpl (Mpl Proto-Oncogene_ Thrombopoietin Receptor) (Eg_ Myeloproliferative Disorder) Gene Analysis; Common Variants (Eg_ W515A_ W515K_ W515L_ W515R)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81338","description":"Mpl (Mpl Proto-Oncogene_ Thrombopoietin Receptor) (Eg_ Myeloproliferative Disorder) Gene Analysis; Common Variants (Eg_ W515A_ W515K_ W515L_ W515R)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEC1","description":"ICD-EEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVE0","description":"ICD-GBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGD0","description":"ICD-OBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1263","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVB1","description":"ICD-JBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0490U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","description":"CPT-0490U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOB0","description":"ICD-PKOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEC0","description":"ICD-ABEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis - bitewing radiographic image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0373","description":"intraoral tomosynthesis - bitewing radiographic image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ic inf pbw 2501-5000 g subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99480","description":"Ic inf pbw 2501-5000 g subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iiv4 vaccine 6-35 months im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90687","description":"Iiv4 vaccine 6-35 months im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTB1","description":"ICD-JBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67911","description":"Revise eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart septum defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33684","description":"Repair heart septum defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA11A","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKME1","description":"ICD-OKME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with dementia at any time prior to or during the month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1271","description":"Patients with dementia at any time prior to or during the month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter Placement And Subsequent Removal Of Cerebral Embolic Protection Device(S)_ Including Arterial Access_ Catheterization_ Imaging_ And Radiological Supervision And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33370","description":"Transcatheter Placement And Subsequent Removal Of Cerebral Embolic Protection Device(S)_ Including Arterial Access_ Catheterization_ Imaging_ And Radiological Supervision And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKF0","description":"ICD-KHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYE1","description":"ICD-OGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUE1","description":"ICD-BHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDED0","description":"ICD-BDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAED0","description":"ICD-CAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOA0","description":"ICD-OLOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBME1","description":"ICD-NBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit anti-spasmotic diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9363","description":"Hit anti-spasmotic diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIB0","description":"ICD-NCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay tumor qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86294","description":"Immunoassay tumor qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat fx rad extra-articul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25607","description":"Treat fx rad extra-articul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote Physiologic Monitoring Treatment Management Services_ Clinical Staff/Physician/Other Qualified Health Care Professional Time In A Calendar Month Requiring Interactive C","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99458","description":"Remote Physiologic Monitoring Treatment Management Services_ Clinical Staff/Physician/Other Qualified Health Care Professional Time In A Calendar Month Requiring Interactive C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETD0","description":"ICD-AETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAB1","description":"ICD-OIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLE0","description":"ICD-JGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel drg > 48 sq in w/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6247","description":"Hydrogel drg > 48 sq in w/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx brst metastic/ recur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9075","description":"Onc dx brst metastic/ recur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted procedure_ intestine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6021","description":"Unlisted procedure_ intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUE1","description":"ICD-NAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEC1","description":"ICD-FBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYA1","description":"ICD-OCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0558","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0558","description":"HCPCS-G0558","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLB0","description":"ICD-ADLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBB1","description":"ICD-KIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNA0","description":"ICD-CHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVD1","description":"ICD-JGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAA0","description":"ICD-JAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXF1","description":"ICD-NFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prepare heart-aorta conduit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33404","description":"Prepare heart-aorta conduit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILD1","description":"ICD-GILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENC0","description":"ICD-JENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Topical anesthetic_ per gram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4736","description":"Topical anesthetic_ per gram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9173","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9173","description":"HCPCS-C9173","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of windpipe injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31800","description":"Repair of windpipe injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQB0","description":"ICD-KGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTA0","description":"ICD-FCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tetanus immune globulin inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1670","description":"Tetanus immune globulin inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ C1 esterase inhibitor (human)_ Haegarda_ 10 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9015","description":"Injection_ C1 esterase inhibitor (human)_ Haegarda_ 10 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Limb exercise test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95875","description":"Limb exercise test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDE1","description":"ICD-EGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42215","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC20B","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBD0","description":"ICD-BEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBB1","description":"ICD-AHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUD1","description":"ICD-MFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB25D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwr wc drivewheel motor repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2368","description":"Pwr wc drivewheel motor repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOC1","description":"ICD-OHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVF1","description":"ICD-NKVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIC0","description":"ICD-JGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKE0","description":"ICD-BDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acute vitreous hemorrhage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1333","description":"Acute vitreous hemorrhage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNE1","description":"ICD-NFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA11B","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01732","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01732","description":"CPT-01732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMD0","description":"ICD-FBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28G","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES14D","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urinary rubber pouch w fcplt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4380","description":"Urinary rubber pouch w fcplt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB22C","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEA0","description":"ICD-ADEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient admitted to hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9857","description":"Patient admitted to hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anterior thoracic derotation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1260","description":"Anterior thoracic derotation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEE0","description":"ICD-CCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Daclizumab_ parenteral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7513","description":"Daclizumab_ parenteral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKE1","description":"ICD-OLKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHE1","description":"ICD-MEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX11","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDND0","description":"ICD-GDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHA0","description":"ICD-KCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKE0","description":"ICD-BIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fuse gallbladder & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47741","description":"Fuse gallbladder & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMF1","description":"ICD-NEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elev bp plan of care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0513F","description":"Elev bp plan of care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHC0","description":"ICD-MDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHB1","description":"ICD-NBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Robot lin-radsurg com_ first","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0339","description":"Robot lin-radsurg com_ first","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull for surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61460","description":"Incise skull for surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC1A","description":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNF0","description":"ICD-JBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWC0","description":"ICD-PKWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ercp stent exchange w/dilate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43276","description":"Ercp stent exchange w/dilate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB151","description":"Special Care High _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nutri counsel-control caries","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1310","description":"Nutri counsel-control caries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAE1","description":"ICD-IIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAB1","description":"ICD-NAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pantoprazole (Hikma)_ not therapeutically equivalent to J2470_ 40 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2471","description":"Injection_ pantoprazole (Hikma)_ not therapeutically equivalent to J2470_ 40 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAF0","description":"ICD-NCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFB1","description":"ICD-FFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remv/repl penis contain pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54416","description":"Remv/repl penis contain pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_ without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0109","description":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_ without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDB0","description":"ICD-AIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35302","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOD0","description":"ICD-DBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11471","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHA1","description":"ICD-MBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWA1","description":"ICD-PHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGF1","description":"ICD-FHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD204","description":"Clinically Complex _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gene test alpha-thalassemia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3845","description":"Gene test alpha-thalassemia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXC1","description":"ICD-KDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFD0","description":"ICD-KIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASF0","description":"ICD-OASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGF0","description":"ICD-GBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct orbit/forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21175","description":"Reconstruct orbit/forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ ep_ cool-tip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2630","description":"Cath_ ep_ cool-tip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXF0","description":"ICD-FGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Csi per asx pt w/pci 2 yrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8963","description":"Csi per asx pt w/pci 2 yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of sinuses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70210","description":"X-ray exam of sinuses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGF1","description":"ICD-GIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABC0","description":"ICD-FABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove exostosis mandible","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21031","description":"Remove exostosis mandible","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUB0","description":"ICD-MLUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of stomach lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43610","description":"Excision of stomach lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2351","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","description":"HCPCS-J2351","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1045T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1045T","description":"CPT-1045T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Evaluate speech production","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92522","description":"Evaluate speech production","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ BTE/BTE","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5221","description":"Hearing aid_ contralateral routing system_ binaural_ BTE/BTE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insulin reuse pen 1.5 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5560","description":"Insulin reuse pen 1.5 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pms2 gene full seq analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81317","description":"Pms2 gene full seq analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis_ solid organ neoplasm_ DNA analysis of 324 genes_ interrogation for sequence variants_ gene copy number amplifications_ gene rearrangements_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0037U","description":"Targeted genomic sequence analysis_ solid organ neoplasm_ DNA analysis of 324 genes_ interrogation for sequence variants_ gene copy number amplifications_ gene rearrangements_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXF0","description":"ICD-OEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHME0","description":"ICD-KHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBA1","description":"ICD-NCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Manipulation of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27275","description":"Manipulation of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACB0","description":"ICD-GACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy irrigation bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4398","description":"Ostomy irrigation bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPE1","description":"ICD-FEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETB1","description":"ICD-IETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALB1","description":"ICD-FALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUF0","description":"ICD-KIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hla i typing 1 locus lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81373","description":"Hla i typing 1 locus lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUC0","description":"ICD-IHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLF0","description":"ICD-GBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOE1","description":"ICD-OKOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient had encephalitis due to the tetanus_ diphtheria or pertussis vaccine any time on or before the patient_s 13th birthday","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1162","description":"Patient had encephalitis due to the tetanus_ diphtheria or pertussis vaccine any time on or before the patient_s 13th birthday","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEC0","description":"ICD-OGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical chemistry test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84999","description":"Clinical chemistry test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTB0","description":"ICD-JBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRE1","description":"ICD-CFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOC1","description":"ICD-PJOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB03","description":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25907","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open biopsy or excision of deep cervical node(s) with intraoperative identification (eg_ mapping) of sentinel lymph node(s) including injection of non-radioactive dye when per","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7503","description":"Open biopsy or excision of deep cervical node(s) with intraoperative identification (eg_ mapping) of sentinel lymph node(s) including injection of non-radioactive dye when per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ticarcillin disod","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0040","description":"Injection_ ticarcillin disod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruct b9 lesion 1-14","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17110","description":"Destruct b9 lesion 1-14","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cd4+cell cnt 200-499 cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3495F","description":"Cd4+cell cnt 200-499 cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJD1","description":"ICD-NCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGC1","description":"ICD-GIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Device evaluation_ interrogation_ and initial programming of intraocular retinal electrode array (eg_ retinal prosthesis)_ in person_ with iterative adjustment of the implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0472T","description":"Device evaluation_ interrogation_ and initial programming of intraocular retinal electrode array (eg_ retinal prosthesis)_ in person_ with iterative adjustment of the implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Teriparatide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3110","description":"Teriparatide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rails bed side full length","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0310","description":"Rails bed side full length","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epidrm a-grft face/nck/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15115","description":"Epidrm a-grft face/nck/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCB1","description":"ICD-CBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNC0","description":"ICD-NJNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXF1","description":"ICD-FGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWE1","description":"ICD-DBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTF1","description":"ICD-OLTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHF0","description":"ICD-OIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diethylstilbestrol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9165","description":"Diethylstilbestrol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove self-contd penis pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54415","description":"Remove self-contd penis pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB234","description":"Clinically Complex _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGB0","description":"ICD-CFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laser surgery of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57513","description":"Laser surgery of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1404","description":"HCPCS-A1404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWA1","description":"ICD-CHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPD1","description":"ICD-OFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28H","description":"Clinically Complex _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALB0","description":"ICD-AALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOD1","description":"ICD-GEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Obstetrics (preeclampsia)_ kinase insert domain receptor (KDR)_ Endoglin (ENG)_ and retinol-binding protein 4 (RBP4)_ by immunoassay_ serum_ algorithm reported as a risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0390U","description":"Obstetrics (preeclampsia)_ kinase insert domain receptor (KDR)_ Endoglin (ENG)_ and retinol-binding protein 4 (RBP4)_ by immunoassay_ serum_ algorithm reported as a risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCA1","description":"ICD-FBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDF1","description":"ICD-EGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL5C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRB0","description":"ICD-PKRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMD1","description":"ICD-JGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore parathyroid glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60505","description":"Explore parathyroid glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tooth root removal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7250","description":"Tooth root removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBD1","description":"ICD-NLBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB235","description":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary colon ca dsordrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81436","description":"Hereditary colon ca dsordrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ midazolam hydrochloride (wg critical care) not therapeutically equivalent to j2250_ per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2251","description":"Injection_ midazolam hydrochloride (wg critical care) not therapeutically equivalent to j2250_ per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pre-op asst doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9615","description":"Pre-op asst doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pediatric speech aid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5952","description":"Pediatric speech aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQA1","description":"ICD-LCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBD0","description":"ICD-GDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJF0","description":"ICD-CDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE221","description":"Special Care High _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUA0","description":"ICD-JIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQF0","description":"ICD-CIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVB0","description":"ICD-CDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPF1","description":"ICD-NCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"LU GNOTYP BCAM EXON 3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0196U","description":"LU GNOTYP BCAM EXON 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter Atrial Septostomy (Tas) For Congenital Cardiac Anomalies To Create Effective Atrial Flow_ Including All Imaging Guidance By The Proceduralist_ When Performed_ An","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33741","description":"Transcatheter Atrial Septostomy (Tas) For Congenital Cardiac Anomalies To Create Effective Atrial Flow_ Including All Imaging Guidance By The Proceduralist_ When Performed_ An","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Novachor_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4194","description":"Novachor_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBE1","description":"ICD-GHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTF1","description":"ICD-FFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJD1","description":"ICD-KDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLD0","description":"ICD-ICLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bundle of his recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93600","description":"Bundle of his recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ibutilide fumarate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1742","description":"Ibutilide fumarate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epoetin beta_ non-esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9973","description":"Epoetin beta_ non-esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"InnovaBurn or InnovaMatrix XL_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2022","description":"InnovaBurn or InnovaMatrix XL_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXA0","description":"ICD-JCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLD1","description":"ICD-EGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis circuit permanent vascular embolization or occlusion (including main circuit or any accessory veins)_ endovascular_ including all imaging and radiological supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36909","description":"Dialysis circuit permanent vascular embolization or occlusion (including main circuit or any accessory veins)_ endovascular_ including all imaging and radiological supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBA1","description":"ICD-OEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Calculated 10-year ascvd risk score of = 20 percent during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1364","description":"Calculated 10-year ascvd risk score of = 20 percent during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWB1","description":"ICD-KGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA234","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amnioexcel or biodexcel_ 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4137","description":"Amnioexcel or biodexcel_ 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICB1","description":"ICD-IICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMB1","description":"ICD-NJMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDE1","description":"ICD-EEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB14","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of blood lipoprotein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83719","description":"Assay of blood lipoprotein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQD0","description":"ICD-PEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25491","description":"Reinforce ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOD1","description":"ICD-GBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMC1","description":"ICD-BGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIB0","description":"ICD-JIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home visit est patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99350","description":"Home visit est patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Copper cu-64_ dotatate_ diagnostic_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9068","description":"Copper cu-64_ dotatate_ diagnostic_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPB0","description":"ICD-OKPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJB1","description":"ICD-GIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision hand/finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26415","description":"Excision hand/finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEB0","description":"ICD-CDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJE0","description":"ICD-OGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPD1","description":"ICD-KGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31766","description":"Reconstruction of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDD1","description":"ICD-GDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ including fluoroscopic guidance_ when performed; with therapeutic aspiration of tracheobronchial tree_ initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31645","description":"Bronchoscopy_ rigid or flexible_ including fluoroscopic guidance_ when performed; with therapeutic aspiration of tracheobronchial tree_ initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chromatography_ qualitative; paper_ 1-dimensional_ analyte not elsewhere specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82487","description":"Chromatography_ qualitative; paper_ 1-dimensional_ analyte not elsewhere specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair single ventricle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33619","description":"Repair single ventricle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEB1","description":"ICD-FEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBA1","description":"ICD-NEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ atezolizumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9022","description":"Injection_ atezolizumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37288","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","description":"CPT-37288","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWF0","description":"ICD-GHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRD1","description":"ICD-PIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of breast lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19120","description":"Removal of breast lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid organ neoplasia)_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ fresh or frozen tissue or cells_ report of specific gene rearra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0013U","description":"Oncology (solid organ neoplasia)_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ fresh or frozen tissue or cells_ report of specific gene rearra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Garamycin gentamicin inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1580","description":"Garamycin gentamicin inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKA0","description":"ICD-GDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBB0","description":"ICD-JEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx cml dx status unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9139","description":"Onc dx cml dx status unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fluoroguide for spine inject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77003","description":"Fluoroguide for spine inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lanadelumab-flyo_ 1 mg (code may be used for Medicare when drug administered under direct supervision of a physician_ not for use when drug is self-administered)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0593","description":"Injection_ lanadelumab-flyo_ 1 mg (code may be used for Medicare when drug administered under direct supervision of a physician_ not for use when drug is self-administered)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIA0","description":"ICD-IAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTC0","description":"ICD-BHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect hip tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27075","description":"Resect hip tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUF1","description":"ICD-NIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMB1","description":"ICD-OLMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIA0","description":"ICD-BAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ metronidazole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0030","description":"Injection_ metronidazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXA0","description":"ICD-JHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documented reason for not screening or recommending a follow-up for high blood pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1288","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including ultrasound guidance; first lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10005","description":"Fine needle aspiration biopsy_ including ultrasound guidance; first lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75726","description":"Artery x-rays abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWE0","description":"ICD-PHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGF1","description":"ICD-KHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIE0","description":"ICD-GIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYD0","description":"ICD-DHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9301","description":"HCPCS-C9301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVD1","description":"ICD-KAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt referral psych docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4062F","description":"Pt referral psych docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Phakic iol refractive error","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0596","description":"Phakic iol refractive error","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for morphometric analysis_ tumor immunohistochemistry (eg_ Her-2/neu_ estrogen receptor/progesterone receptor)_ quantitative or semiqua","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0763T","description":"Digitization of glass microscope slides for morphometric analysis_ tumor immunohistochemistry (eg_ Her-2/neu_ estrogen receptor/progesterone receptor)_ quantitative or semiqua","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA10","description":"High Rehab _ ADL Index 0-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSC0","description":"ICD-ODSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit interim cath care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5502","description":"Hit interim cath care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection for bladder x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51610","description":"Injection for bladder x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDB0","description":"ICD-IIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ant fusion 4-7 vert seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22810","description":"Ant fusion 4-7 vert seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAB0","description":"ICD-NIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKA1","description":"ICD-CEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA2D","description":"Default_ /PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDB1","description":"ICD-EIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB25A","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBE0","description":"ICD-NGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oral mucoadhesive_ any type (liquid_ gel_ paste_ etc.)_ per 1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9156","description":"Oral mucoadhesive_ any type (liquid_ gel_ paste_ etc.)_ per 1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disposable pack w/bowel syst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0352","description":"Disposable pack w/bowel syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLE0","description":"ICD-CCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42800","description":"Biopsy of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chlorpromazine hcl 5mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0161","description":"Chlorpromazine hcl 5mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSD0","description":"ICD-PLSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4KC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KC21","description":"ICD-4KC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of collar bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23480","description":"Revision of collar bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELB0","description":"ICD-JELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LA31","description":"ICD-3LA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMB0","description":"ICD-JCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUF0","description":"ICD-MHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lung lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32150","description":"Removal of lung lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Asth controlled","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9432","description":"Asth controlled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trach pros cleaning device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8513","description":"Trach pros cleaning device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection jaw joint x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21116","description":"Injection jaw joint x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILC1","description":"ICD-GILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBC0","description":"ICD-IHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spinal fluid tap diagnostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62270","description":"Spinal fluid tap diagnostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of wrist lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25130","description":"Removal of wrist lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of oral tissue soft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7286","description":"Biopsy of oral tissue soft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETC1","description":"ICD-NETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPC1","description":"ICD-JDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00103","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00103","description":"CPT-00103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx complx malar w/grft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21366","description":"Opn tx complx malar w/grft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA246","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD145","description":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTF1","description":"ICD-NDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEE0","description":"ICD-MHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVB1","description":"ICD-GFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGE0","description":"ICD-NDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAC1","description":"ICD-MDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended-release (Brixadi)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9154","description":"Injection_ buprenorphine extended-release (Brixadi)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA36","description":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFC0","description":"ICD-FGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLF1","description":"ICD-CBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"So hard plas stabili pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3677","description":"So hard plas stabili pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64640","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAE0","description":"ICD-OFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAE0","description":"ICD-CCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHE0","description":"ICD-JAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE14A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANF1","description":"ICD-CANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVA1","description":"ICD-JCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIB0","description":"ICD-EEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPF1","description":"ICD-OCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOC1","description":"ICD-HIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCD1","description":"ICD-CFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9807","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9807","description":"HCPCS-C9807","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4928","description":"Surgical mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAA1","description":"ICD-BBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spirom fev/fvc>/=70%/w/ocopd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3027F","description":"Spirom fev/fvc>/=70%/w/ocopd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD212","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise sacral spine tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49215","description":"Excise sacral spine tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pathology Clinical Consultation; For A Clinical Problem_ With Limited Review Of Patient_S History And Medical Records And Straightforward Medical Decision Making When Using Ti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80503","description":"Pathology Clinical Consultation; For A Clinical Problem_ With Limited Review Of Patient_S History And Medical Records And Straightforward Medical Decision Making When Using Ti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transplj hematopoietic boost","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38243","description":"Transplj hematopoietic boost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAB1","description":"ICD-KBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINC0","description":"ICD-JINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place needle in vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36000","description":"Place needle in vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incis 1 vertebral seg thorac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22212","description":"Incis 1 vertebral seg thorac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mirvetuximab soravtansine-gynx_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9063","description":"Injection_ mirvetuximab soravtansine-gynx_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDC0","description":"ICD-OKDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVC1","description":"ICD-CHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJA1","description":"ICD-NBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAE0","description":"ICD-GFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTD0","description":"ICD-MDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIC1","description":"ICD-GHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2102","description":"HCPCS-A2102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNF1","description":"ICD-KBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lvef <40% or dep lv sys fcn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8934","description":"Lvef <40% or dep lv sys fcn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIF1","description":"ICD-MLIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKD1","description":"ICD-KCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0008","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAF0","description":"ICD-JBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFE1","description":"ICD-GDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of catheter vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36510","description":"Insertion of catheter vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIA1","description":"ICD-OJIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRD0","description":"ICD-PDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAB1","description":"ICD-MKAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBF0","description":"ICD-FFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWB0","description":"ICD-LAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRB1","description":"ICD-PCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC23A","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heart symp image plnr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0331T","description":"Heart symp image plnr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Office-Based Treatment For Opioid Use Disorder_ Including Care Coordination_ Individual Therapy And Group Therapy And Counseling; At Least 60 Minutes In A Subsequent Calendar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2087","description":"Office-Based Treatment For Opioid Use Disorder_ Including Care Coordination_ Individual Therapy And Group Therapy And Counseling; At Least 60 Minutes In A Subsequent Calendar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB201","description":"Special Care Low _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1019","description":"Replacement supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CT/MRI chest/neck follup rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9554","description":"CT/MRI chest/neck follup rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56631","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Event recorder_ cardiac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1764","description":"Event recorder_ cardiac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4EB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EB21","description":"ICD-4EB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00350","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00350","description":"CPT-00350","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACC0","description":"ICD-IACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXB0","description":"ICD-BIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37264","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","description":"CPT-37264","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERF0","description":"ICD-GERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brain imaging (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78607","description":"Brain imaging (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADF0","description":"ICD-CADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXD0","description":"ICD-JHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNA0","description":"ICD-BGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"PolyCyte_ for topical use only_ per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4241","description":"PolyCyte_ for topical use only_ per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insulin rapid 5 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5550","description":"Insulin rapid 5 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin substitute_ FDA-cleared as a device_ not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4100","description":"Skin substitute_ FDA-cleared as a device_ not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYD1","description":"ICD-CEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEE0","description":"ICD-OIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJC0","description":"ICD-OAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUB1","description":"ICD-JBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAC1","description":"ICD-GHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJA0","description":"ICD-KDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPF0","description":"ICD-JAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Evaluate pt use of inhaler","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94664","description":"Evaluate pt use of inhaler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Occlusive device in vein art","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0269","description":"Occlusive device in vein art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXE0","description":"ICD-FAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFB0","description":"ICD-NBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFE1","description":"ICD-OEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair elbow deb/attch open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24359","description":"Repair elbow deb/attch open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDD1","description":"ICD-ICDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEE0","description":"ICD-ODEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture belly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35122","description":"Repair artery rupture belly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENF0","description":"ICD-CENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRB0","description":"ICD-OLRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB34","description":"Very High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Multi-axial knee/shin system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5840","description":"Multi-axial knee/shin system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCA1","description":"ICD-KCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOF1","description":"ICD-OLOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit tpn 1 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9365","description":"Hit tpn 1 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPC0","description":"ICD-KEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUF1","description":"ICD-OFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0802","description":"HCPCS-B0802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin sub graft f/n/hf/g addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15276","description":"Skin sub graft f/n/hf/g addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Optimal care for patients with episodic neurological conditions mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0003","description":"Optimal care for patients with episodic neurological conditions mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITC0","description":"ICD-CITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wrist arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29846","description":"Wrist arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8G","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQB1","description":"ICD-KGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSA1","description":"ICD-GBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy lymphadenectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38572","description":"Laparoscopy lymphadenectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFD1","description":"ICD-CHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXE1","description":"ICD-NBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion Of Anterior Segment Aqueous Drainage Device Into The Trabecular Meshwork_ Without External Reservoir_ And Without Concomitant Cataract Removal_ One Or More","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0671T","description":"Insertion Of Anterior Segment Aqueous Drainage Device Into The Trabecular Meshwork_ Without External Reservoir_ And Without Concomitant Cataract Removal_ One Or More","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Janssen Covid-19 Vaccine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91303","description":"Janssen Covid-19 Vaccine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELB0","description":"ICD-OELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDE0","description":"ICD-CGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUC1","description":"ICD-IBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDB1","description":"ICD-EHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAE0","description":"ICD-FGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMD1","description":"ICD-NBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Within The Past 2 Years_ Calcium And/Or Vitamin D Optimization Has Not Been Ordered Or Performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2120","description":"Within The Past 2 Years_ Calcium And/Or Vitamin D Optimization Has Not Been Ordered Or Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abobotulinumtoxina","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0586","description":"Abobotulinumtoxina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASB1","description":"ICD-GASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of temporary anchorage device_ requiring flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7299","description":"Removal of temporary anchorage device_ requiring flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTB1","description":"ICD-MJTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJD0","description":"ICD-NGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydroxyurea 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0176","description":"Hydroxyurea 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ pasireotide long acting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2502","description":"Inj_ pasireotide long acting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTC0","description":"ICD-JFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAB1","description":"ICD-MCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interprof phone/online 11-20","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99447","description":"Interprof phone/online 11-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUB0","description":"ICD-BCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Macroscopic exam parasite","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87169","description":"Macroscopic exam parasite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIC1","description":"ICD-ICIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of clot in graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35875","description":"Removal of clot in graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFND0","description":"ICD-JFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cabazitaxel injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9043","description":"Cabazitaxel injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unspecified diagnostic proce","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0999","description":"Unspecified diagnostic proce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Total hip arthroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27132","description":"Total hip arthroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLB0","description":"ICD-JCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transnasal; with biopsy_ single or multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0653T","description":"Esophagogastroduodenoscopy_ flexible_ transnasal; with biopsy_ single or multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOC1","description":"ICD-KCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ercp remove duct calculi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43264","description":"Ercp remove duct calculi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQA0","description":"ICD-HEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ 5-50 genes (eg_ ALK_ BRAF_ CDKN2A_ EGFR_ ERBB2_ KIT_ KRAS_ MET_ NRAS_ PDGFRA_ PDGFRB_ PGR_ PIK3CA_ PTEN_ RET)_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81449","description":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ 5-50 genes (eg_ ALK_ BRAF_ CDKN2A_ EGFR_ ERBB2_ KIT_ KRAS_ MET_ NRAS_ PDGFRA_ PDGFRB_ PGR_ PIK3CA_ PTEN_ RET)_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect hip tum w/innom bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27077","description":"Resect hip tum w/innom bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bx/curett of cervix w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57454","description":"Bx/curett of cervix w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVB0","description":"ICD-JAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair nerve add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64832","description":"Repair nerve add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of androsterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82160","description":"Assay of androsterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUA1","description":"ICD-EDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo remove w/ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50548","description":"Laparo remove w/ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDC0","description":"ICD-EDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD14C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0969T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","description":"CPT-0969T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB1C","description":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"P32 chromic phosphate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9564","description":"P32 chromic phosphate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc thigh/knee les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27337","description":"Exc thigh/knee les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28E","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELB0","description":"ICD-AELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB42","description":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76705","description":"Echo exam of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease_ chronic hepatitis C virus (HCV) infection_ six biochemical assays (ALT_ A2-macroglobulin_ apolipoprotein A-1_ total bilirubin_ GGT_ and haptoglobin) utiliz","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81596","description":"Infectious disease_ chronic hepatitis C virus (HCV) infection_ six biochemical assays (ALT_ A2-macroglobulin_ apolipoprotein A-1_ total bilirubin_ GGT_ and haptoglobin) utiliz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUA0","description":"ICD-IFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVC0","description":"ICD-CEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9303","description":"HCPCS-C9303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemical cauterization of granulation tissue (ie_ proud flesh)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17250","description":"Chemical cauterization of granulation tissue (ie_ proud flesh)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLF0","description":"ICD-KFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOA0","description":"ICD-PEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thaw cryoprsvrd reprod tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89354","description":"Thaw cryoprsvrd reprod tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Manual therapy 1/> regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97140","description":"Manual therapy 1/> regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct abdomen w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74170","description":"Ct abdomen w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50940","description":"Release of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No doc rsn do qual life assm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9635","description":"No doc rsn do qual life assm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Halo repl liner/interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0861","description":"Halo repl liner/interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHID1","description":"ICD-NHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA24B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTF1","description":"ICD-NFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTE1","description":"ICD-FBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIE1","description":"ICD-NIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGND0","description":"ICD-KGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Terbutaline sulf comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7681","description":"Terbutaline sulf comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal surg pulmon sequest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2403","description":"Fetal surg pulmon sequest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc leg/ankle tum dep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27634","description":"Exc leg/ankle tum dep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKF1","description":"ICD-NEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth hrt surg w/pmp age 1+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56251","description":"Anesth hrt surg w/pmp age 1+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQE0","description":"ICD-LHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVA1","description":"ICD-OBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB255","description":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWF0","description":"ICD-OGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOF1","description":"ICD-HBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXA1","description":"ICD-FGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCC0","description":"ICD-AGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKF1","description":"ICD-OAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgery for liver lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47300","description":"Surgery for liver lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of tongue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41120","description":"Partial removal of tongue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3KB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KB21","description":"ICD-3KB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNA1","description":"ICD-FHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy elbow joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24100","description":"Biopsy elbow joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLD1","description":"ICD-MBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQC0","description":"ICD-DBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICD0","description":"ICD-IICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFA1","description":"ICD-GFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCB0","description":"ICD-NGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB12C","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSF0","description":"ICD-CDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQA0","description":"ICD-PLQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC12A","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of serum sodium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84295","description":"Assay of serum sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVD0","description":"ICD-GFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Indwelling catheter special","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4340","description":"Indwelling catheter special","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0805","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0805","description":"CDT-D0805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBC0","description":"ICD-CFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31239","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transab or transvag us","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8806","description":"Transab or transvag us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hla class i/ii antibody qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86829","description":"Hla class i/ii antibody qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRD1","description":"ICD-PDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYE0","description":"ICD-HHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54316","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARA1","description":"ICD-KARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise eyelashes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67820","description":"Revise eyelashes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOA0","description":"ICD-HBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA21","description":"Default_ /14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVD1","description":"ICD-OJVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwr pck base combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0489","description":"Pwr pck base combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48150","description":"Partial removal of pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTD0","description":"ICD-JBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDB0","description":"ICD-EHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJF1","description":"ICD-NDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUC0","description":"ICD-OFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMA1","description":"ICD-GFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4IC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IC21","description":"ICD-4IC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXA0","description":"ICD-JIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat mouth roof fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21421","description":"Treat mouth roof fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBA0","description":"ICD-EFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABD1","description":"ICD-CABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Activation device for intraurethral drainage device with valve_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1011","description":"Activation device for intraurethral drainage device with valve_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIF1","description":"ICD-FAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITA1","description":"ICD-IITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXF1","description":"ICD-GEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAD1","description":"ICD-FCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat craniofacial fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21433","description":"Treat craniofacial fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRA0","description":"ICD-HIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Xray endovasc thor ao repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75957","description":"Xray endovasc thor ao repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYD0","description":"ICD-HIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABE0","description":"ICD-OABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Optx of rib fx w/fixj scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21811","description":"Optx of rib fx w/fixj scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCE0","description":"ICD-JGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCD0","description":"ICD-IDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38X","description":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay metallic 2 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2542","description":"Dental onlay metallic 2 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemin_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1640","description":"Hemin_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE112","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrast exam abdominl aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75625","description":"Contrast exam abdominl aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPC1","description":"ICD-FFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Homaker service nos per 15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5130","description":"Homaker service nos per 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair standard w/ leg r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1150","description":"Wheelchair standard w/ leg r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA14B","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDE1","description":"ICD-CDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJA1","description":"ICD-OGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy lesion ablate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43229","description":"Esophagoscopy lesion ablate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis b vaccine injection administered or previously received and is receiving a first course of anti-tnf therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8870","description":"Hepatitis b vaccine injection administered or previously received and is receiving a first course of anti-tnf therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEB0","description":"ICD-NHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYE1","description":"ICD-KIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA20D","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc prac mgmt adheres guide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9056","description":"Onc prac mgmt adheres guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTC0","description":"ICD-GGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC32","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Socket insert w/o lock mech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5679","description":"Socket insert w/o lock mech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIE0","description":"ICD-JHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ mon_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5244","description":"Hearing aid_ prog_ mon_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL50","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC146","description":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Stating The Patient Has Received Or Is Currently Receiving Palliative Or Hospice Care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9996","description":"Documentation Stating The Patient Has Received Or Is Currently Receiving Palliative Or Hospice Care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBB0","description":"ICD-KEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE13B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFA1","description":"ICD-GGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDB0","description":"ICD-CDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQF0","description":"ICD-OBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat thorax spine fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22327","description":"Treat thorax spine fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLD1","description":"ICD-FFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clear eyelid gland w/heat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0207T","description":"Clear eyelid gland w/heat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWE0","description":"ICD-PAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAC1","description":"ICD-KBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dstrj neurofibromata xtnsv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0420T","description":"Dstrj neurofibromata xtnsv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystometrogram w/vp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51728","description":"Cystometrogram w/vp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59850","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Advancing rheumatology patient care mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0053","description":"Advancing rheumatology patient care mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Meningococcal pentavalent vaccine_ conjugated Men A_ C_ W_ Y- tetanus toxoid carrier_ and Men B-FHbp_ for intracmuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90623","description":"Meningococcal pentavalent vaccine_ conjugated Men A_ C_ W_ Y- tetanus toxoid carrier_ and Men B-FHbp_ for intracmuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Terbutaline sulfate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3105","description":"Terbutaline sulfate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFD0","description":"ICD-JIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spermicide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4269","description":"Spermicide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC53","description":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMC0","description":"ICD-IBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33420","description":"Revision of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB24B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMF1","description":"ICD-IIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ex for nonspeech device rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92605","description":"Ex for nonspeech device rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLA0","description":"ICD-MGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAB1","description":"ICD-IIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHID0","description":"ICD-GHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Technetium tc-99m auto wbc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9569","description":"Technetium tc-99m auto wbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERF0","description":"ICD-PERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFB1","description":"ICD-NEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHD1","description":"ICD-ACHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rec cortico>60d or 1rx 600mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9469","description":"Rec cortico>60d or 1rx 600mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy arm/elbow soft tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24065","description":"Biopsy arm/elbow soft tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWC1","description":"ICD-HAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by infraclavicular or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34716","description":"Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by infraclavicular or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Respite care service 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1005","description":"Respite care service 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBF1","description":"ICD-OJBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSC1","description":"ICD-PBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ntrk1 (Neurotrophic Receptor Tyrosine Kinase 1) (Eg_ Solid Tumors) Translocation Analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81191","description":"Ntrk1 (Neurotrophic Receptor Tyrosine Kinase 1) (Eg_ Solid Tumors) Translocation Analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQB1","description":"ICD-GGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Verify pt site pxd docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6100F","description":"Verify pt site pxd docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34702","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGF0","description":"ICD-CIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc bla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51999","description":"Laparoscope proc bla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18A","description":"Clinically Complex _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Semi-precision abutment - placement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6191","description":"Semi-precision abutment - placement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Change nephroureteral cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50387","description":"Change nephroureteral cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultralightweight wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0005","description":"Ultralightweight wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28A","description":"Special Care High _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44147","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ monaural_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5243","description":"Hearing aid_ monaural_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat thumb fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26650","description":"Treat thumb fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJF0","description":"ICD-FBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27266","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lockingelbow forearm cntrbal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6693","description":"Lockingelbow forearm cntrbal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX26","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX14","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Harvest femoropopliteal vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35572","description":"Harvest femoropopliteal vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOC0","description":"ICD-KGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIE0","description":"ICD-MJIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous arteriovenous fistula creation_ upper extremity_ separate access sites of the peripheral artery and peripheral vein_ including fistula maturation procedures (eg_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36837","description":"Percutaneous arteriovenous fistula creation_ upper extremity_ separate access sites of the peripheral artery and peripheral vein_ including fistula maturation procedures (eg_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hypertonic saline sol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7131","description":"Hypertonic saline sol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53215","description":"Removal of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUA1","description":"ICD-IHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rotary wing air transport","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0431","description":"Rotary wing air transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Histotripsy (i.e._ nonthermal ablation via acoustic energy delivery) of malignant renal tissue_ including image gu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9790","description":"Histotripsy (i.e._ nonthermal ablation via acoustic energy delivery) of malignant renal tissue_ including image gu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIF1","description":"ICD-ABIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHA0","description":"ICD-CFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat pelvic ring fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27217","description":"Treat pelvic ring fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB214","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABA1","description":"ICD-JABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAE1","description":"ICD-FFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJE1","description":"ICD-KDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JB31","description":"ICD-3JB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEB0","description":"ICD-FAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBD0","description":"ICD-IHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYA1","description":"ICD-LGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat thumb fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26665","description":"Treat thumb fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB2D","description":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc med reas no ann srn hcv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9384","description":"Doc med reas no ann srn hcv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL36","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Total hip resurfacing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2118","description":"Total hip resurfacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX40","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQA0","description":"ICD-OKQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Physician Or Other Qualified Health Care Professional Services For Outpatient Pulmonary Rehabilitation; Without Continuous Oximetry Monitoring (Per Session)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94625","description":"Physician Or Other Qualified Health Care Professional Services For Outpatient Pulmonary Rehabilitation; Without Continuous Oximetry Monitoring (Per Session)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICA0","description":"ICD-IICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8E","description":"Very High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap gastric bypass/roux-en-y","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43644","description":"Lap gastric bypass/roux-en-y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFC0","description":"ICD-BDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adjust wrist ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1805","description":"Adjust wrist ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILF0","description":"ICD-IILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHA1","description":"ICD-IFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4IC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IC11","description":"ICD-4IC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLA0","description":"ICD-NBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOA0","description":"ICD-KAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXA0","description":"ICD-FGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXE0","description":"ICD-CFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDD1","description":"ICD-NEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD25C","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBA0","description":"ICD-MCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLED1","description":"ICD-NLED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACC1","description":"ICD-NACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJA1","description":"ICD-NEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical social work mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0066","description":"Clinical social work mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GC31","description":"ICD-3GC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVA1","description":"ICD-BDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMA0","description":"ICD-AEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBA1","description":"ICD-GHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQC0","description":"ICD-KIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD25D","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHC1","description":"ICD-FFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pre-hypertensive or hypertensive blood pressure reading documented_ indicated follow-up not documented_ Patient not eligible/ not appropriate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8951","description":"Pre-hypertensive or hypertensive blood pressure reading documented_ indicated follow-up not documented_ Patient not eligible/ not appropriate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML5D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVB1","description":"ICD-GAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"VEKLURY - Injection_ remdesivir_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0248","description":"VEKLURY - Injection_ remdesivir_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Silicone gel sheet_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6025","description":"Silicone gel sheet_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDF1","description":"ICD-NFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUD1","description":"ICD-KGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sirolimus protein-bound particles_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9331","description":"Injection_ sirolimus protein-bound particles_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLB0","description":"ICD-GDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC206","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDE1","description":"ICD-KCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA15A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA25","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYE0","description":"ICD-PLYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Speech/hearing therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92507","description":"Speech/hearing therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGA1","description":"ICD-BIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCB1","description":"ICD-GCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDB0","description":"ICD-GEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54326","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHB1","description":"ICD-FCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJF1","description":"ICD-NHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCE1","description":"ICD-IHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8F","description":"Very High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQB0","description":"ICD-KCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYA1","description":"ICD-CHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMD1","description":"ICD-KEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHF1","description":"ICD-FAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33780","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCE1","description":"ICD-ECCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dis site tele svcs RHC/FQHC","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2025","description":"Dis site tele svcs RHC/FQHC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8F","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML4D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0538U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","description":"CPT-0538U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVB0","description":"ICD-FBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology_ chemotherapeutic drug cytotoxicity assay of cancer stem cells (CSCs)_ from cultured CSCs and primary tumor cells_ categorical drug response reported based on cytotox","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0435U","description":"Oncology_ chemotherapeutic drug cytotoxicity assay of cancer stem cells (CSCs)_ from cultured CSCs and primary tumor cells_ categorical drug response reported based on cytotox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAF1","description":"ICD-FFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of implant material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19330","description":"Removal of implant material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"FXN (frataxin) (eg_ Friedreich ataxia)_ gene analysis_ including small sequence changes in exonic and intronic regions_ deletions_ duplications_ short tandem repeat (STR) expa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0233U","description":"FXN (frataxin) (eg_ Friedreich ataxia)_ gene analysis_ including small sequence changes in exonic and intronic regions_ deletions_ duplications_ short tandem repeat (STR) expa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC105","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For Not On A Daily Aspirin Or Other Antiplatelet (E.G. History Of Gastrointestinal Bleed_ Intra-Cranial Bleed_ Blood Disorders_ Idiopathic T","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2128","description":"Documentation Of Medical Reason(S) For Not On A Daily Aspirin Or Other Antiplatelet (E.G. History Of Gastrointestinal Bleed_ Intra-Cranial Bleed_ Blood Disorders_ Idiopathic T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJD1","description":"ICD-GDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMB0","description":"ICD-IHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLA0","description":"ICD-ODLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQD0","description":"ICD-DIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE145","description":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIE0","description":"ICD-CEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICC1","description":"ICD-OICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGE0","description":"ICD-FGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nrv cndj tst 3-4 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95908","description":"Nrv cndj tst 3-4 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMD0","description":"ICD-OLMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18H","description":"Clinically Complex _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJF1","description":"ICD-JBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Limited (30 minutes) care plan oversight. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiaryā€™s home_ domiciliary_ rest home_ assi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2014","description":"Limited (30 minutes) care plan oversight. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiaryā€™s home_ domiciliary_ rest home_ assi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy aspiration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49322","description":"Laparoscopy aspiration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL05","description":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mattress innerspring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0271","description":"Mattress innerspring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD213","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert intracorporeal device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33979","description":"Insert intracorporeal device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Relieve inner eye pressure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65820","description":"Relieve inner eye pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFME1","description":"ICD-NFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTB1","description":"ICD-OBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQF0","description":"ICD-KEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOC0","description":"ICD-LDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open nasoethmoid fx w/o fixj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21338","description":"Open nasoethmoid fx w/o fixj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKF1","description":"ICD-BIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE205","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVD0","description":"ICD-FIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5272","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATB1","description":"ICD-FATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMB0","description":"ICD-BFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal allograft pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48556","description":"Removal allograft pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9192","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9192","description":"HCPCS-J9192","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML3B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29871","description":"Knee arthroscopy/drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMF0","description":"ICD-EFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSA1","description":"ICD-OBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87594","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","description":"CPT-87594","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"AJCC Breast Cancer Stage I: T1mic_ T1a or T1b (tumor size <= 1 cm) documented (ONC)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3372F","description":"AJCC Breast Cancer Stage I: T1mic_ T1a or T1b (tumor size <= 1 cm) documented (ONC)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUC1","description":"ICD-KGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMD0","description":"ICD-IFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/bx nodule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32608","description":"Thoracoscopy w/bx nodule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRC1","description":"ICD-HGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFB1","description":"ICD-NBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFD1","description":"ICD-CAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esoph fundoplasty thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43328","description":"Esoph fundoplasty thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTF0","description":"ICD-BCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; interpretation and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0557T","description":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; interpretation and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECA1","description":"ICD-JECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prepare donor heart/lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33933","description":"Prepare donor heart/lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEED0","description":"ICD-GEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMA1","description":"ICD-FAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGF0","description":"ICD-GEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwr seat combo w/o shear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1006","description":"Pwr seat combo w/o shear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUE1","description":"ICD-EDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC4C","description":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMF0","description":"ICD-AAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gammaplex injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1557","description":"Gammaplex injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSC1","description":"ICD-GHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUB0","description":"ICD-JCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28705","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUE0","description":"ICD-FDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDC0","description":"ICD-AHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23462","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRB1","description":"ICD-LDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant spine infusion pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62362","description":"Implant spine infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQA1","description":"ICD-PEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEA1","description":"ICD-OLEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31287","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIA1","description":"ICD-KFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rails bed side half length","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0305","description":"Rails bed side half length","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTA1","description":"ICD-CFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQD1","description":"ICD-CBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIF0","description":"ICD-KGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD14C","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUB0","description":"ICD-GGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8G","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQD0","description":"ICD-OKQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCA0","description":"ICD-OCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUC1","description":"ICD-MGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQF1","description":"ICD-PCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTF0","description":"ICD-MHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection_ percutaneous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50393","description":"Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection_ percutaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMD0","description":"ICD-NJMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00928","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00928","description":"CPT-00928","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAD0","description":"ICD-BDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUC0","description":"ICD-NAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aortic dysfunction/dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81411","description":"Aortic dysfunction/dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hgh risk for thromboembolism","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3552F","description":"Hgh risk for thromboembolism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8H","description":"Low Rehab_ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHD1","description":"ICD-EAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"H pylori (c-13) breath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83013","description":"H pylori (c-13) breath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision (eg_ augmentation_ division of tether)_ replacement_ or removal of thoracic vertebral body tethering_ including thoracoscopy_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22838","description":"Revision (eg_ augmentation_ division of tether)_ replacement_ or removal of thoracic vertebral body tethering_ including thoracoscopy_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC21C","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWF1","description":"ICD-KDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGD0","description":"ICD-OJGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient spent greater than or equal to three days in hospice care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9861","description":"Patient spent greater than or equal to three days in hospice care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Battery pneum vad replacemnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0503","description":"Battery pneum vad replacemnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHE1","description":"ICD-MIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHC0","description":"ICD-EIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infusion ther other than che","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0081","description":"Infusion ther other than che","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFD0","description":"ICD-CGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOC1","description":"ICD-KBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove&replace pm gen singl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33227","description":"Remove&replace pm gen singl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Toxoplasma antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86777","description":"Toxoplasma antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8G","description":"Medium Rehab _ ADL Index 0-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLA1","description":"ICD-ODLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB111","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHD1","description":"ICD-ECHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJF0","description":"ICD-GIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27715","description":"Revision of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9378","description":"Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lg vol nebulizer disposable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7007","description":"Lg vol nebulizer disposable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGA1","description":"ICD-NAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQA1","description":"ICD-DDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHA0","description":"ICD-GHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSF1","description":"ICD-OBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1HB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HB11","description":"ICD-1HB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBD0","description":"ICD-GHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIC0","description":"ICD-MLIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC15C","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18F","description":"Clinically Complex _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJB1","description":"ICD-NLJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22844","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ abdomen; 2 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74019","description":"Radiologic examination_ abdomen; 2 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Moderate (45 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ do","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0078","description":"Moderate (45 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ do","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES141","description":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Congo red blood test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P2029","description":"Congo red blood test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Betamethasone comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7624","description":"Betamethasone comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N block inj vagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64408","description":"N block inj vagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spkt/v greater than or equal to 1. 2 (single-pool clearance of urea [kt] / volume [v])","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8713","description":"Spkt/v greater than or equal to 1. 2 (single-pool clearance of urea [kt] / volume [v])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insulin most rapid 5 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5551","description":"Insulin most rapid 5 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILC0","description":"ICD-MILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neurectomy popliteal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27326","description":"Neurectomy popliteal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Most recent hemoglobin a1c level > 9.0%","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1211","description":"Most recent hemoglobin a1c level > 9.0%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00732","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00732","description":"CPT-00732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clean & inspect rem dent man","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9933","description":"Clean & inspect rem dent man","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIND0","description":"ICD-KIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIA1","description":"ICD-NKIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAB1","description":"ICD-KEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCE0","description":"ICD-KDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI)_ administered by a computer_ wi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96103","description":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI)_ administered by a computer_ wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADF0","description":"ICD-FADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE214","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB4B","description":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21243","description":"Reconstruction of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSF0","description":"ICD-HBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove collar bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23170","description":"Remove collar bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJC0","description":"ICD-CGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAF1","description":"ICD-KIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIE1","description":"ICD-KGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBD1","description":"ICD-BDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMF0","description":"ICD-OAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALB1","description":"ICD-CALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAE0","description":"ICD-NLAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECA1","description":"ICD-OECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQA0","description":"ICD-LBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVC0","description":"ICD-ODVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28E","description":"Special Care High _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Aim Specialty Health_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1007","description":"Clinical Decision Support Mechanism Aim Specialty Health_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAA0","description":"ICD-BGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0642T","description":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETA1","description":"ICD-CETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alerting device_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5269","description":"Alerting device_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLA0","description":"ICD-OCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Expose behav assessment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0362T","description":"Expose behav assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01180","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01180","description":"CPT-01180","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBE0","description":"ICD-OLBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Services performed by birth a doula birth workers_ per 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1032","description":"Services performed by birth a doula birth workers_ per 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMD0","description":"ICD-ODMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMD0","description":"ICD-BAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFE1","description":"ICD-GBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGD1","description":"ICD-GHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat metacarpal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26608","description":"Treat metacarpal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXC1","description":"ICD-KFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIB1","description":"ICD-BEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5275","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of kidney/ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50405","description":"Revision of kidney/ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No scr utr malig/us/samp rng","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9620","description":"No scr utr malig/us/samp rng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPC0","description":"ICD-FIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Isoproterenol non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7659","description":"Isoproterenol non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4397","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","description":"HCPCS-Q4397","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXD0","description":"ICD-GAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKA0","description":"ICD-BIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of neonatal thyroxine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84437","description":"Assay of neonatal thyroxine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA ENTAMOEBA HISTOLYTICA GRP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87337","description":"IAAD IA ENTAMOEBA HISTOLYTICA GRP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHD0","description":"ICD-BAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel dressing >48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6233","description":"Hydrogel dressing >48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28297","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGME0","description":"ICD-NGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB52","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRF1","description":"ICD-CBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMD0","description":"ICD-EDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALC1","description":"ICD-KALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA31","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFC1","description":"ICD-NFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYF0","description":"ICD-LCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pos airway pressure tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7037","description":"Pos airway pressure tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surg proc w/in 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8627","description":"Surg proc w/in 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTC0","description":"ICD-KDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC126","description":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILC1","description":"ICD-BILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDE1","description":"ICD-CFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYD0","description":"ICD-PCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chlamydia culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87110","description":"Chlamydia culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mod sedat phys/qhp ea 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99145","description":"Mod sedat phys/qhp ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFB1","description":"ICD-BBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"M.pneumon dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87581","description":"M.pneumon dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAF1","description":"ICD-GIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPF1","description":"ICD-BIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q9996","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","description":"HCPCS-Q9996","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with an active diagnosis or history of cancer (except basal cell and squamous cell skin carcinoma)_ patients who are h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1018","description":"Patients with an active diagnosis or history of cancer (except basal cell and squamous cell skin carcinoma)_ patients who are h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERF1","description":"ICD-PERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWD1","description":"ICD-PIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKB0","description":"ICD-NBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWC1","description":"ICD-CGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0702","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0702","description":"CDT-D0702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66630","description":"Removal of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCB1","description":"ICD-JFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Control of nosebleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30905","description":"Control of nosebleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALF0","description":"ICD-JALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA5C","description":"Default_ /PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Traditional healing service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0051","description":"Traditional healing service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOE1","description":"ICD-DBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol/subs interv 15-30mn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0396","description":"Alcohol/subs interv 15-30mn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interphalangeal joint repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8659","description":"Interphalangeal joint repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUD0","description":"ICD-GAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJD0","description":"ICD-OKJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNE0","description":"ICD-BDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90483","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","description":"CPT-90483","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0566","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","description":"HCPCS-G0566","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXA0","description":"ICD-CCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDND1","description":"ICD-BDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Forensic autopsy (necropsy)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88040","description":"Forensic autopsy (necropsy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJC1","description":"ICD-JDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No screening performed_ partial screening performed or positive screen without recommendations and reason is not given or otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9921","description":"No screening performed_ partial screening performed or positive screen without recommendations and reason is not given or otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Corneal topography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92025","description":"Corneal topography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYA1","description":"ICD-CEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAD1","description":"ICD-JBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJE0","description":"ICD-GCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mapcp demo physician","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9153","description":"Mapcp demo physician","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nebulizer not used w oxygen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7017","description":"Nebulizer not used w oxygen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUC0","description":"ICD-JEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision or removal of neurostimulator electrode array_ peripheral nerve_ with integrated neurostimulator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64598","description":"Revision or removal of neurostimulator electrode array_ peripheral nerve_ with integrated neurostimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ moxifloxacin (fresenius kabi) not therapeutically equivalent to j2280_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2281","description":"Injection_ moxifloxacin (fresenius kabi) not therapeutically equivalent to j2280_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53665","description":"Dilation of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLC0","description":"ICD-BGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test one fiber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95872","description":"Muscle test one fiber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXB0","description":"ICD-NAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Creation of subcutaneous pocket with insertion of 180 day implantable interstitial glucose sensor_ including system activation and patient training","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0308","description":"Creation of subcutaneous pocket with insertion of 180 day implantable interstitial glucose sensor_ including system activation and patient training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8H","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct thorax w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71250","description":"Ct thorax w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUB0","description":"ICD-CGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCC1","description":"ICD-CDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Caloric vestibular test_ each irrigation (binaural_ bithermalstimulation constitutes four tests)_ with recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92543","description":"Caloric vestibular test_ each irrigation (binaural_ bithermalstimulation constitutes four tests)_ with recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nsg aide service up to 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1004","description":"Nsg aide service up to 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous pulmonary artery revascularization by stent placement_ initial; abnormal connections_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33902","description":"Percutaneous pulmonary artery revascularization by stent placement_ initial; abnormal connections_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cover eye w/membrane suture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65779","description":"Cover eye w/membrane suture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg 3.1-4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11444","description":"Exc face-mm b9+marg 3.1-4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Back upholstery_ replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0982","description":"Back upholstery_ replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIB1","description":"ICD-MKIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVF1","description":"ICD-KBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2JB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JB31","description":"ICD-2JB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMF1","description":"ICD-EGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High activity knee frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5930","description":"High activity knee frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUE1","description":"ICD-OHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Community Transition Svcs (Security Deposit)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7334","description":"Community Transition Svcs (Security Deposit)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFE0","description":"ICD-CAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWB0","description":"ICD-GCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUF1","description":"ICD-OGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFD1","description":"ICD-KDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPA0","description":"ICD-CGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0567U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","description":"CPT-0567U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVB1","description":"ICD-JFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fit aphakia spectcl multifoc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92353","description":"Fit aphakia spectcl multifoc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDD0","description":"ICD-NDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr s/n/ax/gen/trk7.6-12.5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12004","description":"Rpr s/n/ax/gen/trk7.6-12.5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nebulizer ultrasonic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0575","description":"Nebulizer ultrasonic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWD0","description":"ICD-DHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBA0","description":"ICD-BFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPF0","description":"ICD-BEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Methylergonovin maleate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2210","description":"Methylergonovin maleate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66160","description":"Glaucoma surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKD1","description":"ICD-NBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tongue and neck surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41135","description":"Tongue and neck surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTB0","description":"ICD-GHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWA1","description":"ICD-CIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBB0","description":"ICD-MJBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alglucosidase alfa injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0220","description":"Alglucosidase alfa injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLE1","description":"ICD-FDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ copanlisib_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9030","description":"Injection_ copanlisib_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFC1","description":"ICD-GGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSF1","description":"ICD-OLSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGD1","description":"ICD-KBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA35","description":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCD0","description":"ICD-OFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ ep_ othr than cool-tip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1733","description":"Cath_ ep_ othr than cool-tip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"12-lead ecg performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3120F","description":"12-lead ecg performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0500","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEC0","description":"ICD-IEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCF0","description":"ICD-ABCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGE1","description":"ICD-BHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0504","description":"HCPCS-B0504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on eye; iridectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0121U","description":"Anesthesia for procedures on eye; iridectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIB1","description":"ICD-AFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIE0","description":"ICD-GFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUD0","description":"ICD-MBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"C/o for orthotic/prosth use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97762","description":"C/o for orthotic/prosth use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCE0","description":"ICD-OGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVF1","description":"ICD-OIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNF1","description":"ICD-GHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX26","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism (eg_ pharmacogenomics) genomic sequence analysis panel_ must include testing of at least 6 genes_ including CYP2C19_ CYP2D6_ and CYP2D6 duplication/deletion an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81418","description":"Drug metabolism (eg_ pharmacogenomics) genomic sequence analysis panel_ must include testing of at least 6 genes_ including CYP2C19_ CYP2D6_ and CYP2D6 duplication/deletion an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWD0","description":"ICD-HDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1GA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GA21","description":"ICD-1GA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLID0","description":"ICD-OLID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAD1","description":"ICD-OEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAED1","description":"ICD-MAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJME1","description":"ICD-NJME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMC0","description":"ICD-EIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYF1","description":"ICD-CIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iliac revasc w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37221","description":"Iliac revasc w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0614","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","description":"HCPCS-J0614","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amniotext patch_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4247","description":"Amniotext patch_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNF0","description":"ICD-BGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEA0","description":"ICD-ECEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQD0","description":"ICD-HIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision secondary cataract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66820","description":"Incision secondary cataract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUA1","description":"ICD-KGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNC0","description":"ICD-NBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQF1","description":"ICD-PGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAF0","description":"ICD-GCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWA0","description":"ICD-PEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTE0","description":"ICD-OBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYD1","description":"ICD-OLYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABF0","description":"ICD-FABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEA0","description":"ICD-KFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"General Inpatient Care - A flat per diem rates before area wage adjustment for inpatient acute care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0605","description":"General Inpatient Care - A flat per diem rates before area wage adjustment for inpatient acute care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Solid Organ Neoplasm)_ Targeted Genomic Sequence Dna Analysis Of 505 Genes_ Interrogation For Somatic Alterations (Snvs [Single Nucleotide Variant]_ Small Insertions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0250U","description":"Oncology (Solid Organ Neoplasm)_ Targeted Genomic Sequence Dna Analysis Of 505 Genes_ Interrogation For Somatic Alterations (Snvs [Single Nucleotide Variant]_ Small Insertions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDID0","description":"ICD-EDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTD1","description":"ICD-ADTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEB0","description":"ICD-BFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUF0","description":"ICD-GGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Take-Home Supply Of Methadone; Up To 7 Additional Day Supply (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Addition To Code F","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2078","description":"Take-Home Supply Of Methadone; Up To 7 Additional Day Supply (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Addition To Code F","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKB0","description":"ICD-NJKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPB0","description":"ICD-KFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSC1","description":"ICD-HGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES154","description":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Separate eyelid adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68340","description":"Separate eyelid adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHA1","description":"ICD-NLHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eeg monitoring/giving drugs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95954","description":"Eeg monitoring/giving drugs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGC1","description":"ICD-OKGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE22D","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDME0","description":"ICD-IDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8C","description":"Medium Rehab _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUC0","description":"ICD-FBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWB1","description":"ICD-KEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDA1","description":"ICD-EGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQC0","description":"ICD-HCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Albumin (human)_ 5%_ 250 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9045","description":"Albumin (human)_ 5%_ 250 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHF0","description":"ICD-CEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOB1","description":"ICD-KAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anterior thoracic vertebral body tethering_ including thoracoscopy_ when performed; 8 or more vertebral segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22837","description":"Anterior thoracic vertebral body tethering_ including thoracoscopy_ when performed; 8 or more vertebral segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLF0","description":"ICD-GHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Platelet survival kinetics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78190","description":"Platelet survival kinetics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL40","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLE1","description":"ICD-CGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JC31","description":"ICD-4JC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pos airway press chinstrap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7036","description":"Pos airway press chinstrap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUE0","description":"ICD-OHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAC0","description":"ICD-OCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIA0","description":"ICD-MGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQA1","description":"ICD-GEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Panitumumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9303","description":"Panitumumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2IC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IC11","description":"ICD-2IC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDA0","description":"ICD-KFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFA1","description":"ICD-FIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Asthma discharge plan presnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5250F","description":"Asthma discharge plan presnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPD0","description":"ICD-GBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLC1","description":"ICD-MBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMF0","description":"ICD-OLMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYF0","description":"ICD-DCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of natriuretic peptide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83880","description":"Assay of natriuretic peptide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment x10sv retinopathy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67228","description":"Treatment x10sv retinopathy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ht inj anticoag diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9372","description":"Ht inj anticoag diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETD0","description":"ICD-KETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair carpal bone shorten","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25394","description":"Repair carpal bone shorten","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCA0","description":"ICD-KHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYC0","description":"ICD-OGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Internal eye photography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92286","description":"Internal eye photography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC10D","description":"Clinically Complex _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNE1","description":"ICD-CDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC3B","description":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAC0","description":"ICD-JEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHF1","description":"ICD-MHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC110","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4389","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","description":"HCPCS-Q4389","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFE1","description":"ICD-JFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sp bone agrft local add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20936","description":"Sp bone agrft local add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIA0","description":"ICD-BBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of thigh tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27306","description":"Incision of thigh tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOB1","description":"ICD-GEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBE0","description":"ICD-OFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Haloperidol decanoate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1631","description":"Haloperidol decanoate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stent placemt ante carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37218","description":"Stent placemt ante carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient achieved a PDC of at least 75% for their asthma controller medication","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9810","description":"Patient achieved a PDC of at least 75% for their asthma controller medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDF1","description":"ICD-BFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGE0","description":"ICD-GBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; implantable monitor only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0532T","description":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; implantable monitor only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace g-j tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49452","description":"Replace g-j tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIED0","description":"ICD-EIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJE0","description":"ICD-BAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVB0","description":"ICD-JCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTE0","description":"ICD-AHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAE1","description":"ICD-ADAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOC0","description":"ICD-CIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEA0","description":"ICD-BIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise hip joint replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27138","description":"Revise hip joint replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDD0","description":"ICD-KFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQD1","description":"ICD-HDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBB0","description":"ICD-AEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of urethra lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53230","description":"Removal of urethra lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACC0","description":"ICD-MACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJE1","description":"ICD-JBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBID1","description":"ICD-CBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASB0","description":"ICD-LASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLA0","description":"ICD-MFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit noc per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9379","description":"Hit noc per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67917","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOC0","description":"ICD-KBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDC1","description":"ICD-JIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWE1","description":"ICD-OJWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIA1","description":"ICD-BEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28296","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of spinal fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22830","description":"Exploration of spinal fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPA1","description":"ICD-GAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWD0","description":"ICD-PCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHE0","description":"ICD-IFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIA0","description":"ICD-NAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVF0","description":"ICD-CBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKD0","description":"ICD-OFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thromboxane urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84431","description":"Thromboxane urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTE1","description":"ICD-GDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Arthroereisis_ subtalar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2117","description":"Arthroereisis_ subtalar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDC1","description":"ICD-AIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC55","description":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis training incompl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90993","description":"Dialysis training incompl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD134","description":"Special Care Low _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N block inj axillary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64417","description":"N block inj axillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHA0","description":"ICD-FAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Xe133 xenon 10mci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9558","description":"Xe133 xenon 10mci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATC0","description":"ICD-IATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41823","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCA1","description":"ICD-FFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng leg splnt plstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4041","description":"Cast sup lng leg splnt plstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2041","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","description":"HCPCS-A2041","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUB1","description":"ICD-MEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINA0","description":"ICD-FINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBC1","description":"ICD-KHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIA0","description":"ICD-EDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat tail bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27200","description":"Treat tail bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kafo fem fx cast semi-rigid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2134","description":"Kafo fem fx cast semi-rigid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01656","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01656","description":"CPT-01656","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTD1","description":"ICD-MGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Culture othr specimn aerobic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87070","description":"Culture othr specimn aerobic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Levonorgestrel-releasing intrauterine contraceptive system_ (Kyleena)_ 19.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7296","description":"Levonorgestrel-releasing intrauterine contraceptive system_ (Kyleena)_ 19.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMA0","description":"ICD-GFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIME1","description":"ICD-EIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFE1","description":"ICD-NJFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARB1","description":"ICD-KARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJF1","description":"ICD-KAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKC0","description":"ICD-CEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB12B","description":"Clinically Complex _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18I","description":"Special Care Low _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inject skin lesions 0.5 cm but <= 1 cm in greatest dimension) documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9705","description":"AJCC breast cancer stage I: T1b (tumor > 0.5 cm but <= 1 cm in greatest dimension) documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70260","description":"X-ray exam of skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fall plan of care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0518F","description":"Fall plan of care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECF1","description":"ICD-KECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Zinc paste band w >=3in<5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6456","description":"Zinc paste band w >=3in<5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Guided tissue regeneration","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3432","description":"Guided tissue regeneration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLB1","description":"ICD-MDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIF0","description":"ICD-GCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJC0","description":"ICD-FDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPC0","description":"ICD-FFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Multiaxial ankle w dorsiflex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5968","description":"Multiaxial ankle w dorsiflex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLB0","description":"ICD-OHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKC1","description":"ICD-JAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEC1","description":"ICD-MDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.25-7/4.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2209","description":"Lens sphcy bifocal 4.25-7/4.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITE1","description":"ICD-CITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDE1","description":"ICD-ECDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMB1","description":"ICD-IFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJF0","description":"ICD-ODJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of leg at hip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27295","description":"Amputation of leg at hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduction of skull defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62117","description":"Reduction of skull defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXD0","description":"ICD-GDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSF1","description":"ICD-LDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUE0","description":"ICD-FGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 std cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0823","description":"Pwc gp 2 std cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ob us detailed sngl fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76811","description":"Ob us detailed sngl fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFF0","description":"ICD-OIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL16","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDA1","description":"ICD-EBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-programble infusion pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0782","description":"Non-programble infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCA0","description":"ICD-OBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEED1","description":"ICD-JEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVF1","description":"ICD-NFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQD1","description":"ICD-HFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDF0","description":"ICD-BGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLC0","description":"ICD-FFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc medrsn no histo type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9282","description":"Doc medrsn no histo type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee orthosis (KO)_ single upright_ thigh and calf_ with adjustable flexion and extension joint (unicentric or polycentric)_ medial-lateral and rotation control_ with or witho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1851","description":"Knee orthosis (KO)_ single upright_ thigh and calf_ with adjustable flexion and extension joint (unicentric or polycentric)_ medial-lateral and rotation control_ with or witho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming; battery component only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0862T","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming; battery component only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4355","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","description":"HCPCS-Q4355","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYF1","description":"ICD-OCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEA1","description":"ICD-KAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMC1","description":"ICD-IDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDE1","description":"ICD-FBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHE0","description":"ICD-NKHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJF0","description":"ICD-NFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB120","description":"Reduced Physical Function _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFA0","description":"ICD-ODFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28A","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prefabricated abutment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6056","description":"Prefabricated abutment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of rbc pg6d enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84085","description":"Assay of rbc pg6d enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylinder 4.25d/12-2d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2107","description":"Spherocylinder 4.25d/12-2d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD22B","description":"Reduced Physical Function _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTB1","description":"ICD-MHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUA1","description":"ICD-OCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB251","description":"Special Care Low _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wound srfc culturetech used","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4260F","description":"Wound srfc culturetech used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVF1","description":"ICD-FGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPC1","description":"ICD-GHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPA1","description":"ICD-NKPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSA1","description":"ICD-KHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIE1","description":"ICD-KFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18H","description":"Special Care High _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/band ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45398","description":"Colonoscopy w/band ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUF1","description":"ICD-NKUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXE0","description":"ICD-FBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVE0","description":"ICD-BIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAE0","description":"ICD-NKAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5909","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5909","description":"CDT-D5909","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elevat legrst low extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0046","description":"Elevat legrst low extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDC0","description":"ICD-JCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNB1","description":"ICD-JDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMB1","description":"ICD-CAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice care supervision","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0182","description":"Hospice care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE23B","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB234","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8E","description":"High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ortho dvc repair per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4205","description":"Ortho dvc repair per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1CC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CC11","description":"ICD-1CC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGF1","description":"ICD-GDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pd mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8762","description":"Pd mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Post-coital mucous exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0115","description":"Post-coital mucous exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Npm1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81310","description":"Npm1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSE0","description":"ICD-OGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55821","description":"Removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/endoscope us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45391","description":"Colonoscopy w/endoscope us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJE0","description":"ICD-BHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPE0","description":"ICD-FIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPE0","description":"ICD-JFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78599","description":"Respiratory nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRA0","description":"ICD-KHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ballistocardiogram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3902","description":"Ballistocardiogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVF1","description":"ICD-JHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAD0","description":"ICD-KEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD20B","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hip canad sing axi cons fric","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5250","description":"Hip canad sing axi cons fric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPF0","description":"ICD-OJPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Frozen blood freeze/thaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86932","description":"Frozen blood freeze/thaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBB1","description":"ICD-BBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVF0","description":"ICD-OAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYD1","description":"ICD-PLYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25800","description":"Fusion of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNB1","description":"ICD-NGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITD1","description":"ICD-FITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flowcytometry/read 2-8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88187","description":"Flowcytometry/read 2-8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFME1","description":"ICD-KFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rigidlined cust fab two","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0486","description":"Tlso rigidlined cust fab two","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1801","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1801","description":"CDT-D1801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay clozapine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80159","description":"Drug assay clozapine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSC0","description":"ICD-LHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBE1","description":"ICD-JFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOA1","description":"ICD-PFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"C-reactive protein hs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86141","description":"C-reactive protein hs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRC1","description":"ICD-KHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBB0","description":"ICD-JDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWD1","description":"ICD-KDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking waistlngth 40-50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6541","description":"Gc stocking waistlngth 40-50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAC0","description":"ICD-CIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hep b core antibody igm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86705","description":"Hep b core antibody igm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKE0","description":"ICD-OJKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flexion/extension wrist unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6620","description":"Flexion/extension wrist unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Afo multilig ank sup pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1906","description":"Afo multilig ank sup pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBF0","description":"ICD-MLBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt talk psychsoc&rx oh dpnd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4320F","description":"Pt talk psychsoc&rx oh dpnd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leg/ankle surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27899","description":"Leg/ankle surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXF0","description":"ICD-FAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABD0","description":"ICD-CABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTC1","description":"ICD-MBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dna/rna amplified probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87150","description":"Dna/rna amplified probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQA1","description":"ICD-PDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLB0","description":"ICD-MKLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC210","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amnion bio or Axobiomembrane_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4211","description":"Amnion bio or Axobiomembrane_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93016","description":"Cardiovascular stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOB1","description":"ICD-LIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIC0","description":"ICD-OFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANA1","description":"ICD-BANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDB0","description":"ICD-OHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD10D","description":"Special Care Low _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8X","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAD1","description":"ICD-BCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEB0","description":"ICD-BAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lengthening of thigh tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27393","description":"Lengthening of thigh tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of inner eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66770","description":"Removal of inner eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Embolization endpoints are not documented separately for each embolized vessel or ovarian artery angiography or embolization not performed in the presence of variant uterine a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9963","description":"Embolization endpoints are not documented separately for each embolized vessel or ovarian artery angiography or embolization not performed in the presence of variant uterine a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ivig demo_ services/supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2052","description":"Ivig demo_ services/supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of leg epiphyses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27740","description":"Repair of leg epiphyses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic control pelvic sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2580","description":"Pelvic control pelvic sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDC0","description":"ICD-IGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCB0","description":"ICD-NFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC12B","description":"Special Care Low _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIE0","description":"ICD-BDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Post chmbr intraocular lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2632","description":"Post chmbr intraocular lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Renal biopsy perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50200","description":"Renal biopsy perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIB0","description":"ICD-KGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Tedizolid Phosphate_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9446","description":"Injection_ Tedizolid Phosphate_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIC0","description":"ICD-GHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWF1","description":"ICD-GGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endo poly hip_ pneu/hyd/rot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5961","description":"Endo poly hip_ pneu/hyd/rot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSA0","description":"ICD-HBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIF1","description":"ICD-AIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Division of fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58605","description":"Division of fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE10B","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA20","description":"Medium Rehab _ ADL Index 0-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDC1","description":"ICD-ECDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAB1","description":"ICD-ECAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0506","description":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSE0","description":"ICD-OHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACA1","description":"ICD-EACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWC0","description":"ICD-PFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEB1","description":"ICD-NCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACB1","description":"ICD-KACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXB0","description":"ICD-NCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRB0","description":"ICD-LCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGC1","description":"ICD-KAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of finger/thumb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26951","description":"Amputation of finger/thumb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBED1","description":"ICD-OBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIE0","description":"ICD-OHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIF1","description":"ICD-JBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGA0","description":"ICD-CEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Close mult vsd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33675","description":"Close mult vsd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKA1","description":"ICD-KHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous vertebral augmentations_ first lumbar and any additional thoracic or lumbar vertebral bodies_ including cavity creations (fracture reductions and bone biopsies in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7508","description":"Percutaneous vertebral augmentations_ first lumbar and any additional thoracic or lumbar vertebral bodies_ including cavity creations (fracture reductions and bone biopsies in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCC0","description":"ICD-MJCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMC1","description":"ICD-JAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKB1","description":"ICD-OCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth tympanotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12651","description":"Anesth tympanotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUC0","description":"ICD-KGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA20A","description":"Clinically Complex _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMF1","description":"ICD-ABMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Human ig im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90281","description":"Human ig im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove aorta constriction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33840","description":"Remove aorta constriction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOA1","description":"ICD-GFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVC1","description":"ICD-JAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new 180 day implantable sensor_ including s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0309","description":"Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new 180 day implantable sensor_ including s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2711","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","description":"HCPCS-J2711","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEME0","description":"ICD-FEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIA1","description":"ICD-AIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPB0","description":"ICD-OJPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77402","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain bl w/cath insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51102","description":"Drain bl w/cath insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRA0","description":"ICD-HFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIF0","description":"ICD-AGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adult size brief/diaper xl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4524","description":"Adult size brief/diaper xl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo guidance radiotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6001","description":"Echo guidance radiotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt not rcvng warf thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4301F","description":"Pt not rcvng warf thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXE1","description":"ICD-KCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBE0","description":"ICD-EEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo examination procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76999","description":"Echo examination procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHB1","description":"ICD-MJHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUA1","description":"ICD-FFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28A","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient Not Referred_ Reason Not Otherwise Specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0039","description":"Patient Not Referred_ Reason Not Otherwise Specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQC0","description":"ICD-LHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHB1","description":"ICD-AHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"In111 capromab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9507","description":"In111 capromab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of urethra defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53275","description":"Repair of urethra defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE255","description":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEF1","description":"ICD-KEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSE1","description":"ICD-KBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBD0","description":"ICD-NDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUE1","description":"ICD-IEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB11","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9816","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9816","description":"HCPCS-C9816","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tonsils","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42826","description":"Removal of tonsils","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49000","description":"Exploration of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fats/lipids feces quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82710","description":"Fats/lipids feces quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Opioids & opiate analogs 1/2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80362","description":"Opioids & opiate analogs 1/2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15953","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00172","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00172","description":"CPT-00172","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30420","description":"Reconstruction of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTB0","description":"ICD-BBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHE0","description":"ICD-EEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise lesion testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54512","description":"Excise lesion testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61606","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood typing paternity test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86910","description":"Blood typing paternity test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote evaluation of recorded video and/or images submitted by an established patient (e.g._ store and forward)_ including inte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2010","description":"Remote evaluation of recorded video and/or images submitted by an established patient (e.g._ store and forward)_ including inte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABB1","description":"ICD-KABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interface_ cough stim device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7020","description":"Interface_ cough stim device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 hd sing pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0838","description":"Pwc gp 2 hd sing pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE154","description":"Special Care High _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00844","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00844","description":"CPT-00844","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOD1","description":"ICD-HEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML46","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUA0","description":"ICD-OKUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKC0","description":"ICD-KBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01320","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01320","description":"CPT-01320","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWE1","description":"ICD-LCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28H","description":"Special Care High _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Service Coordination**","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1011","description":"Service Coordination**","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecg/monitoring and analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93271","description":"Ecg/monitoring and analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRE0","description":"ICD-KFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection for bladder x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51600","description":"Injection for bladder x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ctlso axilla sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1010","description":"Ctlso axilla sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0993T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","description":"CPT-0993T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Periradicular surgery","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3427","description":"Periradicular surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI fetal sngl/1st gestation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74712","description":"MRI fetal sngl/1st gestation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPE1","description":"ICD-JGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Complex body section x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76101","description":"Complex body section x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"W/c dpth 20-21 in seat frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2342","description":"W/c dpth 20-21 in seat frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fertility cycle (contraception & conception) tracking software application_ fda cleared_ per month_ includes accessories (e.g._ thermometer)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9293","description":"Fertility cycle (contraception & conception) tracking software application_ fda cleared_ per month_ includes accessories (e.g._ thermometer)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC14B","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Med reminder serv per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5185","description":"Med reminder serv per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","description":"HCPCS-M1503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX06","description":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARB1","description":"ICD-CARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEF1","description":"ICD-BFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of leg vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37780","description":"Revision of leg vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEA0","description":"ICD-BEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert hepatic shunt (tips)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37182","description":"Insert hepatic shunt (tips)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abdomen surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22999","description":"Abdomen surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGB0","description":"ICD-BIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Absorp drg >16<=48 suc pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0745","description":"Absorp drg >16<=48 suc pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGF0","description":"ICD-CEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01160","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01160","description":"CPT-01160","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16370","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16370","description":"CPT-16370","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQA0","description":"ICD-PKQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMC0","description":"ICD-MHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28C","description":"Special Care Low _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ genital region_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6571","description":"Gradient compression garment_ genital region_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove/replace ur sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53447","description":"Remove/replace ur sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ped critical care initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99471","description":"Ped critical care initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCC1","description":"ICD-FFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BB11","description":"ICD-2BB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft aortoiliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35537","description":"Art byp grft aortoiliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPF1","description":"ICD-FBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal application device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7034","description":"Nasal application device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","description":"HCPCS-M1403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSE0","description":"ICD-OFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVA0","description":"ICD-GDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD20D","description":"Special Care Low _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lso sagit rigid panel prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0635","description":"Lso sagit rigid panel prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls repos perph cnula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33958","description":"Ecmo/ecls repos perph cnula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCD1","description":"ICD-ICCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRB1","description":"ICD-OIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB23A","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOC1","description":"ICD-LHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perfluoroalkyl substances (PFAS) (eg_ perfluorooctanoic acid_ perfluorooctane sulfonic acid)_ 16 PFAS compounds by liquid chromatography with tandem mass spectrometry (LC-MS/M","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0394U","description":"Perfluoroalkyl substances (PFAS) (eg_ perfluorooctanoic acid_ perfluorooctane sulfonic acid)_ 16 PFAS compounds by liquid chromatography with tandem mass spectrometry (LC-MS/M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGA1","description":"ICD-FDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score ls >= 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8659","description":"Fun stat score ls >= 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cephalothin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1890","description":"Cephalothin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVE0","description":"ICD-CDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Njx paravert w/us cer/thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0213T","description":"Njx paravert w/us cer/thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of hand or foot nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64834","description":"Repair of hand or foot nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIA1","description":"ICD-EGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHD1","description":"ICD-MBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2030","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","description":"HCPCS-A2030","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lengthening of hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26478","description":"Lengthening of hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert needle bone cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36680","description":"Insert needle bone cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSC0","description":"ICD-OBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEF1","description":"ICD-KBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hf measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8548","description":"Hf measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Placement bile duct support","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47801","description":"Placement bile duct support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Combo ankle/foot prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5975","description":"Combo ankle/foot prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCE1","description":"ICD-NKCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"BioNextPATCH_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4228","description":"BioNextPATCH_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL3B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYB0","description":"ICD-DBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; Without Contrast Material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0633T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; Without Contrast Material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAF0","description":"ICD-MDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test 2 limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95861","description":"Muscle test 2 limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGF0","description":"ICD-JGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJA1","description":"ICD-GDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1829","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","description":"HCPCS-E1829","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX31","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy for foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44390","description":"Colonoscopy for foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMF1","description":"ICD-OCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLB0","description":"ICD-NCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Androstanediol glucuronide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82154","description":"Androstanediol glucuronide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCF1","description":"ICD-EDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel dsg<=16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6231","description":"Hydrogel dsg<=16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJE0","description":"ICD-NEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9054","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","description":"HCPCS-J9054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45500","description":"Repair of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ loncastuximab tesirine-lpyl_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9084","description":"Injection_ loncastuximab tesirine-lpyl_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj aripiprazole ext rel 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0401","description":"Inj aripiprazole ext rel 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKC0","description":"ICD-NDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKD0","description":"ICD-FDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHC1","description":"ICD-IHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE10C","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOE0","description":"ICD-OJOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl perph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33965","description":"Ecmo/ecls rmvl perph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUC1","description":"ICD-AFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inject l ventr/atrial angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93565","description":"Inject l ventr/atrial angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFC1","description":"ICD-FIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALD1","description":"ICD-IALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0169","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","description":"HCPCS-J0169","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient Already Receiving Physical/Occupational/Speech/Recreational Therapy During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0040","description":"Patient Already Receiving Physical/Occupational/Speech/Recreational Therapy During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (pemfexy)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9304","description":"Injection_ pemetrexed (pemfexy)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXE0","description":"ICD-NEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMA0","description":"ICD-NKMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA24","description":"Very High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull for surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61450","description":"Incise skull for surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWC1","description":"ICD-HFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary rehab w exer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0424","description":"Pulmonary rehab w exer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCC0","description":"ICD-JCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2GC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GC11","description":"ICD-2GC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPF1","description":"ICD-KAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suction lipectomy upr extrem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15878","description":"Suction lipectomy upr extrem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERD0","description":"ICD-DERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD215","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETF0","description":"ICD-AETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33984","description":"Ecmo/ecls rmvl prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient lift electric","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0635","description":"Patient lift electric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Space maintainer_ removable bilateral_ maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1526","description":"Space maintainer_ removable bilateral_ maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Th/wght bear nar m-l brim cu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2526","description":"Th/wght bear nar m-l brim cu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Set radiation therapy field","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77280","description":"Set radiation therapy field","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Creation of arteriovenous fistula_ percutaneous; direct_ any site_ including all imaging and radiologic supervision and interpr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9754","description":"Creation of arteriovenous fistula_ percutaneous; direct_ any site_ including all imaging and radiologic supervision and interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFB0","description":"ICD-GEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bath/shower chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0240","description":"Bath/shower chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABC1","description":"ICD-EABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA35","description":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTF1","description":"ICD-BCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCF1","description":"ICD-KHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAB0","description":"ICD-NDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFD1","description":"ICD-FBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auditor evoke potent limit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92586","description":"Auditor evoke potent limit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEF0","description":"ICD-NLEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAC0","description":"ICD-GBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHF1","description":"ICD-EEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear rx iv admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79101","description":"Nuclear rx iv admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dyphylline injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1180","description":"Dyphylline injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 16 gene report_ with variant analysis and reported phenotypes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0347U","description":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 16 gene report_ with variant analysis and reported phenotypes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D6196","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D6196","description":"CDT-D6196","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inner ear surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69949","description":"Inner ear surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFF1","description":"ICD-KHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chylmd trach dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87491","description":"Chylmd trach dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Endoscopic Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0616","description":"Hospital Special Treatment Room Support Component (Hstrsc) Endoscopic Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAA0","description":"ICD-NFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXB1","description":"ICD-OGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPC0","description":"ICD-BAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Postop app non-wgt bear dsg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5460","description":"Postop app non-wgt bear dsg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOB1","description":"ICD-HBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ATXN1 (ataxin 1) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81178","description":"ATXN1 (ataxin 1) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIB1","description":"ICD-FEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputate leg at thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27592","description":"Amputate leg at thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBF1","description":"ICD-JDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glycosylated hemoglobin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83036","description":"Glycosylated hemoglobin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive testis surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54535","description":"Extensive testis surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXD0","description":"ICD-BCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDE1","description":"ICD-IEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKC0","description":"ICD-KAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGA0","description":"ICD-OAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTD1","description":"ICD-OFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHA0","description":"ICD-GAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGA1","description":"ICD-FGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAB0","description":"ICD-KHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24560","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWD0","description":"ICD-GAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKE0","description":"ICD-KHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNA0","description":"ICD-OCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vascular Surgery Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4038","description":"Vascular Surgery Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Retreat root canal molar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3348","description":"Retreat root canal molar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIB1","description":"ICD-FFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA12","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAF1","description":"ICD-NDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vis item/svc in other code","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2797","description":"Vis item/svc in other code","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGC0","description":"ICD-BFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFC1","description":"ICD-OIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98006","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","description":"CPT-98006","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No interv req for leak","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9305","description":"No interv req for leak","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNE1","description":"ICD-BCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNB1","description":"ICD-JHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of middle ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70134","description":"X-ray exam of middle ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERB1","description":"ICD-KERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac MRI for morph w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75561","description":"Cardiac MRI for morph w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWF0","description":"ICD-LBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHE1","description":"ICD-KFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESA0","description":"ICD-LESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57530","description":"Removal of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote assessment of recorded video and/or images submitted by an established patient (e.g._ store and forward)_ including interpretation with follow-up with the patient withi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2250","description":"Remote assessment of recorded video and/or images submitted by an established patient (e.g._ store and forward)_ including interpretation with follow-up with the patient withi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEF1","description":"ICD-OIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJB0","description":"ICD-KIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Myelography lumbar injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62302","description":"Myelography lumbar injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDD1","description":"ICD-JBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cryo embryo transf case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4037","description":"Cryo embryo transf case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAB0","description":"ICD-AAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"3-d radiotherapy plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77295","description":"3-d radiotherapy plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAC0","description":"ICD-AEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX16","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXA1","description":"ICD-CBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX4A","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEB0","description":"ICD-KIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA114","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAE1","description":"ICD-AHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISA1","description":"ICD-DISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVC1","description":"ICD-KCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWC0","description":"ICD-OCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHD1","description":"ICD-MFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1102","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1102","description":"CDT-D1102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMB1","description":"ICD-AEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFE0","description":"ICD-BFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOA1","description":"ICD-OCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Accessories for patient inserted indwelling intraurethral drainage device with valve_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4342","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53010","description":"Incision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRE0","description":"ICD-KDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEF1","description":"ICD-MAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Conn tiss_ human(inc fascia)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1762","description":"Conn tiss_ human(inc fascia)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIB1","description":"ICD-BBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB245","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXC1","description":"ICD-FGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prolotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0076","description":"Prolotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cvd risk assessment performed_ have a documented calculated risk score","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1258","description":"Cvd risk assessment performed_ have a documented calculated risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rabies ig heat treated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90376","description":"Rabies ig heat treated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNA0","description":"ICD-KHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVA1","description":"ICD-NGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLA0","description":"ICD-MDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE23A","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61510","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWE1","description":"ICD-PLWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGA1","description":"ICD-CHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXF0","description":"ICD-GAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.25-7/2.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2208","description":"Lens sphcy bifocal 4.25-7/2.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB54","description":"High Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSA1","description":"ICD-DFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Complete phys skin exam done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2029F","description":"Complete phys skin exam done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAE1","description":"ICD-MCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65130","description":"Insert ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIF1","description":"ICD-ACIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of blood fatty acids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82725","description":"Assay of blood fatty acids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transpl allograft pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48554","description":"Transpl allograft pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABE1","description":"ICD-IABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mh partial hosp tx under 24h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0035","description":"Mh partial hosp tx under 24h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9725","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Each additional cervical vertebral body (list separately in addition to code for primary procedure)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2361","description":"Each additional cervical vertebral body (list separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASA0","description":"ICD-DASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason for not receiving at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively (e.g._ i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9776","description":"Documentation of medical reason for not receiving at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively (e.g._ i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Procainamide hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2690","description":"Procainamide hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIE0","description":"ICD-MFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB21","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Upr/lxtr art stdy 3+ lvls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93923","description":"Upr/lxtr art stdy 3+ lvls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDD0","description":"ICD-OCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPE1","description":"ICD-NGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPC0","description":"ICD-KFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKC0","description":"ICD-KCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBF0","description":"ICD-GGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection Factor IX_ (antihemophilic factor_ recombinant)_ glycopegylated_ (Rebinyn)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7203","description":"Injection Factor IX_ (antihemophilic factor_ recombinant)_ glycopegylated_ (Rebinyn)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAD1","description":"ICD-NLAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insj/rplc car modulj vnt elt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0411T","description":"Insj/rplc car modulj vnt elt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mr spectroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76390","description":"Mr spectroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Imterprete diagnostic image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0391","description":"Imterprete diagnostic image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth for liver biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70251","description":"Anesth for liver biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1412","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","description":"HCPCS-M1412","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERA0","description":"ICD-GERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27705","description":"Incision of tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pres/absn urine incon assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1090F","description":"Pres/absn urine incon assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLF0","description":"ICD-MCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 120 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0150U","description":"Drug assay_ definitive_ 120 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47135","description":"Transplantation of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACC1","description":"ICD-CACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOF0","description":"ICD-PDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of pelvis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26990","description":"Drainage of pelvis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCD0","description":"ICD-BCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB3A","description":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ vasopressin (american regent) not therapeutically equivalent to j2598_ 1 unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2599","description":"Injection_ vasopressin (american regent) not therapeutically equivalent to j2598_ 1 unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBF1","description":"ICD-BCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX11","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXF0","description":"ICD-GFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALC0","description":"ICD-CALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXA1","description":"ICD-GAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSA0","description":"ICD-HHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dextroamphetamine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0160","description":"Dextroamphetamine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA214","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bed board","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0273","description":"Bed board","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol hepatic fream","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B5200","description":"Parenteral sol hepatic fream","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mitomycin pyelocalyceal instillation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9064","description":"Mitomycin pyelocalyceal instillation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYC0","description":"ICD-LIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acetylcholine receptor (AChR); modulating antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86043","description":"Acetylcholine receptor (AChR); modulating antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVB0","description":"ICD-KDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4438","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of hip cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29305","description":"Application of hip cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFND0","description":"ICD-FFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA2D","description":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUD1","description":"ICD-FGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25355","description":"Revision of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNC1","description":"ICD-OGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCC0","description":"ICD-MBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical opening esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43352","description":"Surgical opening esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMA0","description":"ICD-NLMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4385","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","description":"HCPCS-Q4385","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Perfusion Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed); Multiple Studies At","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78431","description":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Perfusion Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed); Multiple Studies At","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vagina lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57135","description":"Remove vagina lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWA0","description":"ICD-HEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Allergy patch tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95044","description":"Allergy patch tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAA0","description":"ICD-BHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACE0","description":"ICD-NACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01120","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01120","description":"CPT-01120","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mtms by pharm np 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99605","description":"Mtms by pharm np 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPB1","description":"ICD-JAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Change of ureter tube/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50688","description":"Change of ureter tube/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Eac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95720","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Eac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transperi needle place pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55875","description":"Transperi needle place pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSB0","description":"ICD-HGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWA0","description":"ICD-HAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEF1","description":"ICD-BBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCD0","description":"ICD-JHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Professional services_ initial visit_ for the administration of subcutaneous immunotherapy or other subcutaneous infusion drug or biological for each infusion drug administrat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0089","description":"Professional services_ initial visit_ for the administration of subcutaneous immunotherapy or other subcutaneous infusion drug or biological for each infusion drug administrat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMC0","description":"ICD-BDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX25","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX0D","description":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96132","description":"Neuropsychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegcetacoplan_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9151","description":"Injection_ pegcetacoplan_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAD1","description":"ICD-BGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor renal graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50325","description":"Prep donor renal graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADD0","description":"ICD-GADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA5D","description":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65220","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEA1","description":"ICD-GFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEA1","description":"ICD-EEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAF0","description":"ICD-JCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETB0","description":"ICD-IETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft of thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27472","description":"Repair/graft of thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMF0","description":"ICD-GAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDE1","description":"ICD-NCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Augmentation lower jaw bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21125","description":"Augmentation lower jaw bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABD1","description":"ICD-IABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLC0","description":"ICD-CDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic submucosal dissection (ESD)_ including endoscopyor colonoscopy_ mucosal closure_ when performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9779","description":"Endoscopic submucosal dissection (ESD)_ including endoscopyor colonoscopy_ mucosal closure_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA20D","description":"Clinically Complex _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Guide wire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1769","description":"Guide wire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dissolve clot heart vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92975","description":"Dissolve clot heart vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELD1","description":"ICD-CELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prep ak ischial plast molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5560","description":"Prep ak ischial plast molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBB1","description":"ICD-EEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB124","description":"Clinically Complex _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoe lifts tapered to one-ha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3332","description":"Shoe lifts tapered to one-ha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD124","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8G","description":"High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA33","description":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDE1","description":"ICD-CCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug test(s)_ definitive_ utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0659","description":"Drug test(s)_ definitive_ utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX40","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB134","description":"Special Care Low _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fmr1 gene characterization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81244","description":"Fmr1 gene characterization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOF0","description":"ICD-LGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCE1","description":"ICD-IBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAF0","description":"ICD-KAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41116","description":"Excision of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCE1","description":"ICD-ICCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB14D","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL07","description":"High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHE0","description":"ICD-OFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAC0","description":"ICD-IFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2028","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","description":"HCPCS-A2028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Us leiomyomata ablate >200","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0072T","description":"Us leiomyomata ablate >200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29891","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBC1","description":"ICD-GDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQB0","description":"ICD-OHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRB0","description":"ICD-LBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMA0","description":"ICD-MJMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction By Neurolytic Agent_ Genicular Nerve Branches Including Imaging Guidance_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64624","description":"Destruction By Neurolytic Agent_ Genicular Nerve Branches Including Imaging Guidance_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic pulpotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3220","description":"Therapeutic pulpotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC1C","description":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wedge resect of lung initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32505","description":"Wedge resect of lung initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOD0","description":"ICD-CDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIC0","description":"ICD-CBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61867","description":"Implant neuroelectrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUB0","description":"ICD-CBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Granisetron 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0091","description":"Granisetron 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of spinal shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63744","description":"Revision of spinal shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replc sockt below e/w disa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6883","description":"Replc sockt below e/w disa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA17","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAF1","description":"ICD-ODAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28220","description":"Release of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCB1","description":"ICD-MKCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSE1","description":"ICD-OGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA11A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Functional outcome assessment not documented as being performed_ documentation the patient is not eligible for a functional outcome assessment using a standardized tool at the","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8540","description":"Functional outcome assessment not documented as being performed_ documentation the patient is not eligible for a functional outcome assessment using a standardized tool at the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cholangiography_ percutaneous_ transhepatic_ radiological supervisionand interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74320","description":"Cholangiography_ percutaneous_ transhepatic_ radiological supervisionand interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUA1","description":"ICD-NDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMA1","description":"ICD-MKMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61692","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC3C","description":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIC0","description":"ICD-KCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unpln rup post cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9389","description":"Unpln rup post cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIC0","description":"ICD-AHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine creatinine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82570","description":"Assay of urine creatinine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental skin graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7920","description":"Dental skin graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD234","description":"Special Care High _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA211","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown porcelain fused base m","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2751","description":"Crown porcelain fused base m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Carecoordination prenatal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1002","description":"Carecoordination prenatal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCF0","description":"ICD-ECCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Calc bmi abv up param f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8417","description":"Calc bmi abv up param f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No xray/ct/ et al ordd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3320F","description":"No xray/ct/ et al ordd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCF0","description":"ICD-AHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXF1","description":"ICD-JGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCA0","description":"ICD-EDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat radius fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24666","description":"Treat radius fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous methb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88741","description":"Transcutaneous methb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX40","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull for brain wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61571","description":"Incise skull for brain wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Idet single level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22526","description":"Idet single level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt trnsfrd from anesth to cc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0581F","description":"Pt trnsfrd from anesth to cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRF0","description":"ICD-CGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8G","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHB1","description":"ICD-EHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEE1","description":"ICD-AHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUF0","description":"ICD-KFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vanomycin dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87500","description":"Vanomycin dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Recording (Includes Connection And Initial Recording)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93242","description":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Recording (Includes Connection And Initial Recording)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of vulva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56620","description":"Partial removal of vulva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"E-Graft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4318","description":"E-Graft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ahi or rdi initial dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8842","description":"Ahi or rdi initial dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKB1","description":"ICD-BFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGB0","description":"ICD-JDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release palm contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26040","description":"Release palm contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ Visco-3_ for intra-articular injection_ per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7333","description":"Hyaluronan or derivative_ Visco-3_ for intra-articular injection_ per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIB0","description":"ICD-JFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of aldosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82088","description":"Assay of aldosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVB0","description":"ICD-FGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Humate-p_ inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7187","description":"Humate-p_ inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colorec ca scr_ sto bas dna","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0464","description":"Colorec ca scr_ sto bas dna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ 25 mcg/0.25 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91321","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ 25 mcg/0.25 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97001","description":"Pt evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exchange nephrostomy catheter_ percutaneous_ with ureteral stricture balloon dilation_ including diagnostic nephrostogram and/or ureterogram when performed_ imaging guidance (","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7548","description":"Exchange nephrostomy catheter_ percutaneous_ with ureteral stricture balloon dilation_ including diagnostic nephrostogram and/or ureterogram when performed_ imaging guidance (","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTB0","description":"ICD-IDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHE1","description":"ICD-BHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHD1","description":"ICD-KIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implt neurostim elctr each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8680","description":"Implt neurostim elctr each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL10","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acid perfusion of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91030","description":"Acid perfusion of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQC1","description":"ICD-DGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVA1","description":"ICD-OAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBE0","description":"ICD-IEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laps rmvl nstim array vagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0313T","description":"Laps rmvl nstim array vagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFF0","description":"ICD-JEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABF0","description":"ICD-KABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Macular pigment optical density measurement by heterochromatic flicker photometry_ unilateral or bilateral_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0506T","description":"Macular pigment optical density measurement by heterochromatic flicker photometry_ unilateral or bilateral_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Theragenesis_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2008","description":"Theragenesis_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSF1","description":"ICD-KGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB12D","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion catheter artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36660","description":"Insertion catheter artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEC0","description":"ICD-BIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Audiometry for hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0618","description":"Audiometry for hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bk thigh lacer glut/ischia m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5682","description":"Bk thigh lacer glut/ischia m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1EC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EC11","description":"ICD-1EC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray adrenal glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75842","description":"Vein x-ray adrenal glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBE1","description":"ICD-OLBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAE1","description":"ICD-GGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMD1","description":"ICD-EAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJB0","description":"ICD-GAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIB1","description":"ICD-KGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDF0","description":"ICD-KIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQC0","description":"ICD-KBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB20C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Baclofen 10 mg injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0475","description":"Baclofen 10 mg injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHF0","description":"ICD-BIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Srs linear based","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77372","description":"Srs linear based","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHB0","description":"ICD-NJHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA231","description":"Clinically Complex _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat pelvic ring fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27193","description":"Treat pelvic ring fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNC1","description":"ICD-FDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft arm/leg <4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64892","description":"Nerve graft arm/leg <4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGD1","description":"ICD-OKGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compression stocking bk40-50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6532","description":"Compression stocking bk40-50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hhcp-svs of s/l path_ea 15mn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0153","description":"Hhcp-svs of s/l path_ea 15mn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tissue exam by pathologist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88305","description":"Tissue exam by pathologist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB230","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient has metastatic disease at diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9834","description":"Patient has metastatic disease at diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE135","description":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHE0","description":"ICD-CFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX5A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCA0","description":"ICD-OLCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCA0","description":"ICD-AGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of psa total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84153","description":"Assay of psa total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHC1","description":"ICD-CDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Varicella-zoster ig im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90396","description":"Varicella-zoster ig im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAC0","description":"ICD-CEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC220","description":"Clinically Complex _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC50","description":"Very High Rehab _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (ovarian)_ spheroid cell culture_ 4-drug panel (carboplatin_ doxorubicin_ gemcitabine_ paclitaxel)_ tumor chemotherapy response prediction for each drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0324U","description":"Oncology (ovarian)_ spheroid cell culture_ 4-drug panel (carboplatin_ doxorubicin_ gemcitabine_ paclitaxel)_ tumor chemotherapy response prediction for each drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac MRI for morph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75557","description":"Cardiac MRI for morph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBE0","description":"ICD-OCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTA0","description":"ICD-OFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWB0","description":"ICD-KEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGF1","description":"ICD-JDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD214","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ald fm/dm receiver_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5287","description":"Ald fm/dm receiver_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enteral ng tubing w/ stylet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4081","description":"Enteral ng tubing w/ stylet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDA1","description":"ICD-NJDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shingrix vaccine documented as administered or previously received","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1064","description":"Shingrix vaccine documented as administered or previously received","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy gastrostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43653","description":"Laparoscopy gastrostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXD1","description":"ICD-KAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISE0","description":"ICD-CISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prosthesis_ penile_ non-inf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2622","description":"Prosthesis_ penile_ non-inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELA1","description":"ICD-JELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62321","description":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hip core decompression","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2325","description":"Hip core decompression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFF1","description":"ICD-JEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee control condylar pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2810","description":"Knee control condylar pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBE1","description":"ICD-CIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA23","description":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of urethral lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57230","description":"Repair of urethral lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artery-vein nonautograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36830","description":"Artery-vein nonautograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRE1","description":"ICD-OCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWA1","description":"ICD-PFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFD1","description":"ICD-GGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0695U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695U","description":"CPT-0695U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA01","description":"Medium Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise excessive skin hip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15834","description":"Excise excessive skin hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCA0","description":"ICD-JFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscop w/vc inj + scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31571","description":"Laryngoscop w/vc inj + scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iodine I-131 iobenguane_ diagnostic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9407","description":"Iodine I-131 iobenguane_ diagnostic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIB1","description":"ICD-OGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC254","description":"Special Care Low _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITB1","description":"ICD-FITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55705","description":"Biopsy of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Refitting of obturator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5933","description":"Refitting of obturator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE225","description":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMD0","description":"ICD-CDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDC1","description":"ICD-MFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prescrl fuse w/ instr l5-s1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22586","description":"Prescrl fuse w/ instr l5-s1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXC0","description":"ICD-NAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove palate/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42120","description":"Remove palate/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVB0","description":"ICD-KAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYC0","description":"ICD-LGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHF1","description":"ICD-MCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYA0","description":"ICD-DCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19357","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJE1","description":"ICD-OGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVD1","description":"ICD-KHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTC1","description":"ICD-MKTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWD1","description":"ICD-CEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANC1","description":"ICD-BANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rimantadine hcl_ brand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9036","description":"Rimantadine hcl_ brand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rehabilitation program 1/2 d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2001","description":"Rehabilitation program 1/2 d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAD0","description":"ICD-AGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ATXN10 (ataxin 10) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81183","description":"ATXN10 (ataxin 10) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXD1","description":"ICD-CGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXA1","description":"ICD-KIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repl girdle milwaukee orth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4000","description":"Repl girdle milwaukee orth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTC1","description":"ICD-OKTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB3C","description":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUE0","description":"ICD-BBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Walker crutch attachment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0157","description":"Walker crutch attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor viii vw ristoctn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85245","description":"Clot factor viii vw ristoctn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOB1","description":"ICD-OKOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate_ inclusive of all imaging guidance and monitoring; singl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36465","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate_ inclusive of all imaging guidance and monitoring; singl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES22D","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resp virus 6-11 targets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87632","description":"Resp virus 6-11 targets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous ablation therapy of incompetent vein_ extremity_ by transcatheter delivery of a chemical adhesive (eg_ cyanoacrylate) remote from the access site_ inclusive of all","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36483","description":"Endovenous ablation therapy of incompetent vein_ extremity_ by transcatheter delivery of a chemical adhesive (eg_ cyanoacrylate) remote from the access site_ inclusive of all","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTD0","description":"ICD-MHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Distal transcutaneous electrical nerve stimulator_ stimulates peripheral nerves of the upper arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4540","description":"Distal transcutaneous electrical nerve stimulator_ stimulates peripheral nerves of the upper arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDC1","description":"ICD-BCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27620","description":"Explore/treat ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEE1","description":"ICD-IDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHE1","description":"ICD-ADHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Strapping of toes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29550","description":"Strapping of toes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-15013","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","description":"CPT-15013","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGD1","description":"ICD-FGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIB0","description":"ICD-IFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGD0","description":"ICD-OGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLF0","description":"ICD-EGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1059T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1059T","description":"CPT-1059T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUD0","description":"ICD-MCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cryosurg ablate fa each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19105","description":"Cryosurg ablate fa each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent repair of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64872","description":"Subsequent repair of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNF1","description":"ICD-KFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB0B","description":"High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1023T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","description":"CPT-1023T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFF1","description":"ICD-JAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"RARE DS GEN DNA ALYS EA COMP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0213U","description":"RARE DS GEN DNA ALYS EA COMP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Legion pneumo dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87542","description":"Legion pneumo dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intrvasc us noncoronary addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37253","description":"Intrvasc us noncoronary addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8H","description":"High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed total elec w/o matt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0266","description":"Hosp bed total elec w/o matt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE136","description":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Obinutuzumab inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9301","description":"Obinutuzumab inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (heparin-induced thrombocytopenia)_ platelet antibody reactivity by flow cytometry_ serum (Versitiā„¢ Heparin-Induced Thrombocytopenia Evaluation)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0275U","description":"Hematology (heparin-induced thrombocytopenia)_ platelet antibody reactivity by flow cytometry_ serum (Versitiā„¢ Heparin-Induced Thrombocytopenia Evaluation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay nonantibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83516","description":"Immunoassay nonantibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA11A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMB0","description":"ICD-EIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sgd accessory_ mounting sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2512","description":"Sgd accessory_ mounting sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES13C","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Opioid &opiate analog 5/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80364","description":"Opioid &opiate analog 5/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSD0","description":"ICD-OGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iop down <15% of pre-svc lvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3285F","description":"Iop down <15% of pre-svc lvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEF0","description":"ICD-MJEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTA0","description":"ICD-NHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRC1","description":"ICD-OLRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOB0","description":"ICD-KHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJC0","description":"ICD-CAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc supervision palliative","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9054","description":"Onc supervision palliative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No doc of pain","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8732","description":"No doc of pain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNC1","description":"ICD-GCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLB0","description":"ICD-FFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Office consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99241","description":"Office consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fats/lipids feces qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82705","description":"Fats/lipids feces qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAB0","description":"ICD-OEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTD0","description":"ICD-OBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0665","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","description":"HCPCS-G0665","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vaporizer room type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0605","description":"Vaporizer room type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Body pos goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8982","description":"Body pos goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Follow up home visit/prental","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1004","description":"Follow up home visit/prental","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo transthoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93303","description":"Echo transthoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic Ultrafiltration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0692T","description":"Therapeutic Ultrafiltration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thrombin time titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85675","description":"Thrombin time titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLD0","description":"ICD-ABLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBF0","description":"ICD-MBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bacterium antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86609","description":"Bacterium antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIC0","description":"ICD-FCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leuprolide Injectable_ Camcevi_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1952","description":"Leuprolide Injectable_ Camcevi_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVD1","description":"ICD-FHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Allergen specific igg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86001","description":"Allergen specific igg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconst lwr jaw w/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21194","description":"Reconst lwr jaw w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBE0","description":"ICD-MCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBF1","description":"ICD-AFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair lightweight det a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1090","description":"Wheelchair lightweight det a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal and replacement of total replacement heart system (artificial heart)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33928","description":"Removal and replacement of total replacement heart system (artificial heart)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Torsion ank & half solid sti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2375","description":"Torsion ank & half solid sti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pms2 known familial variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81318","description":"Pms2 known familial variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJE0","description":"ICD-NCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHD1","description":"ICD-FBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67882","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Donor serv ivf case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4025","description":"Donor serv ivf case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACC0","description":"ICD-CACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC5A","description":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cont airway pressure device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0601","description":"Cont airway pressure device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTA1","description":"ICD-OLTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAE0","description":"ICD-OJAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEND1","description":"ICD-JEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Th/wght bear nar m-l brim mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2525","description":"Th/wght bear nar m-l brim mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL0A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bed pan standard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0275","description":"Bed pan standard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Card MRI veloc flow mapping","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75565","description":"Card MRI veloc flow mapping","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEE0","description":"ICD-IFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXE1","description":"ICD-CHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJE0","description":"ICD-GGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLD1","description":"ICD-BHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMC0","description":"ICD-JBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYA1","description":"ICD-OJYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSC1","description":"ICD-LDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC16","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove shoulder joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23105","description":"Remove shoulder joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE24C","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVC1","description":"ICD-OLVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBA1","description":"ICD-BEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYC1","description":"ICD-OFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHB0","description":"ICD-MAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNA0","description":"ICD-FGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWB1","description":"ICD-PAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Post >=4srfc resinbase cmpst","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2394","description":"Post >=4srfc resinbase cmpst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML45","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefazolin sodium (baxter)_ not therapeutically equivalent to j0690_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0689","description":"Injection_ cefazolin sodium (baxter)_ not therapeutically equivalent to j0690_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0453T","description":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCA0","description":"ICD-GGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Asp presc disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9435","description":"Asp presc disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE151","description":"Special Care Low _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fracture frame free standing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0930","description":"Fracture frame free standing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 3 xhd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0855","description":"Pwc gp 3 xhd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2DA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DA11","description":"ICD-2DA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEF1","description":"ICD-OBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Right And Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone(S); Normal Nativ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93596","description":"Right And Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone(S); Normal Nativ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB12A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Solid skin barrier 6x6","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5121","description":"Solid skin barrier 6x6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTF0","description":"ICD-GFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17106","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without open decompression or fusion_ including image guidance when performed_ lumbar; single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22869","description":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without open decompression or fusion_ including image guidance when performed_ lumbar; single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft achilles tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27652","description":"Repair/graft achilles tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat sesamoid bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28531","description":"Treat sesamoid bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYB1","description":"ICD-PAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extrnl beam other than prost","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4201F","description":"Extrnl beam other than prost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ampho b cholesteryl sulfate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0288","description":"Ampho b cholesteryl sulfate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rasburicase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2783","description":"Rasburicase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice or home hlth in home","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5001","description":"Hospice or home hlth in home","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE104","description":"Special Care Low _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYC0","description":"ICD-CCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hh aide or cn aide per visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1021","description":"Hh aide or cn aide per visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Perfusion Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed); Single Study_ At Re","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78430","description":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Perfusion Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed); Single Study_ At Re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJA0","description":"ICD-FHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKC1","description":"ICD-GFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cholera vaccine for injectable use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90725","description":"Cholera vaccine for injectable use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKB0","description":"ICD-CDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCC0","description":"ICD-ADCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inc thyr node <1.0 in rpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9552","description":"Inc thyr node <1.0 in rpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alloskin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4115","description":"Alloskin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCA1","description":"ICD-MCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBE1","description":"ICD-KIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOF0","description":"ICD-KFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL2B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFF1","description":"ICD-ODFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQA0","description":"ICD-CHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVE1","description":"ICD-NGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFF0","description":"ICD-NIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB23C","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIF0","description":"ICD-EHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBA0","description":"ICD-FGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMF0","description":"ICD-MDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEE0","description":"ICD-OLEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Symptoms improved/consist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1450F","description":"Symptoms improved/consist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Culture typing added method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87158","description":"Culture typing added method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSE0","description":"ICD-CFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of metatarsal heads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28114","description":"Removal of metatarsal heads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOF1","description":"ICD-LCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES34D","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92288","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","description":"CPT-92288","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXD1","description":"ICD-JEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILB1","description":"ICD-EILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD10C","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hkafo torsion ball bearing j","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2060","description":"Hkafo torsion ball bearing j","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAF0","description":"ICD-ECAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of tibia fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27758","description":"Treatment of tibia fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTD0","description":"ICD-BDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBA1","description":"ICD-BHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMB0","description":"ICD-GHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX3B","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy and biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45331","description":"Sigmoidoscopy and biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE130","description":"Special Care Low _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYA0","description":"ICD-LHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKD1","description":"ICD-FHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5171","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5171","description":"HCPCS-Q5171","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of thigh muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27430","description":"Revision of thigh muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Motor &/ sens nrve cndj test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95905","description":"Motor &/ sens nrve cndj test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHC1","description":"ICD-MAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIA1","description":"ICD-BFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chem/antisept solution_ 8oz","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4674","description":"Chem/antisept solution_ 8oz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB21","description":"High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Genetic test spec analysis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0423","description":"Genetic test spec analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00924","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00924","description":"CPT-00924","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0562","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","description":"HCPCS-G0562","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE250","description":"Special Care High _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHA1","description":"ICD-BDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release inner ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69960","description":"Release inner ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA17","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Arthrodesis_ pre-sacral interbody technique_ disc space preparation_ discectomy_ without instrumentation_ with image guidance_ includes bone graft when performed; L4-L5 inters","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0196T","description":"Arthrodesis_ pre-sacral interbody technique_ disc space preparation_ discectomy_ without instrumentation_ with image guidance_ includes bone graft when performed; L4-L5 inters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD13B","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVA1","description":"ICD-BBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDF1","description":"ICD-GDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIA1","description":"ICD-MCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No surg site infection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9311","description":"No surg site infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair mouth/nose fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30600","description":"Repair mouth/nose fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tigecycline (accord) not therapeutically equivalent to j3243_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3244","description":"Injection_ tigecycline (accord) not therapeutically equivalent to j3243_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0491U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","description":"CPT-0491U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Analgesics non-opioid 3-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80330","description":"Analgesics non-opioid 3-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE212","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES12A","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVD0","description":"ICD-BAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBC1","description":"ICD-ICBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETF1","description":"ICD-JETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAC0","description":"ICD-OEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of facial bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70150","description":"X-ray exam of facial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAE1","description":"ICD-KEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDA1","description":"ICD-GIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB106","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIF1","description":"ICD-OEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc neck les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21555","description":"Exc neck les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIA0","description":"ICD-GBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21280","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKA1","description":"ICD-OKKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spectinomycn di-hcl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3320","description":"Spectinomycn di-hcl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJA0","description":"ICD-CGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCF1","description":"ICD-MDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB31","description":"High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electronic Analysis With Complex Programming Of Implanted Integrated Neurostimulation System (Eg_ Electrode Array And Receiver)_ Including Contact Group(S)_ Amplitude_ Pulse W","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0590T","description":"Electronic Analysis With Complex Programming Of Implanted Integrated Neurostimulation System (Eg_ Electrode Array And Receiver)_ Including Contact Group(S)_ Amplitude_ Pulse W","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHC1","description":"ICD-JCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO elbow_ wrist or hand intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9737","description":"Patient unable to complete the FOTO elbow_ wrist or hand intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMA1","description":"ICD-BHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28C","description":"Special Care Low _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIF1","description":"ICD-EEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHD0","description":"ICD-NCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth hernia repair preemie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83651","description":"Anesth hernia repair preemie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise major vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33820","description":"Revise major vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUE1","description":"ICD-NLUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPD1","description":"ICD-CAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1702","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1702","description":"HCPCS-A1702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGC1","description":"ICD-BDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/plcmt stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45347","description":"Sigmoidoscopy w/plcmt stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp3 xhd mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0864","description":"Pwc gp3 xhd mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology (coronary artery disease [CAD])_ DNA_ genome-wide association studies (564856 single-nucleotide polymorphisms [SNPs]_ targeted variant genotyping)_ patient lifestyl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0466U","description":"Cardiology (coronary artery disease [CAD])_ DNA_ genome-wide association studies (564856 single-nucleotide polymorphisms [SNPs]_ targeted variant genotyping)_ patient lifestyl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNA1","description":"ICD-NDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRA1","description":"ICD-LCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin exo frct swg & sta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5718","description":"Knee-shin exo frct swg & sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXF1","description":"ICD-CGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITE0","description":"ICD-BITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0563U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","description":"CPT-0563U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of tibia & fibula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27709","description":"Incision of tibia & fibula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Levalbuterol comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7607","description":"Levalbuterol comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc viral load <200","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9243","description":"Doc viral load <200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFB0","description":"ICD-CEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc post surg anatomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9613","description":"Doc post surg anatomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL11","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull (press relief)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61343","description":"Incise skull (press relief)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nrv cndj test 11-12 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95912","description":"Nrv cndj test 11-12 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8I","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leg strap h style each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0039","description":"Leg strap h style each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Closed tmp manipulation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7820","description":"Closed tmp manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHB1","description":"ICD-KCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lip surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40799","description":"Lip surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGB0","description":"ICD-NCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Attendance at delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99464","description":"Attendance at delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEE1","description":"ICD-OHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJC0","description":"ICD-FCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEA1","description":"ICD-FIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXB0","description":"ICD-OEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXE0","description":"ICD-GBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE204","description":"Clinically Complex _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone/skin graft metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20972","description":"Bone/skin graft metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKA1","description":"ICD-BEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; placement_ manipulation of transducer_ and image acquisition only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76988","description":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; placement_ manipulation of transducer_ and image acquisition only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJF0","description":"ICD-NHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Virtual reality cognitive behavioral therapy device (cbt)_ including pre-programmed therapy software","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1905","description":"Virtual reality cognitive behavioral therapy device (cbt)_ including pre-programmed therapy software","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cmv antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86644","description":"Cmv antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXC1","description":"ICD-JDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove transplanted kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50370","description":"Remove transplanted kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXB1","description":"ICD-JAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAF0","description":"ICD-BDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ remimazolam_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2249","description":"Injection_ remimazolam_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2596","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","description":"HCPCS-J2596","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect/excise lesion skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61615","description":"Resect/excise lesion skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXA1","description":"ICD-KBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRB0","description":"ICD-PIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLA1","description":"ICD-KBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC13","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD15C","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGF1","description":"ICD-OAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFME1","description":"ICD-MFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCF1","description":"ICD-ACCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML01","description":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High strength ltwt whlchr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0004","description":"High strength ltwt whlchr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIF1","description":"ICD-NJIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup long leg fiberglass","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4030","description":"Cast sup long leg fiberglass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD130","description":"Special Care High _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIID1","description":"ICD-IIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ko elastic w/joints pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1812","description":"Ko elastic w/joints pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVB1","description":"ICD-BIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBE1","description":"ICD-MHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCB1","description":"ICD-NLCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWD0","description":"ICD-OLWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Preventive counseling group","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99412","description":"Preventive counseling group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit tpn total diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9364","description":"Hit tpn total diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were not listed on the kidney-pancreas transplant waitlist or patients who did not receive a living donor transplant within the first year following initiation of","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1260","description":"Patients who were not listed on the kidney-pancreas transplant waitlist or patients who did not receive a living donor transplant within the first year following initiation of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHA1","description":"ICD-IDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA24","description":"Medium Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"West nile virus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86789","description":"West nile virus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Addition_ endoskeletal knee-shin system_ polycentric_ pneumatic swing_ and stance phase control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5841","description":"Addition_ endoskeletal knee-shin system_ polycentric_ pneumatic swing_ and stance phase control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSC1","description":"ICD-HFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHE0","description":"ICD-GBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laser treatment of retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67040","description":"Laser treatment of retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBE0","description":"ICD-CBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Waiver service_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2025","description":"Waiver service_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of arm bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24134","description":"Removal of arm bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esw wound healing init wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0299T","description":"Esw wound healing init wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSD0","description":"ICD-KGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAB1","description":"ICD-JHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99231","description":"Subsequent hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD25B","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRA1","description":"ICD-DCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC116","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDC1","description":"ICD-OHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove tonsils and adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42821","description":"Remove tonsils and adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ (Kovaltry)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7211","description":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ (Kovaltry)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise excessive skin buttck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15835","description":"Excise excessive skin buttck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRC0","description":"ICD-DIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Underarm springassist crutch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0117","description":"Underarm springassist crutch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBE0","description":"ICD-ABBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair windpipe opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31613","description":"Repair windpipe opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKB1","description":"ICD-ODKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJC0","description":"ICD-NLJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAF0","description":"ICD-JAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAF1","description":"ICD-GCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYE1","description":"ICD-DDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0861T","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Med abortion inc all ex drug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0199","description":"Med abortion inc all ex drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28E","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup gauntlet fiberglass","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4014","description":"Cast sup gauntlet fiberglass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Initiated Episode Of Rehabilitation Therapy_ Medical_ Or Chiropractic Care For Neck Impairment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1143","description":"Initiated Episode Of Rehabilitation Therapy_ Medical_ Or Chiropractic Care For Neck Impairment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRC1","description":"ICD-LCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQC1","description":"ICD-PDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA220","description":"Clinically Complex _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Voltage-Gated Calcium Channel Antibody_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86596","description":"Voltage-Gated Calcium Channel Antibody_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHD1","description":"ICD-FDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL4A","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYD1","description":"ICD-LBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUC0","description":"ICD-GIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Retainer For Metal Fpd - Perdominantly Base Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6121","description":"Implant Supported Retainer For Metal Fpd - Perdominantly Base Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Md service required for pmd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0372","description":"Md service required for pmd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antidepressants class 6/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80334","description":"Antidepressants class 6/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARB1","description":"ICD-HARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOC0","description":"ICD-PCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAED0","description":"ICD-KAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cysto laser tx ureteral calc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2070","description":"Cysto laser tx ureteral calc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWE1","description":"ICD-PEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pulse-echo ultrasound bone density measurement resulting in indicator of axial bone mineral density_ tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0508T","description":"Pulse-echo ultrasound bone density measurement resulting in indicator of axial bone mineral density_ tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB5A","description":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Custom breast prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8035","description":"Custom breast prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Complex cystometrogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51726","description":"Complex cystometrogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath w/drainage 2-way latex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4314","description":"Cath w/drainage 2-way latex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUB1","description":"ICD-MCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemolysins/agglutinins auto","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86940","description":"Hemolysins/agglutinins auto","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBC0","description":"ICD-ECBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXE0","description":"ICD-BHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBE1","description":"ICD-KBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEED0","description":"ICD-IEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEF1","description":"ICD-EBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMB0","description":"ICD-IIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"PalinGen or PalinGen XPlus_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4173","description":"PalinGen or PalinGen XPlus_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPB0","description":"ICD-CFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYD0","description":"ICD-KFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVC0","description":"ICD-KEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Initial foot exam pt lops","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0245","description":"Initial foot exam pt lops","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Asp therp used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8598","description":"Asp therp used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBB1","description":"ICD-EHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE25C","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBF0","description":"ICD-FBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMA1","description":"ICD-BFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD220","description":"Clinically Complex _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML24","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBB0","description":"ICD-NGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHF1","description":"ICD-CCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJD0","description":"ICD-GEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFD1","description":"ICD-GFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lower limb pros vacuum pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5781","description":"Lower limb pros vacuum pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJE1","description":"ICD-GIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-60661","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","description":"CPT-60661","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDD1","description":"ICD-KBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAD0","description":"ICD-CCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGE1","description":"ICD-GDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLE1","description":"ICD-FFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOC0","description":"ICD-DDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOE1","description":"ICD-KDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-97007","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","description":"CPT-97007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tacrol envarsus ex rel oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7503","description":"Tacrol envarsus ex rel oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHC1","description":"ICD-IAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Powered upper extremity range of motion assist device_ elbow_ wrist_ hand with single or double upright(s)_ includes microproce","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8701","description":"Powered upper extremity range of motion assist device_ elbow_ wrist_ hand with single or double upright(s)_ includes microproce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Air ambulan nonemerg rotary","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9961","description":"Air ambulan nonemerg rotary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pasrr level ii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2011","description":"Pasrr level ii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACC1","description":"ICD-GACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychological testing (eg_ Halstead-Reitan Neuropsychological Battery_ Wechsler Memory Scales and Wisconsin Card Sorting Test)_ with qualified health care professional in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96119","description":"Neuropsychological testing (eg_ Halstead-Reitan Neuropsychological Battery_ Wechsler Memory Scales and Wisconsin Card Sorting Test)_ with qualified health care professional in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlso flex trnk sj-ss pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0457","description":"Tlso flex trnk sj-ss pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKA1","description":"ICD-FFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQB1","description":"ICD-GFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIA0","description":"ICD-MLIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of thiocyanate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84430","description":"Assay of thiocyanate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Occupational therapy_ in the","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9129","description":"Occupational therapy_ in the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKC0","description":"ICD-BEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB105","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUF1","description":"ICD-NFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTE1","description":"ICD-CDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"W/c vent tray fixed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1029","description":"W/c vent tray fixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIC1","description":"ICD-NLIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECB0","description":"ICD-GECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOB1","description":"ICD-PBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0685","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0685","description":"HCPCS-G0685","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urine pregnancy test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81025","description":"Urine pregnancy test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRB0","description":"ICD-DFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYE0","description":"ICD-KCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJD1","description":"ICD-OGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ethchlorvynol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6050","description":"Ethchlorvynol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUE1","description":"ICD-OCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKB0","description":"ICD-NLKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABC1","description":"ICD-FABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surgery of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86052","description":"Anesth surgery of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGA0","description":"ICD-BAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFC1","description":"ICD-NLFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98012","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","description":"CPT-98012","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure_ including separate incision(s) and closure_ when performed; first 60 minutes (List separately in ad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96547","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure_ including separate incision(s) and closure_ when performed; first 60 minutes (List separately in ad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76506","description":"Echo exam of head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36901","description":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALD0","description":"ICD-GALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00920","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00920","description":"CPT-00920","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJB1","description":"ICD-CGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFE0","description":"ICD-JAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoe outflare wedge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3390","description":"Shoe outflare wedge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flotufolastat F-18_ diagnostic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9156","description":"Flotufolastat F-18_ diagnostic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lefort iii w/fhd w/ lefort i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21160","description":"Lefort iii w/fhd w/ lefort i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOF0","description":"ICD-PCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo guide ova aspiration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76948","description":"Echo guide ova aspiration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHC1","description":"ICD-JIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXA0","description":"ICD-JFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prp i/hern init reduc >5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49505","description":"Prp i/hern init reduc >5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crh stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80412","description":"Crh stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLD0","description":"ICD-NGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA245","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC24","description":"Medium Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0617U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","description":"CPT-0617U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1814","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","description":"HCPCS-E1814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCC1","description":"ICD-JHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEF0","description":"ICD-KBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBD1","description":"ICD-EGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESC0","description":"ICD-KESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55842","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"22nf nonsealed leadacid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2360","description":"22nf nonsealed leadacid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXB1","description":"ICD-KDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDED1","description":"ICD-GDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAD0","description":"ICD-OGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Family psytx w/o patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90846","description":"Family psytx w/o patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIE0","description":"ICD-NLIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD22A","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVF0","description":"ICD-FGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Preparation for bladder xray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51605","description":"Preparation for bladder xray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMD1","description":"ICD-CEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSE0","description":"ICD-DCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNA1","description":"ICD-NKNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHE1","description":"ICD-FGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEE0","description":"ICD-ACEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB03","description":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITA0","description":"ICD-JITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4429","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","description":"HCPCS-Q4429","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rbc antibody screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86850","description":"Rbc antibody screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vaccina ig im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90393","description":"Vaccina ig im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYE0","description":"ICD-HEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair lightwt fixed arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1250","description":"Wheelchair lightwt fixed arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIC0","description":"ICD-EEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rhythm ecg tracing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93041","description":"Rhythm ecg tracing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKF0","description":"ICD-OBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUB1","description":"ICD-MBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUE1","description":"ICD-BCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHC0","description":"ICD-CIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spu Or Asc Patient Transferred To The Hospital Or Discharged From The Sp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0595","description":"Spu Or Asc Patient Transferred To The Hospital Or Discharged From The Sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUE1","description":"ICD-NBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0575U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","description":"CPT-0575U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVF1","description":"ICD-BAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mod solid food suppl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9434","description":"Mod solid food suppl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lomustine 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0178","description":"Lomustine 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINE0","description":"ICD-GINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTC1","description":"ICD-CBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTB0","description":"ICD-FCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hallus-valgus nt dyn pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3100","description":"Hallus-valgus nt dyn pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Norsn incomp inf antibio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9302","description":"Norsn incomp inf antibio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert tun ip cath w/port","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49419","description":"Insert tun ip cath w/port","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYD1","description":"ICD-KHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAB0","description":"ICD-OAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDME0","description":"ICD-JDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBB1","description":"ICD-NGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYD0","description":"ICD-CIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vein byp pop-tibl peroneal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35587","description":"Vein byp pop-tibl peroneal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lifestyle mod 4th stage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0342","description":"Lifestyle mod 4th stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIA0","description":"ICD-OCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct upper extremity w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73201","description":"Ct upper extremity w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hla class i phenotype qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86830","description":"Hla class i phenotype qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBE1","description":"ICD-FEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXB1","description":"ICD-CFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not prescribing warfarin or another FDA-approved anticoagulant (e.g._ atrial appendage device in place)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8968","description":"Documentation of medical reason(s) for not prescribing warfarin or another FDA-approved anticoagulant (e.g._ atrial appendage device in place)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGE0","description":"ICD-BHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOC1","description":"ICD-HHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBF0","description":"ICD-OCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWC0","description":"ICD-HCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJC1","description":"ICD-KCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTD0","description":"ICD-BCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYB0","description":"ICD-PGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQA0","description":"ICD-HCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMB0","description":"ICD-OCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCED1","description":"ICD-NCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo total proctocolectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44212","description":"Laparo total proctocolectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (panzyga)_ intravenous_ non-lyophilized (e.g._ liquid)_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1576","description":"Injection_ immune globulin (panzyga)_ intravenous_ non-lyophilized (e.g._ liquid)_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lith ion non prosth recharge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4601","description":"Lith ion non prosth recharge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSC1","description":"ICD-DBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nutritional support offered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4551F","description":"Nutritional support offered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEC1","description":"ICD-KFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHD0","description":"ICD-KEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYA0","description":"ICD-DGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Allowrap ds or dry 1 sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4150","description":"Allowrap ds or dry 1 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYD0","description":"ICD-LAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acetylcholine receptor (AChR); binding antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86041","description":"Acetylcholine receptor (AChR); binding antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLB0","description":"ICD-ODLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB43","description":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTF1","description":"ICD-FHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCB1","description":"ICD-NBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGE0","description":"ICD-OGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Solid caster tire each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2221","description":"Solid caster tire each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Speech audiom thresh & recog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0211T","description":"Speech audiom thresh & recog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRB1","description":"ICD-CFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLA1","description":"ICD-CHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKD1","description":"ICD-JAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel dsg>16<=48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6232","description":"Hydrogel dsg>16<=48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCD0","description":"ICD-KFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJB0","description":"ICD-FDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pm device interrogate remote","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93294","description":"Pm device interrogate remote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUC0","description":"ICD-BEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronch ebus ivntj perph les","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31654","description":"Bronch ebus ivntj perph les","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD217","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWC0","description":"ICD-PIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUF0","description":"ICD-KHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth cran surg hemotoma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21151","description":"Anesth cran surg hemotoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX56","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAF0","description":"ICD-IAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRA1","description":"ICD-HFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD254","description":"Special Care High _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIF0","description":"ICD-MEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHF1","description":"ICD-KEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMF1","description":"ICD-EAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVB1","description":"ICD-CDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAB0","description":"ICD-OJAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD13A","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCED1","description":"ICD-OCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen tent excl croup/ped t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0455","description":"Oxygen tent excl croup/ped t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYD1","description":"ICD-HDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup shrt leg plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4037","description":"Cast sup shrt leg plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Indium in-111 auto wbc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9570","description":"Indium in-111 auto wbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTE1","description":"ICD-BCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUA0","description":"ICD-JDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Precision attachment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6950","description":"Precision attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Im admin each addl component","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90461","description":"Im admin each addl component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (sandoz)_ not therapeutically equivalent to j9305_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9297","description":"Injection_ pemetrexed (sandoz)_ not therapeutically equivalent to j9305_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES31C","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILD0","description":"ICD-BILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skills train and dev_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2014","description":"Skills train and dev_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gefitinib oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8565","description":"Gefitinib oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hematology_ Red Blood Cell (Rbc) Adhesion To Endothelial/Subendothelial Adhesion Molecules_ Functional Assessment_ Whole Blood_ With Algorithmic Analysis And Result Reported A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0303U","description":"Hematology_ Red Blood Cell (Rbc) Adhesion To Endothelial/Subendothelial Adhesion Molecules_ Functional Assessment_ Whole Blood_ With Algorithmic Analysis And Result Reported A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAF1","description":"ICD-EHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Baseline mrs > 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1236","description":"Baseline mrs > 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of leg tendon each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27659","description":"Repair of leg tendon each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB255","description":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A8005","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","description":"HCPCS-A8005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1033T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1033T","description":"CPT-1033T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMD1","description":"ICD-JIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of sweat sodium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84302","description":"Assay of sweat sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chore services per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5120","description":"Chore services per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICF1","description":"ICD-NICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOD1","description":"ICD-OIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEB1","description":"ICD-OEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45114","description":"Partial removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHD0","description":"ICD-JIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA25B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastric motility studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91020","description":"Gastric motility studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52330","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67966","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mh clubhouse svc_ per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2030","description":"Mh clubhouse svc_ per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Post-op hip abduct custom fa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1685","description":"Post-op hip abduct custom fa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis via av fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4052F","description":"Hemodialysis via av fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chin cup interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2324","description":"Chin cup interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt instr no bd rest 4 days/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4248F","description":"Pt instr no bd rest 4 days/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIE1","description":"ICD-IAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap inc hern recur comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49657","description":"Lap inc hern recur comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXC0","description":"ICD-KIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAC1","description":"ICD-EAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise palsy hand tendon(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25315","description":"Revise palsy hand tendon(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcochlear approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61596","description":"Transcochlear approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTE0","description":"ICD-KFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIF0","description":"ICD-GHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHE1","description":"ICD-AAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stress breaker","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6940","description":"Stress breaker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Allogen_ per cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4212","description":"Allogen_ per cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt or manip for maint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8990","description":"Pt or manip for maint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUF0","description":"ICD-EAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Follow up pulm nod","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9345","description":"Follow up pulm nod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQA0","description":"ICD-LFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1503","description":"HCPCS-A1503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLE0","description":"ICD-EBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHND1","description":"ICD-KHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay carboxyhb qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82376","description":"Assay carboxyhb qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEB0","description":"ICD-ECEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHA0","description":"ICD-NLHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHF1","description":"ICD-NHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNE0","description":"ICD-CGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of stomach partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43633","description":"Removal of stomach partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTC0","description":"ICD-EGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJA0","description":"ICD-GBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCF1","description":"ICD-OKCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove shoulder bone part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23130","description":"Remove shoulder bone part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Buccal/labial frenectomy (frenulectomy)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7961","description":"Buccal/labial frenectomy (frenulectomy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLE1","description":"ICD-IGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sex chromatin identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88130","description":"Sex chromatin identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC204","description":"Special Care High _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNA0","description":"ICD-KGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection of sinus tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20500","description":"Injection of sinus tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLA0","description":"ICD-ICLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foscarnet sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1455","description":"Foscarnet sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1901","description":"HCPCS-C1901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nonemerg transp mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0215","description":"Nonemerg transp mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML3D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC145","description":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFF0","description":"ICD-FGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Odontoplasty 1-2 teeth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9971","description":"Odontoplasty 1-2 teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQC0","description":"ICD-GEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAD0","description":"ICD-GDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIA0","description":"ICD-NJIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUA0","description":"ICD-OJUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Osteogen ultrasound stimltor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0760","description":"Osteogen ultrasound stimltor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No reason_ no refer hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9526","description":"No reason_ no refer hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWA0","description":"ICD-LFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of stomach and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43825","description":"Fusion of stomach and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITB1","description":"ICD-IITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOF1","description":"ICD-KDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50700","description":"Revision of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHC1","description":"ICD-CBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Igg 1 2 3 or 4 each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82787","description":"Igg 1 2 3 or 4 each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00210","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00210","description":"CPT-00210","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28600","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQB0","description":"ICD-PAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ra disease activity low","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3470F","description":"Ra disease activity low","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive hearing test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92557","description":"Comprehensive hearing test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUF0","description":"ICD-MCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9245","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9245","description":"CDT-D9245","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB07","description":"Low Rehab_ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAID0","description":"ICD-KAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis b dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87515","description":"Hepatitis b dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28615","description":"Repair foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNF1","description":"ICD-CHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Construction of absent anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46740","description":"Construction of absent anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSA0","description":"ICD-OJSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB26","description":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Developmental testing_ (includes assessment of motor_ language_ social_ adaptive_ and/or cognitive functioning by standardized developmental instruments) with interpretation a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96111","description":"Developmental testing_ (includes assessment of motor_ language_ social_ adaptive_ and/or cognitive functioning by standardized developmental instruments) with interpretation a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00410","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00410","description":"CPT-00410","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYF0","description":"ICD-OCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYB1","description":"ICD-PFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUB0","description":"ICD-KFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Preparation of tumor cavity_ with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with partial mastectomy (List separately i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19294","description":"Preparation of tumor cavity_ with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with partial mastectomy (List separately i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Netupitant palonosetron oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8655","description":"Netupitant palonosetron oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28080","description":"Removal of foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients age 75 or older on their initiation of dialysis date","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1264","description":"Patients age 75 or older on their initiation of dialysis date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOC0","description":"ICD-KHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOF0","description":"ICD-HIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco use txmnt counseling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4000F","description":"Tobacco use txmnt counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTD0","description":"ICD-NDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE15D","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWC1","description":"ICD-DHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFD0","description":"ICD-OEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1396","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","description":"HCPCS-M1396","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8X","description":"Very High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYA1","description":"ICD-PGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPE1","description":"ICD-JDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise excessive skin leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15833","description":"Excise excessive skin leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc skin abd add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15847","description":"Exc skin abd add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOC0","description":"ICD-KEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive sternum surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21630","description":"Extensive sternum surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILC0","description":"ICD-OILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone cutting segmented","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7944","description":"Bone cutting segmented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYA1","description":"ICD-HGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCD0","description":"ICD-OGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVB0","description":"ICD-JDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYB0","description":"ICD-DEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anes spine transthor w/vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62651","description":"Anes spine transthor w/vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAC1","description":"ICD-OGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSE1","description":"ICD-DGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD12D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4414","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","description":"HCPCS-Q4414","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMA1","description":"ICD-ABMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC12B","description":"Reduced Physical Function _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ bra_ for nighttime use_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6529","description":"Gradient compression garment_ bra_ for nighttime use_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOC0","description":"ICD-KCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC10A","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism (adverse drug reactions and drug response)_ genomic analysis panel_ variant analysis of 25 genes with reported phenotypes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0434U","description":"Drug metabolism (adverse drug reactions and drug response)_ genomic analysis panel_ variant analysis of 25 genes with reported phenotypes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67909","description":"Revise eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroretinography (ERG) with interpretation and report_ pattern (PERG)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0509T","description":"Electroretinography (ERG) with interpretation and report_ pattern (PERG)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLA1","description":"ICD-EGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFB1","description":"ICD-GDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1009","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANC0","description":"ICD-KANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQF1","description":"ICD-LAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOD1","description":"ICD-LIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJF0","description":"ICD-FDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB13A","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYB1","description":"ICD-CBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Double transfer toe-hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26554","description":"Double transfer toe-hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ liposomal_ 1 mg daunorubicin and 2.27 mg cytarabine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9024","description":"Injection_ liposomal_ 1 mg daunorubicin and 2.27 mg cytarabine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1357","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB136","description":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score knee not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8650","description":"Fun stat score knee not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of bladder abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51080","description":"Drainage of bladder abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair double ventricle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33612","description":"Repair double ventricle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flu vac pandem prsrv free im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90666","description":"Flu vac pandem prsrv free im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXD1","description":"ICD-KFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOF0","description":"ICD-PBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETF1","description":"ICD-NETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"NeoPatch_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4176","description":"NeoPatch_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNF1","description":"ICD-BDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sm 153 lexidronam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9604","description":"Sm 153 lexidronam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chlamydia trachomatis ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87270","description":"Chlamydia trachomatis ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICED0","description":"ICD-ICED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCD0","description":"ICD-BDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy w/biopsy(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52204","description":"Cystoscopy w/biopsy(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alpha-fetoprotein amniotic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82106","description":"Alpha-fetoprotein amniotic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sever cranial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64771","description":"Sever cranial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLB1","description":"ICD-OBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dermacell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4122","description":"Dermacell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPE1","description":"ICD-KCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prep renal graft/venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50327","description":"Prep renal graft/venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hard protect helmet custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A8003","description":"Hard protect helmet custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nrv cndj test 9-10 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95911","description":"Nrv cndj test 9-10 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCD1","description":"ICD-OCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prescription digital behavioral therapy_ FDA-cleared_ per course of treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9291","description":"Prescription digital behavioral therapy_ FDA-cleared_ per course of treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hightop w/ supp/pronator inf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3204","description":"Hightop w/ supp/pronator inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX06","description":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mdd moderate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3089F","description":"Mdd moderate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40654","description":"Repair lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXD1","description":"ICD-BHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODED1","description":"ICD-ODED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hla typing dr/dq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86817","description":"Hla typing dr/dq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHC1","description":"ICD-FGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPB1","description":"ICD-FDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1470","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","description":"HCPCS-M1470","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC14D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pedicle e/n/e/l/ntroral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15576","description":"Pedicle e/n/e/l/ntroral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCD1","description":"ICD-JCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIC0","description":"ICD-CDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29873","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Test socket below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5620","description":"Test socket below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC241","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXD0","description":"ICD-NLXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8E","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bowel surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44899","description":"Bowel surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUC0","description":"ICD-FCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_Nivolumab_ 1mg (Opdivo)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9453","description":"Injection_Nivolumab_ 1mg (Opdivo)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAF0","description":"ICD-GFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit enteral bolus nurs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9343","description":"Hit enteral bolus nurs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNB0","description":"ICD-FBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28575","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMF1","description":"ICD-MHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJD0","description":"ICD-OEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA53","description":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ reslizumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2786","description":"Injection_ reslizumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC54","description":"High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLA1","description":"ICD-BDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOF0","description":"ICD-PJOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMC0","description":"ICD-ODMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHD1","description":"ICD-FAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt has no resp insufficiency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1505F","description":"Pt has no resp insufficiency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA07","description":"Medium Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJC1","description":"ICD-CAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implnt_bon void filler-putty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9359","description":"Implnt_bon void filler-putty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEA1","description":"ICD-AEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQE1","description":"ICD-PDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAF1","description":"ICD-MFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIB0","description":"ICD-KDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCF1","description":"ICD-GHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTA1","description":"ICD-NFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTE0","description":"ICD-JHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3CB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CB31","description":"ICD-3CB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWD0","description":"ICD-PHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace prox & dist upright","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4070","description":"Replace prox & dist upright","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45111","description":"Partial removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ elastography; parenchyma (eg_ organ)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76981","description":"Ultrasound_ elastography; parenchyma (eg_ organ)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRB1","description":"ICD-GFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRE0","description":"ICD-CBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ef special metabolic inherit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4157","description":"Ef special metabolic inherit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALC1","description":"ICD-JALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCB0","description":"ICD-NHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA46","description":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYF1","description":"ICD-PAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIA0","description":"ICD-KCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYB0","description":"ICD-DAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMF0","description":"ICD-FGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone imaging multiple areas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78305","description":"Bone imaging multiple areas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acp discuss/dscn mkr docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1123F","description":"Acp discuss/dscn mkr docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0517U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","description":"CPT-0517U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCC1","description":"ICD-MLCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 100 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0148U","description":"Drug assay_ definitive_ 100 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implantable/insertable device for device intensive procedure_ not otherwise classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1889","description":"Implantable/insertable device for device intensive procedure_ not otherwise classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTF1","description":"ICD-AGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDF1","description":"ICD-GGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6029","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","description":"HCPCS-L6029","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Consult inc prep of slides","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0485","description":"Consult inc prep of slides","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adhesiolysis tube ovary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58740","description":"Adhesiolysis tube ovary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording_ and disconnection per patient encounter_ wireless cardiac stimula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0521T","description":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording_ and disconnection per patient encounter_ wireless cardiac stimula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit chemo per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9329","description":"Hit chemo per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electronic Positional Obstructive Sleep Apnea Treatment_ With Sensor_ Includes All Components And Accessories_ Any Type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1001","description":"Electronic Positional Obstructive Sleep Apnea Treatment_ With Sensor_ Includes All Components And Accessories_ Any Type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLD0","description":"ICD-JCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFA0","description":"ICD-NBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGA1","description":"ICD-JBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy excise lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58662","description":"Laparoscopy excise lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYA0","description":"ICD-OGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N-et; per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2002","description":"N-et; per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2181","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61539","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy submucous njx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45381","description":"Colonoscopy submucous njx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAE1","description":"ICD-FEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHC0","description":"ICD-MHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1023","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1023","description":"HCPCS-E1023","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOD1","description":"ICD-OJOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G9871","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","description":"HCPCS-G9871","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus)_ derived from anatomical image da","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0745T","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus)_ derived from anatomical image da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPB0","description":"ICD-BBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lev 3 hosp type b ed visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0382","description":"Lev 3 hosp type b ed visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neurological procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95999","description":"Neurological procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay free hydroxyproline","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83500","description":"Assay free hydroxyproline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sex chromatin identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88140","description":"Sex chromatin identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC125","description":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8D","description":"Very High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair wide w/ leg rests","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1092","description":"Wheelchair wide w/ leg rests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"NPM1 (nucleophosmin) (eg_ acute myeloid leukemia) gene analysis_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0049U","description":"NPM1 (nucleophosmin) (eg_ acute myeloid leukemia) gene analysis_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFF1","description":"ICD-GFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No med visit in 24mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9246","description":"No med visit in 24mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ calcium gluconate (wg critical care)_ per 10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0611","description":"Injection_ calcium gluconate (wg critical care)_ per 10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJD1","description":"ICD-KBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace aortic valve open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33363","description":"Replace aortic valve open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTE1","description":"ICD-BGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy shoulder tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23066","description":"Biopsy shoulder tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCID0","description":"ICD-GCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD13D","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Opto-acoustic imaging_ breast_ unilateral_ including axilla when performed_ real-time with image documentation_ augmentative analysis and report (List separately in addition t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0857T","description":"Opto-acoustic imaging_ breast_ unilateral_ including axilla when performed_ real-time with image documentation_ augmentative analysis and report (List separately in addition t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEC1","description":"ICD-BGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB22A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-76014","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","description":"CPT-76014","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES32C","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOD0","description":"ICD-GEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repl batt alkaline 1.5 v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0603","description":"Repl batt alkaline 1.5 v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC25B","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHD0","description":"ICD-KDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAB0","description":"ICD-ODAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8A","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPB0","description":"ICD-OGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Phys blood bank serv authrj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86079","description":"Phys blood bank serv authrj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Scaling in the presence of generalized moderate or severe gingival inflammation--full mouth_ after oral evaluation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4346","description":"Scaling in the presence of generalized moderate or severe gingival inflammation--full mouth_ after oral evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE22C","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICC1","description":"ICD-AICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22852","description":"Remove spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQA0","description":"ICD-PCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine_ on or after their 60th birthday and before or during measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1179","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine_ on or after their 60th birthday and before or during measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNA0","description":"ICD-NJNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA23D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNF1","description":"ICD-ODNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELD0","description":"ICD-EELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pediatric febrile illness (Kawasaki disease [KD])_ interferon alpha-inducible protein 27 (IFI27) and mast cell-expressed membrane protein 1 (MCEMP1)_ RNA_ using reverse transc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0389U","description":"Pediatric febrile illness (Kawasaki disease [KD])_ interferon alpha-inducible protein 27 (IFI27) and mast cell-expressed membrane protein 1 (MCEMP1)_ RNA_ using reverse transc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCV2 3MCG TRS-SUCR 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0081A","description":"ADM SARSCV2 3MCG TRS-SUCR 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVA0","description":"ICD-GCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQC1","description":"ICD-OJQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMB1","description":"ICD-GCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath tbs c/v manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88164","description":"Cytopath tbs c/v manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEB0","description":"ICD-BDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCE1","description":"ICD-MKCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67914","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPA1","description":"ICD-KCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise penis/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54332","description":"Revise penis/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repositioning of phrenic nerve stimulator transvenous lead(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33281","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQE1","description":"ICD-CAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATB1","description":"ICD-NATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE24A","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOB1","description":"ICD-DDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair bowel-skin fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44640","description":"Repair bowel-skin fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Circum 28 days or older","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54161","description":"Circum 28 days or older","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the pe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1338","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoe heel new leather standa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3455","description":"Shoe heel new leather standa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epstein-barr capsid vca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86665","description":"Epstein-barr capsid vca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML0D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDC0","description":"ICD-BCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat kneecap fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27520","description":"Treat kneecap fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCD1","description":"ICD-NJCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy/removal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38500","description":"Biopsy/removal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-elastic extremity binder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4465","description":"Non-elastic extremity binder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWE0","description":"ICD-KEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place needles pelvic for rt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55920","description":"Place needles pelvic for rt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychological testing (eg_ Wisconsin Card Sorting Test)_ administered by a computer_ with qualified health care professional interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96120","description":"Neuropsychological testing (eg_ Wisconsin Card Sorting Test)_ administered by a computer_ with qualified health care professional interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Solid skin barrier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4362","description":"Solid skin barrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSE0","description":"ICD-DBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDB0","description":"ICD-JGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Metabolic panel total ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80048","description":"Metabolic panel total ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interscapular-thor switch ct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6970","description":"Interscapular-thor switch ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-83884","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","description":"CPT-83884","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB131","description":"Special Care Low _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC20D","description":"Clinically Complex _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABF1","description":"ICD-JABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wound prep trk/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15002","description":"Wound prep trk/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLA0","description":"ICD-BGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBE0","description":"ICD-MJBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Change of gastrostomy tube_ percutaneous_ without imaging or endoscopic guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43760","description":"Change of gastrostomy tube_ percutaneous_ without imaging or endoscopic guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLF0","description":"ICD-JBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta)_ quantification_ including reverse transcription_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87523","description":"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta)_ quantification_ including reverse transcription_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGA1","description":"ICD-CIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip socket fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27222","description":"Treat hip socket fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB12B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSE1","description":"ICD-CHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28160","description":"Partial removal of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMF1","description":"ICD-JAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLE1","description":"ICD-BCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunization admin each add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90472","description":"Immunization admin each add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB26","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPF0","description":"ICD-JDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC31","description":"Very High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDA0","description":"ICD-OLDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hla typing a b or c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86813","description":"Hla typing a b or c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Candida dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87482","description":"Candida dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBD0","description":"ICD-BBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid organ neoplasia)_ gene rearrangement detection by whole gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0120U","description":"Oncology (solid organ neoplasia)_ gene rearrangement detection by whole gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYE1","description":"ICD-ODYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unusual physician travel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99082","description":"Unusual physician travel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTF0","description":"ICD-ODTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMA0","description":"ICD-MGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1253","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCA0","description":"ICD-NKCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMC0","description":"ICD-JHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPC0","description":"ICD-CIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPF1","description":"ICD-BDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB101","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBE0","description":"ICD-NEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFA0","description":"ICD-OEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v auto in fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88174","description":"Cytopath c/v auto in fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLD1","description":"ICD-BDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biovance tri-layer or biovance 3l_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4283","description":"Biovance tri-layer or biovance 3l_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOE0","description":"ICD-HFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Integra meshed bil wound mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9363","description":"Integra meshed bil wound mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHC1","description":"ICD-OEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTC0","description":"ICD-IBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of nose lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30020","description":"Drainage of nose lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC215","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRB1","description":"ICD-HDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSF1","description":"ICD-ODSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFA0","description":"ICD-BEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC16","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMD1","description":"ICD-FEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exome (ie_ somatic mutations)_ paired formalin-fixed paraffin-embedded tumor tissue and normal specimen_ sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0036U","description":"Exome (ie_ somatic mutations)_ paired formalin-fixed paraffin-embedded tumor tissue and normal specimen_ sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg_ low-ejection fraction_ pulmonary hypertension_ hypertrophic cardiomyopathy); related","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0765T","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg_ low-ejection fraction_ pulmonary hypertension_ hypertrophic cardiomyopathy); related","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEC1","description":"ICD-BHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp pop-tibl-prl-other","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35671","description":"Art byp pop-tibl-prl-other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt doc no fall in asc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8911","description":"Pt doc no fall in asc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTA0","description":"ICD-BBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Other pt/ot d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8992","description":"Other pt/ot d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary service/procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94799","description":"Pulmonary service/procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration behind upper jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31040","description":"Exploration behind upper jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIA1","description":"ICD-FDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol amino acid 3.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4168","description":"Parenteral sol amino acid 3.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28B","description":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQB0","description":"ICD-KAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJF1","description":"ICD-GIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ hip_ unilateral; one view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73500","description":"Radiologic examination_ hip_ unilateral; one view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18B","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0894T","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Individual filled at least two prescriptions for any antipsychotic medication and had a pdc of 0.8 or greater","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9369","description":"Individual filled at least two prescriptions for any antipsychotic medication and had a pdc of 0.8 or greater","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection for tear sac x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68850","description":"Injection for tear sac x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTE1","description":"ICD-KFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAID0","description":"ICD-BAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchial valve remov addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31649","description":"Bronchial valve remov addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1102","description":"HCPCS-B1102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUE0","description":"ICD-KFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWF1","description":"ICD-GFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPE0","description":"ICD-NDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal surg myelomeningo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2404","description":"Fetal surg myelomeningo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL13","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No order for ceph no reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9198","description":"No order for ceph no reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEED1","description":"ICD-GEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vantas implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9225","description":"Vantas implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBE1","description":"ICD-MGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism Infinx_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1018","description":"Clinical decision support mechanism Infinx_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of ovarian cyst(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58805","description":"Drainage of ovarian cyst(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYC0","description":"ICD-OAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJD0","description":"ICD-FIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cntct lens pmma-toric/prism","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2501","description":"Cntct lens pmma-toric/prism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTD1","description":"ICD-CFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Euflexxa inj per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7323","description":"Euflexxa inj per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXD0","description":"ICD-FIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ argatroban (auromedics)_ not therapeutically equivalent to j0884_ 1 mg (for esrd on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0899","description":"Injection_ argatroban (auromedics)_ not therapeutically equivalent to j0884_ 1 mg (for esrd on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWF0","description":"ICD-LHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test thor paraspinal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95869","description":"Muscle test thor paraspinal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk_ Breasts_ Scalp_ Arms_ And/Or Legs; Each Additional 50 Cc Injectate_ Or Part Thereof (List Separately In","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15772","description":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk_ Breasts_ Scalp_ Arms_ And/Or Legs; Each Additional 50 Cc Injectate_ Or Part Thereof (List Separately In","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTB0","description":"ICD-NKTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUF1","description":"ICD-GCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4373","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","description":"HCPCS-Q4373","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQB1","description":"ICD-LIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGED0","description":"ICD-JGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDB1","description":"ICD-GEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27725","description":"Repair of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALB0","description":"ICD-OALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDA0","description":"ICD-MHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICB1","description":"ICD-EICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect nasopharynx skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61586","description":"Resect nasopharynx skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA03","description":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plasma fresh frozen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86927","description":"Plasma fresh frozen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCA0","description":"ICD-NJCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHB1","description":"ICD-AFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPB1","description":"ICD-NFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACD0","description":"ICD-BACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Above knee flex cover system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5964","description":"Above knee flex cover system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMD0","description":"ICD-IEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQD1","description":"ICD-GBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGE0","description":"ICD-OJGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWB0","description":"ICD-LHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0556U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","description":"CPT-0556U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No card tamp e/in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9409","description":"No card tamp e/in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4350","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","description":"HCPCS-Q4350","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral infusion pump sta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0791","description":"Parenteral infusion pump sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBC0","description":"ICD-EBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEED0","description":"ICD-JEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNC1","description":"ICD-NBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB130","description":"Special Care Low _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKA1","description":"ICD-FDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYF0","description":"ICD-PBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAE1","description":"ICD-CIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove epididymis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54830","description":"Remove epididymis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKE1","description":"ICD-OHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mlh1 gene known variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81293","description":"Mlh1 gene known variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXB0","description":"ICD-NGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gammagard liquid injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1569","description":"Gammagard liquid injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8A","description":"High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA5B","description":"Low Rehab_ ADL Index 0-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSD1","description":"ICD-KHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUA0","description":"ICD-ODUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVE1","description":"ICD-CEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression glove_ custom_ heavy weight_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6580","description":"Gradient compression glove_ custom_ heavy weight_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSB0","description":"ICD-LFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagus surgery for veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43401","description":"Esophagus surgery for veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8G","description":"High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOE0","description":"ICD-DGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytp fna eval ea addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88177","description":"Cytp fna eval ea addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMD1","description":"ICD-BGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ coagulation Factor Xa (recombinant)_ inactivated-zhzo (Andexxa)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7169","description":"Injection_ coagulation Factor Xa (recombinant)_ inactivated-zhzo (Andexxa)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVF1","description":"ICD-KHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSB0","description":"ICD-GDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPE1","description":"ICD-OLPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMF1","description":"ICD-EBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection anistreplase 30 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0350","description":"Injection anistreplase 30 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEF0","description":"ICD-OEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIC0","description":"ICD-AGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGF0","description":"ICD-ODGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of lower extremity joint with Motor <22.05._without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0806","description":"Replacement of lower extremity joint with Motor <22.05._without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 1ST DOSE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0001A","description":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 1ST DOSE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNC0","description":"ICD-OHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASE1","description":"ICD-OASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28H","description":"Special Care Low _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"DMPK (DM1 protein kinase) (eg_ myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81234","description":"DMPK (DM1 protein kinase) (eg_ myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENA0","description":"ICD-KENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/stent plcmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45389","description":"Colonoscopy w/stent plcmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRB1","description":"ICD-OJRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid organ neoplasia)_ DNA_ targeted sequencing of protein-coding exons of 468 cancer-associated genes_ including interrogation for somatic mutations and microsatel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0048U","description":"Oncology (solid organ neoplasia)_ DNA_ targeted sequencing of protein-coding exons of 468 cancer-associated genes_ including interrogation for somatic mutations and microsatel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGB0","description":"ICD-BGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mold socket ank hgt w/ toe f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5010","description":"Mold socket ank hgt w/ toe f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFB1","description":"ICD-GBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAB0","description":"ICD-EEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHB1","description":"ICD-FEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTD1","description":"ICD-GHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Lynch syndrome)_ genomic DNA sequence analysis of MLH1_ MSH2_ MSH6_ PMS2_ and EPCAM_ including small sequence changes in exonic and intronic regions_ deletions_ dupl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0238U","description":"Oncology (Lynch syndrome)_ genomic DNA sequence analysis of MLH1_ MSH2_ MSH6_ PMS2_ and EPCAM_ including small sequence changes in exonic and intronic regions_ deletions_ dupl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHA0","description":"ICD-FIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic management program_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9455","description":"Diabetic management program_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELB0","description":"ICD-IELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aicd_ other than sing/dual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1882","description":"Aicd_ other than sing/dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine hemoglobin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83069","description":"Assay of urine hemoglobin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sex transformation m to f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55970","description":"Sex transformation m to f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDB0","description":"ICD-GCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwr pack base elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0488","description":"Pwr pack base elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVC1","description":"ICD-OIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ziconotide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2278","description":"Ziconotide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54105","description":"Biopsy of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA55","description":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastrointestinal fat absorpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3708","description":"Gastrointestinal fat absorpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Two Or More Antipsychotic Prescriptions Ordered For Patients Who Had A Diagnosis Of Schizophrenia_ Schizoaffective Disorder_ Or Bipolar Disorder On Or Between January 1 Of The","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0032","description":"Two Or More Antipsychotic Prescriptions Ordered For Patients Who Had A Diagnosis Of Schizophrenia_ Schizoaffective Disorder_ Or Bipolar Disorder On Or Between January 1 Of The","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGME1","description":"ICD-AGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tangential biopsy of skin (eg_ shave_ scoop_ saucerize_ curette); single lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11102","description":"Tangential biopsy of skin (eg_ shave_ scoop_ saucerize_ curette); single lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"D5w/0.45ns w kcl and mgs04","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5014","description":"D5w/0.45ns w kcl and mgs04","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transdermal gfr monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0603T","description":"Transdermal gfr monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were deceased when the hu survey reached them","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1254","description":"Patients who were deceased when the hu survey reached them","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0103","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0103","description":"CDT-D0103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1402","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1402","description":"CDT-D1402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTB1","description":"ICD-NLTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAA1","description":"ICD-BAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD130","description":"Reduced Physical Function _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBD0","description":"ICD-KBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDC1","description":"ICD-OCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCB0","description":"ICD-KCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQB0","description":"ICD-CCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRD0","description":"ICD-HHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34001","description":"Removal of artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIE1","description":"ICD-BIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVD1","description":"ICD-NFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX34","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIF1","description":"ICD-OHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB24C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQA1","description":"ICD-CHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIF0","description":"ICD-BFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYC1","description":"ICD-PCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ring flange plastic/leather","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1100","description":"Ring flange plastic/leather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m fanolesomab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9566","description":"Tc99m fanolesomab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0528","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0528","description":"HCPCS-J0528","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33775","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DC21","description":"ICD-3DC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKD1","description":"ICD-CGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILD0","description":"ICD-OILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tib/per revasc w/ather","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37229","description":"Tib/per revasc w/ather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEME1","description":"ICD-MEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert idrl body crvcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63304","description":"Remove vert idrl body crvcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compression stocking bk18-30","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6530","description":"Compression stocking bk18-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICD1","description":"ICD-CICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOA0","description":"ICD-DHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drop lock retainer each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2785","description":"Drop lock retainer each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng leg ped fbrgls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4032","description":"Cast sup lng leg ped fbrgls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert balloon device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33973","description":"Insert balloon device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ multianalyte molecular profile by photometric detection of macromolecules adsorbed on nanosponge array slides with machine learning_ utilizing first morni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0228U","description":"Oncology (prostate)_ multianalyte molecular profile by photometric detection of macromolecules adsorbed on nanosponge array slides with machine learning_ utilizing first morni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVF1","description":"ICD-NEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biovance 1 square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4154","description":"Biovance 1 square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIF0","description":"ICD-NEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no ahi or rdi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8843","description":"Doc reas no ahi or rdi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHE0","description":"ICD-JFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pet image full body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78813","description":"Pet image full body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat shoulder dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23655","description":"Treat shoulder dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA32","description":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLB0","description":"ICD-GCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esrd srv 2-3 vsts p mo 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90961","description":"Esrd srv 2-3 vsts p mo 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJF1","description":"ICD-CIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNB1","description":"ICD-GHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVE0","description":"ICD-JGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Division of fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58600","description":"Division of fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of foot infection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28003","description":"Treatment of foot infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay porc 4/more sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2644","description":"Dental onlay porc 4/more sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair commode seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0968","description":"Wheelchair commode seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUD1","description":"ICD-BAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLD1","description":"ICD-IDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHC0","description":"ICD-MFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pituitary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61548","description":"Removal of pituitary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Myelography lumbar injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62303","description":"Myelography lumbar injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISE0","description":"ICD-HISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYE1","description":"ICD-CBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prevocational services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W6107","description":"Prevocational services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMA1","description":"ICD-NKMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVA1","description":"ICD-GDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII (antihemophiliac factor_ recombinant) PEGylated_ 1 I.U.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9137","description":"Injection_ Factor VIII (antihemophiliac factor_ recombinant) PEGylated_ 1 I.U.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADC0","description":"ICD-CADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWB1","description":"ICD-OCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spine & skull spinal fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22590","description":"Spine & skull spinal fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Humidifier for use w/ regula","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0555","description":"Humidifier for use w/ regula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insj/rplc cardiac modulj pls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0409T","description":"Insj/rplc cardiac modulj pls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE10D","description":"Clinically Complex _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Observational behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by one tec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0361T","description":"Observational behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by one tec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin barrier with flange","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4373","description":"Skin barrier with flange","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEF0","description":"ICD-NJEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEB0","description":"ICD-AGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXB1","description":"ICD-JIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reteplase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2993","description":"Reteplase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crutch and cane holder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2207","description":"Crutch and cane holder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYB1","description":"ICD-DIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBF1","description":"ICD-GBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEB0","description":"ICD-KFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA0A","description":"Low Rehab_ ADL Index 0-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGC1","description":"ICD-FEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIA1","description":"ICD-ODIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hep a vac injxn admin/recvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4148F","description":"Hep a vac injxn admin/recvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE140","description":"Special Care Low _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc no pain comfort 48hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9251","description":"Doc no pain comfort 48hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tetanus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86774","description":"Tetanus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ translumin angio laser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1885","description":"Cath_ translumin angio laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: new onset headache in pediatric patients with disabilities for which headache is a concern as inferred from behavio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2194","description":"Patients with clinical indications for imaging of the head: new onset headache in pediatric patients with disabilities for which headache is a concern as inferred from behavio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQD1","description":"ICD-DFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHB1","description":"ICD-CIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/abn lvef b-bloc no rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8452","description":"Pt w/abn lvef b-bloc no rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vagus n eltrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64570","description":"Remove vagus n eltrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rsect hip tum incl femur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27078","description":"Rsect hip tum incl femur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDE0","description":"ICD-MLDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Free/remove chest lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32320","description":"Free/remove chest lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28C","description":"Special Care High _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL0B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epoetin alfa_ non-esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0885","description":"Epoetin alfa_ non-esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICE0","description":"ICD-GICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC255","description":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEC1","description":"ICD-FEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Droperidol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1790","description":"Droperidol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tcranial magn stim tx plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90867","description":"Tcranial magn stim tx plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLE1","description":"ICD-BHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWA0","description":"ICD-OAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIA0","description":"ICD-AAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB10B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFA1","description":"ICD-OIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lyse chest fibrin init day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32561","description":"Lyse chest fibrin init day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLD1","description":"ICD-OBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEB0","description":"ICD-BIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytolethal distending toxin B (CdtB) and vinculin IgG antibodies by immunoassay (ie_ ELISA)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0085U","description":"Cytolethal distending toxin B (CdtB) and vinculin IgG antibodies by immunoassay (ie_ ELISA)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAD1","description":"ICD-MGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGE1","description":"ICD-BDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj perflexane lip micros_ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9955","description":"Inj perflexane lip micros_ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65175","description":"Removal of ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc visc aorta 3 graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34843","description":"Endovasc visc aorta 3 graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pierce skull & remove clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61154","description":"Pierce skull & remove clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lyse chest fibrin subq day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32562","description":"Lyse chest fibrin subq day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTD1","description":"ICD-GFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDID0","description":"ICD-KDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIA1","description":"ICD-MBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSF1","description":"ICD-CDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDC0","description":"ICD-FGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEE1","description":"ICD-OKEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay blood carbon dioxide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82374","description":"Assay blood carbon dioxide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB1B","description":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50130","description":"Removal of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBB0","description":"ICD-BCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD226","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHC1","description":"ICD-OLHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy fundoplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43280","description":"Laparoscopy fundoplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOE1","description":"ICD-DHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cros hearing aid dispens fee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5200","description":"Cros hearing aid dispens fee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMA0","description":"ICD-NAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABF1","description":"ICD-BABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJA1","description":"ICD-JAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGND0","description":"ICD-JGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJA0","description":"ICD-BBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Docking station for use with oral device/appliance used to reduce upper airway collapsibility","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1037","description":"Docking station for use with oral device/appliance used to reduce upper airway collapsibility","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove thoracic lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38746","description":"Remove thoracic lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open brachial artery exposure for delivery of endovascular prosthesis_ unilateral (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34834","description":"Open brachial artery exposure for delivery of endovascular prosthesis_ unilateral (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of serum potassium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84132","description":"Assay of serum potassium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIB0","description":"ICD-MCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMC1","description":"ICD-IIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACC1","description":"ICD-IACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special joystick handle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2323","description":"Special joystick handle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIE0","description":"ICD-GEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVB0","description":"ICD-OEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIME0","description":"ICD-KIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93971","description":"Extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJD1","description":"ICD-BAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immntx 1 sting insect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95130","description":"Immntx 1 sting insect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implantable pump replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0786","description":"Implantable pump replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37263","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","description":"CPT-37263","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB23A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMF0","description":"ICD-FCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMF1","description":"ICD-JCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXE1","description":"ICD-BIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA144","description":"Clinically Complex _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHE1","description":"ICD-OHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD220","description":"Reduced Physical Function _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0803","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0803","description":"CDT-D0803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB10D","description":"Clinically Complex _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIC0","description":"ICD-MEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAC0","description":"ICD-OGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Warfarin respon genetic test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9143","description":"Warfarin respon genetic test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBA0","description":"ICD-EGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICF1","description":"ICD-FICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct elbow med ligmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24346","description":"Reconstruct elbow med ligmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHA1","description":"ICD-NKHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNE0","description":"ICD-BCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDD0","description":"ICD-JDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYA0","description":"ICD-KIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCF0","description":"ICD-IBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRA1","description":"ICD-GHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Init day hosp neonate care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99477","description":"Init day hosp neonate care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ibuprofen injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1741","description":"Ibuprofen injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHA1","description":"ICD-AGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOB0","description":"ICD-HAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLC0","description":"ICD-ICLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Somatrem injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2940","description":"Somatrem injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKC1","description":"ICD-JGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC60","description":"High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Russell viper venom diluted","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85613","description":"Russell viper venom diluted","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGID0","description":"ICD-FGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of hand joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26843","description":"Fusion of hand joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGF1","description":"ICD-KAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEA1","description":"ICD-NEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0004","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDE1","description":"ICD-IFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JA11","description":"ICD-4JA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOC0","description":"ICD-LIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYB1","description":"ICD-KEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1449","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","description":"HCPCS-M1449","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51820","description":"Revision of urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1DC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DC21","description":"ICD-1DC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMA0","description":"ICD-CGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD160","description":"Reduced Physical Function _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urinalysis nonauto w/o scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81002","description":"Urinalysis nonauto w/o scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHED0","description":"ICD-AHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kit gene analys d816 variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81273","description":"Kit gene analys d816 variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSB1","description":"ICD-GCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAF0","description":"ICD-AHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCE0","description":"ICD-FHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQE0","description":"ICD-PKQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensve oral evaluation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0150","description":"Comprehensve oral evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC13A","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1047T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1047T","description":"CPT-1047T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fluid flow or fluid GF_ 1 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4206","description":"Fluid flow or fluid GF_ 1 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQE1","description":"ICD-KGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXD0","description":"ICD-GCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFE0","description":"ICD-OKFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEE0","description":"ICD-NEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUD0","description":"ICD-FFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX5B","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Streptozocin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9320","description":"Streptozocin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUD0","description":"ICD-NLUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc foot/toe tum dep 1.5cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28041","description":"Exc foot/toe tum dep 1.5cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKB1","description":"ICD-FCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD160","description":"Special Care High _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDC1","description":"ICD-KBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLE0","description":"ICD-JHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA240","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L1933","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","description":"HCPCS-L1933","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLE0","description":"ICD-NKLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC21B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; venovenous collaterals originating below the heart (e","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93588","description":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; venovenous collaterals originating below the heart (e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE11C","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXC1","description":"ICD-OEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93976","description":"Vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRF1","description":"ICD-PCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAE1","description":"ICD-GCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE154","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rbc_ l/r_ cmv-neg_ irrad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9058","description":"Rbc_ l/r_ cmv-neg_ irrad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Root surgery bicuspid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3421","description":"Root surgery bicuspid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear exam of tear flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78660","description":"Nuclear exam of tear flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sho","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC06","description":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resin infiltration of lesion","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2990","description":"Resin infiltration of lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair arm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24341","description":"Repair arm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj tedizolid phosphate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3090","description":"Inj tedizolid phosphate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNC0","description":"ICD-GBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJE1","description":"ICD-CAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Egd lesion ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43270","description":"Egd lesion ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gen w/c cushion wdth < 22 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2601","description":"Gen w/c cushion wdth < 22 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD234","description":"Clinically Complex _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSF0","description":"ICD-OGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal donor liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47141","description":"Partial removal donor liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8A","description":"Low Rehab_ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGF1","description":"ICD-JAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIE1","description":"ICD-FGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urine specimen collect mult","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9615","description":"Urine specimen collect mult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLB0","description":"ICD-NHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-traumatic spinal cord injury with Motor <23.75._without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0506","description":"Non-traumatic spinal cord injury with Motor <23.75._without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHB1","description":"ICD-JCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESB1","description":"ICD-PESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair modified fontan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33615","description":"Repair modified fontan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L5827","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","description":"HCPCS-L5827","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASD1","description":"ICD-GASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; initial single probe stain p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0851T","description":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; initial single probe stain p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD23B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDID1","description":"ICD-IDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUB1","description":"ICD-GCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHME0","description":"ICD-NHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAE0","description":"ICD-MKAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWE1","description":"ICD-PCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55715","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","description":"CPT-55715","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Igk rearrangeabn clonal pop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81264","description":"Igk rearrangeabn clonal pop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Specialty care transport","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0434","description":"Specialty care transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65091","description":"Revise eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB105","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Commode chair foot rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0175","description":"Commode chair foot rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise vag graft open abd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57296","description":"Revise vag graft open abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rilonacept injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2793","description":"Rilonacept injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHB0","description":"ICD-KHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAE1","description":"ICD-EFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMD1","description":"ICD-FDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc brst cncr stage 0 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3370F","description":"Ajcc brst cncr stage 0 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Head And Neck Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1088","description":"Radiation Therapy For Head And Neck Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHE0","description":"ICD-CGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB21B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67973","description":"Reconstruction of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL26","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcvng anti-rheum thxpy ra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4195F","description":"Pt rcvng anti-rheum thxpy ra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCF0","description":"ICD-CGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection_ all nonselec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34706","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection_ all nonselec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconst lwr jaw w/fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21196","description":"Reconst lwr jaw w/fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAD1","description":"ICD-JEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEB1","description":"ICD-MKEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destroy c/th facet jnt addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64634","description":"Destroy c/th facet jnt addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXA0","description":"ICD-NGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release of eye fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67015","description":"Release of eye fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBA0","description":"ICD-MJBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noner transport meals escort","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0210","description":"Noner transport meals escort","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIED0","description":"ICD-KIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITF0","description":"ICD-AITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB226","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLA0","description":"ICD-CGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair heavy duty fixed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1285","description":"Wheelchair heavy duty fixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration popliteal artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35741","description":"Exploration popliteal artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBE0","description":"ICD-GIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct colonography dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74261","description":"Ct colonography dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITB1","description":"ICD-CITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAA0","description":"ICD-BBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ped compr care pkg_ per hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1026","description":"Ped compr care pkg_ per hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 120 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0143U","description":"Drug assay_ definitive_ 120 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraop cyto path consult 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88333","description":"Intraop cyto path consult 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24006","description":"Release elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBE0","description":"ICD-GCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal foreign body jawbone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41806","description":"Removal foreign body jawbone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIED1","description":"ICD-GIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKD1","description":"ICD-NKKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj multihance multipack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9578","description":"Inj multihance multipack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prepare penis study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54230","description":"Prepare penis study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTE1","description":"ICD-EGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWC0","description":"ICD-PDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear antigen antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86235","description":"Nuclear antigen antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQD0","description":"ICD-LBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01844","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01844","description":"CPT-01844","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYE1","description":"ICD-HDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBA1","description":"ICD-AIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWB1","description":"ICD-OLWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assess cyst contrast inject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49424","description":"Assess cyst contrast inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAE1","description":"ICD-NBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC140","description":"Special Care High _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echograp trans r pros study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76873","description":"Echograp trans r pros study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prev resin rest_ perm tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1352","description":"Prev resin rest_ perm tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cinacalcet_ oral_ 1 mg_ (for ESRD on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0604","description":"Cinacalcet_ oral_ 1 mg_ (for ESRD on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQC0","description":"ICD-CIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDE0","description":"ICD-CFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDC1","description":"ICD-BDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic source imaging","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8035","description":"Magnetic source imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoe clubfoot wedge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3380","description":"Shoe clubfoot wedge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr s/tr/ext 7.6-12.5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12034","description":"Intmd rpr s/tr/ext 7.6-12.5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBC0","description":"ICD-MLBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pain management (opioid-use disorder) genotyping panel_ 16 common variants (ie_ ABCB1_ COMT_ DAT1_ DBH_ DOR_ DRD1_ DRD2_ DRD4_ GABA_ GAL_ HTR2A_ HTTLPR_ MTHFR_ MUOR_ OPRK1_ OP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0078U","description":"Pain management (opioid-use disorder) genotyping panel_ 16 common variants (ie_ ABCB1_ COMT_ DAT1_ DBH_ DOR_ DRD1_ DRD2_ DRD4_ GABA_ GAL_ HTR2A_ HTTLPR_ MTHFR_ MUOR_ OPRK1_ OP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sterile gauze>16 <= 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6403","description":"Sterile gauze>16 <= 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEE1","description":"ICD-JIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Promoting wellness mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0005","description":"Promoting wellness mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Functional status performed once in the last 12 months","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9916","description":"Functional status performed once in the last 12 months","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cntct toric prism ballast","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2511","description":"Cntct toric prism ballast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incontinence product_ disposable_ penile wrap_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4545","description":"Incontinence product_ disposable_ penile wrap_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA2A","description":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCA1","description":"ICD-MLCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28D","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHC0","description":"ICD-BAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB24D","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUB0","description":"ICD-OFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGED0","description":"ICD-EGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of chest lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32310","description":"Removal of chest lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Functional status was measured by the Oxford Knee Score (OKS) patient reported outcome tool within three months preoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1047","description":"Functional status was measured by the Oxford Knee Score (OKS) patient reported outcome tool within three months preoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Group adaptive behavior treatment by protocol_ administered by technician under the direction of a physician or other qualified health care professional_ face-to-face with two","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97154","description":"Group adaptive behavior treatment by protocol_ administered by technician under the direction of a physician or other qualified health care professional_ face-to-face with two","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEC0","description":"ICD-BBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGE0","description":"ICD-OBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion/graft of finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26862","description":"Fusion/graft of finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Closure of nephrovisceral fistula (eg_ renocolic)_ including visceral repair; thoracic approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50526","description":"Closure of nephrovisceral fistula (eg_ renocolic)_ including visceral repair; thoracic approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion Of Substernal Implantable Defibrillator Electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0572T","description":"Insertion Of Substernal Implantable Defibrillator Electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBE0","description":"ICD-KEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenervation anal musc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46505","description":"Chemodenervation anal musc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPA0","description":"ICD-CIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVF1","description":"ICD-BDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXC1","description":"ICD-NAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery w/tunnel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33505","description":"Repair artery w/tunnel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy faceplt/silicone ring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4384","description":"Ostomy faceplt/silicone ring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFC1","description":"ICD-GIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50900","description":"Repair of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr fe/e/en/l/m 20.1-30.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12017","description":"Rpr fe/e/en/l/m 20.1-30.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATF1","description":"ICD-GATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWE0","description":"ICD-KCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2GB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GB11","description":"ICD-2GB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24546","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18H","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Occluder lens/es","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2770","description":"Occluder lens/es","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Drug-Delivery Device(S)_ Intra-Articular (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20705","description":"Removal Of Drug-Delivery Device(S)_ Intra-Articular (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGE1","description":"ICD-NEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mod sedat phys/qhp <5 yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99143","description":"Mod sedat phys/qhp <5 yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDF1","description":"ICD-OKDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX0B","description":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0478U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","description":"CPT-0478U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES304","description":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ bivalent_ preservative free_ 10 mcg/0.2 mL dosa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91316","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ bivalent_ preservative free_ 10 mcg/0.2 mL dosa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert ureteral support","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50605","description":"Insert ureteral support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Oncology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4031","description":"Radiation Oncology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGF1","description":"ICD-FCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISD0","description":"ICD-LISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBC0","description":"ICD-OFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAC1","description":"ICD-MCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHC1","description":"ICD-MGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILE1","description":"ICD-BILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC112","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGF0","description":"ICD-KHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth bleeding control","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91651","description":"Anesth bleeding control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"1>=risk or>= mod risk for te","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8972","description":"1>=risk or>= mod risk for te","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA31","description":"Medium Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAF0","description":"ICD-NBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lvef < 40% or lvsd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8923","description":"Lvef < 40% or lvsd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digoxin thxpy for 6 mos/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4220F","description":"Digoxin thxpy for 6 mos/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18C","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enamel microabrasion","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9970","description":"Enamel microabrasion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"1high risk med ord","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9365","description":"1high risk med ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYC0","description":"ICD-DEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHB0","description":"ICD-ICHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJE0","description":"ICD-FGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of urethra gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53250","description":"Removal of urethra gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAE1","description":"ICD-FCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electric stimulation therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97014","description":"Electric stimulation therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGB1","description":"ICD-NAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAED1","description":"ICD-JAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Daptomycin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0878","description":"Daptomycin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICF0","description":"ICD-BICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBF0","description":"ICD-KBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIND1","description":"ICD-BIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFF0","description":"ICD-CBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQA1","description":"ICD-CBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOF1","description":"ICD-HCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX02","description":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCD1","description":"ICD-ECCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dark field examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87164","description":"Dark field examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLB0","description":"ICD-GBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJC0","description":"ICD-KGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBB1","description":"ICD-NBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIA1","description":"ICD-GHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Smoking cessation class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9453","description":"Smoking cessation class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Major vessel shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33767","description":"Major vessel shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth spine cord surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63051","description":"Anesth spine cord surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25444","description":"Reconstruct wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBF0","description":"ICD-ADBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diaper serv reusable diaper","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4538","description":"Diaper serv reusable diaper","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert intrauterine device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58300","description":"Insert intrauterine device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBD0","description":"ICD-AEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUB1","description":"ICD-EBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEE1","description":"ICD-CIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair esophagus opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43425","description":"Repair esophagus opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI orbit/face/neck w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70540","description":"MRI orbit/face/neck w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHND1","description":"ICD-GHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCA0","description":"ICD-IDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPF0","description":"ICD-NBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Levonorgestrel iu 52mg 5 yr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7298","description":"Levonorgestrel iu 52mg 5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRB0","description":"ICD-DGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21079","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUD1","description":"ICD-FDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chap services at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9473","description":"Chap services at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGD1","description":"ICD-OGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWA1","description":"ICD-HHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCE0","description":"ICD-EHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray measurement of pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74710","description":"X-ray measurement of pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ivf package","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4011","description":"Ivf package","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHB0","description":"ICD-IHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTC1","description":"ICD-NJTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (pancreatic)_ 59 methylation haplotype block markers_ next-generation sequencing_ plasma_ reported as cancer signal detected or not detected","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0405U","description":"Oncology (pancreatic)_ 59 methylation haplotype block markers_ next-generation sequencing_ plasma_ reported as cancer signal detected or not detected","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFD1","description":"ICD-NLFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXA1","description":"ICD-BIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJC1","description":"ICD-BDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAB0","description":"ICD-MLAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient is currently on a daily aspirin or other antiplatelet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9793","description":"Patient is currently on a daily aspirin or other antiplatelet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSF0","description":"ICD-GFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCC0","description":"ICD-NJCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; vascular procedures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0133U","description":"Anesthesia for intracranial procedures; vascular procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFC1","description":"ICD-BAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC213","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinogen test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85366","description":"Fibrinogen test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Indwelling intraurethral drainage device with valve_ patient inserted_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1010","description":"Indwelling intraurethral drainage device with valve_ patient inserted_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Virus inoculate tissue addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87253","description":"Virus inoculate tissue addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMB1","description":"ICD-GBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOB0","description":"ICD-OKOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQC0","description":"ICD-LGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prq cardiac angioplast 1 art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92920","description":"Prq cardiac angioplast 1 art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC21","description":"Medium Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRC0","description":"ICD-OCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1501","description":"HCPCS-C1501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYB1","description":"ICD-GAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc lymphatic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38589","description":"Laparoscope proc lymphatic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLB0","description":"ICD-KHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp5 ped mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0891","description":"Pwc gp5 ped mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD205","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSA0","description":"ICD-HGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRA1","description":"ICD-DFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54660","description":"Revision of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49615","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLA0","description":"ICD-JHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit int pain per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9327","description":"Hit int pain per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBED1","description":"ICD-NBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWA0","description":"ICD-DAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dermabind ch_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4288","description":"Dermabind ch_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urinary bladder retention","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78730","description":"Urinary bladder retention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCB0","description":"ICD-MBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA17","description":"Default_ /5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBA1","description":"ICD-ABBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXA1","description":"ICD-JBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC20C","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRB0","description":"ICD-PJRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Ramucirumab_ 5 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9025","description":"Injection_ Ramucirumab_ 5 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dimecaprol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0470","description":"Dimecaprol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUE1","description":"ICD-BAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRA1","description":"ICD-KHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clot inhibit prot c antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85302","description":"Clot inhibit prot c antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Egfr gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81235","description":"Egfr gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44143","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance for analysis of tissue composition (eg_ fat_ iron_ water content)_ including multiparametric data acquisition_ data preparation and transmissio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0649T","description":"Quantitative magnetic resonance for analysis of tissue composition (eg_ fat_ iron_ water content)_ including multiparametric data acquisition_ data preparation and transmissio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Miscellaneous external component_ supply or accessory for use with the Argus II Retinal Prosthesis System","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8608","description":"Miscellaneous external component_ supply or accessory for use with the Argus II Retinal Prosthesis System","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Matristem burn matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4120","description":"Matristem burn matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHD0","description":"ICD-KBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMA0","description":"ICD-JDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco use assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1000F","description":"Tobacco use assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJA0","description":"ICD-CHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood pressure reading not documented_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1281","description":"Blood pressure reading not documented_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29851","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lefort iii w/ lefort i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21155","description":"Lefort iii w/ lefort i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0572U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","description":"CPT-0572U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nondisposable pump canister","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7001","description":"Nondisposable pump canister","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYB0","description":"ICD-PDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRF0","description":"ICD-OCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA235","description":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice home care in hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5010","description":"Hospice home care in hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental sedative filling","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2940","description":"Dental sedative filling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vitamin D_ 25 hydroxy D2 and D3_ by LC-MS/MS_ serum microsample_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0038U","description":"Vitamin D_ 25 hydroxy D2 and D3_ by LC-MS/MS_ serum microsample_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRC0","description":"ICD-KIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBC1","description":"ICD-MDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACE0","description":"ICD-MACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance_ unilate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0718T","description":"Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance_ unilate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDC1","description":"ICD-IFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA50","description":"Medium Rehab _ ADL Index 0-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of fetal heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76825","description":"Echo exam of fetal heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAD1","description":"ICD-GGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELF0","description":"ICD-EELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Totazoline hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2670","description":"Totazoline hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGE0","description":"ICD-KDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQE1","description":"ICD-HFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXC0","description":"ICD-GCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert body dcmprn thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63101","description":"Remove vert body dcmprn thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Med reas not incl histo type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9419","description":"Med reas not incl histo type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFC0","description":"ICD-GEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOA0","description":"ICD-LFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA32","description":"Default_ /30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clearance of airways","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31725","description":"Clearance of airways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKE0","description":"ICD-NFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18A","description":"Special Care High _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMD1","description":"ICD-OEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQA0","description":"ICD-PIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nicotine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6055","description":"Nicotine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision malig lesion>1.25cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7414","description":"Excision malig lesion>1.25cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of ankle ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27698","description":"Repair of ankle ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco-use counsel>10min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0437","description":"Tobacco-use counsel>10min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC111","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIC1","description":"ICD-IAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSB1","description":"ICD-GGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Major vessel shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33755","description":"Major vessel shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Twelve volt battery utah/equ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7364","description":"Twelve volt battery utah/equ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-76017","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","description":"CPT-76017","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1603","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1603","description":"CDT-D1603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVC1","description":"ICD-JFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB52","description":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neck spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22554","description":"Neck spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKA0","description":"ICD-KEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNC0","description":"ICD-KBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXF0","description":"ICD-NBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy br/wa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44381","description":"Small bowel endoscopy br/wa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4352","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","description":"HCPCS-Q4352","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUE1","description":"ICD-KAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETA0","description":"ICD-BETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSD1","description":"ICD-LCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICC1","description":"ICD-FICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILF0","description":"ICD-NILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXC1","description":"ICD-BIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRE1","description":"ICD-OHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRC0","description":"ICD-CBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v thin layer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88142","description":"Cytopath c/v thin layer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOD0","description":"ICD-HAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILF1","description":"ICD-BILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Root canal therapy 3 canals","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3330","description":"Root canal therapy 3 canals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBF0","description":"ICD-AHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEF0","description":"ICD-IDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prep ak ischial direct form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5570","description":"Prep ak ischial direct form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Whole mitochondrial genome","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81460","description":"Whole mitochondrial genome","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0743","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","description":"HCPCS-E0743","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/stent plcmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44402","description":"Colonoscopy w/stent plcmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFND1","description":"ICD-CFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cryocautery of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57511","description":"Cryocautery of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Ct Guidance_ Lumbar; Each Additional Le","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0630T","description":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Ct Guidance_ Lumbar; Each Additional Le","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDE0","description":"ICD-CDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVD1","description":"ICD-NKVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ustekinumab Intravenous Inj 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9989","description":"Ustekinumab Intravenous Inj 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTA0","description":"ICD-JHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of bradykinin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82286","description":"Assay of bradykinin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCA0","description":"ICD-NGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYD1","description":"ICD-HFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPC0","description":"ICD-NGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSD1","description":"ICD-DHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYC1","description":"ICD-OBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECA0","description":"ICD-OECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC33","description":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection for spleen x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38200","description":"Injection for spleen x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBD0","description":"ICD-KFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Muscle transfers","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23397","description":"Muscle transfers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Speech lang goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9175","description":"Speech lang goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orthotic(s)/prosthetic(s) management and/or training_ upper extremity(ies)_ lower extremity(ies)_ and/or trunk_ subsequent orthotic(s)/prosthetic(s) encounter_ each 15 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97763","description":"Orthotic(s)/prosthetic(s) management and/or training_ upper extremity(ies)_ lower extremity(ies)_ and/or trunk_ subsequent orthotic(s)/prosthetic(s) encounter_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUE1","description":"ICD-NCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1012T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","description":"CPT-1012T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays adrenals","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75733","description":"Artery x-rays adrenals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWF0","description":"ICD-GEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Periurethral Transperineal Adjustable Balloon Continence Device; Percutaneous Adjustment Of Balloon(S) Fluid Volume","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53454","description":"Periurethral Transperineal Adjustable Balloon Continence Device; Percutaneous Adjustment Of Balloon(S) Fluid Volume","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDF0","description":"ICD-AFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKE0","description":"ICD-OKKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31370","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOD1","description":"ICD-OLOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFB1","description":"ICD-KBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBC1","description":"ICD-ACBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC52","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMB1","description":"ICD-JEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB212","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD23A","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEME1","description":"ICD-GEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1079T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1079T","description":"CPT-1079T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTB1","description":"ICD-JCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic management program_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9465","description":"Diabetic management program_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAC0","description":"ICD-CFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8G","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Col chromotography qual/quan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82542","description":"Col chromotography qual/quan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Commode chair with fixed arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0163","description":"Commode chair with fixed arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28X","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8C","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMC0","description":"ICD-NHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Change ureter stent percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50382","description":"Change ureter stent percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILD1","description":"ICD-FILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB130","description":"Special Care High _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8X","description":"Very High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18I","description":"Special Care Low _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote body and limb kinematic measurement-based therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or ot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0734T","description":"Remote body and limb kinematic measurement-based therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or ot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMC1","description":"ICD-NCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX4C","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBE0","description":"ICD-IFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s)_ all","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34708","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s)_ all","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Albuterol non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7613","description":"Albuterol non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAD1","description":"ICD-ODAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome analysis 15-20","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88262","description":"Chromosome analysis 15-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCD0","description":"ICD-FHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHC1","description":"ICD-BAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE14C","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD130","description":"Special Care Low _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOA0","description":"ICD-PIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Above elbow myoelectronic ct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6955","description":"Above elbow myoelectronic ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of circulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37180","description":"Revision of circulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBC0","description":"ICD-KCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81400","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGF0","description":"ICD-FBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBC1","description":"ICD-GBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auditory osseointegrated device_ external sound processor_ excludes transducer/actuator_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8691","description":"Auditory osseointegrated device_ external sound processor_ excludes transducer/actuator_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endo knee-shin mnl lck ultra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5811","description":"Endo knee-shin mnl lck ultra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA131","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of protein serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84155","description":"Assay of protein serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCC1","description":"ICD-BDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYB0","description":"ICD-LAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enteral supp not otherwise c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9998","description":"Enteral supp not otherwise c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Microsomal antibody each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86376","description":"Microsomal antibody each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2047","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2047","description":"HCPCS-A2047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remis 12m phq-9 score <5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9509","description":"Remis 12m phq-9 score <5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA30","description":"Ultra High Rehab _ ADL Index 0-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBF1","description":"ICD-OGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1465","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","description":"HCPCS-M1465","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA4A","description":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDD0","description":"ICD-GGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLD1","description":"ICD-GGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFD1","description":"ICD-BDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Methyldopate hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0210","description":"Methyldopate hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAD0","description":"ICD-NEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical opening of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43510","description":"Surgical opening of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epoetin beta non esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0888","description":"Epoetin beta non esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB231","description":"Clinically Complex _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLC1","description":"ICD-GGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHID0","description":"ICD-CHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXA1","description":"ICD-OCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTA1","description":"ICD-GCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Windowing of cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29730","description":"Windowing of cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIF0","description":"ICD-IDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0704","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0704","description":"HCPCS-B0704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQE0","description":"ICD-GHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWD1","description":"ICD-KEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISD0","description":"ICD-OISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYE0","description":"ICD-KDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25490","description":"Reinforce radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDC0","description":"ICD-IHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO lumbar intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an ade","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9733","description":"Patient unable to complete the FOTO lumbar intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an ade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFE0","description":"ICD-GGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Long tongue stirrup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2265","description":"Long tongue stirrup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brain biopsy w/ct/mr guide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61751","description":"Brain biopsy w/ct/mr guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC54","description":"Very High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUA0","description":"ICD-MHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPF0","description":"ICD-GGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGC0","description":"ICD-ODGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHC0","description":"ICD-MIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Liver surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47399","description":"Liver surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBD1","description":"ICD-MCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0506U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","description":"CPT-0506U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHE1","description":"ICD-KBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv saliv glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64611","description":"Chemodenerv saliv glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IB21","description":"ICD-1IB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJF0","description":"ICD-NCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGF1","description":"ICD-KIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36905","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHA0","description":"ICD-EIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWE0","description":"ICD-CHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDD1","description":"ICD-OCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMD1","description":"ICD-MHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise & drain bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51040","description":"Incise & drain bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/pseudobulb affect/als","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3756F","description":"Pt w/pseudobulb affect/als","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBC1","description":"ICD-FHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIC0","description":"ICD-NHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMC1","description":"ICD-IBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA2D","description":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUB0","description":"ICD-IDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA124","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJE1","description":"ICD-OLJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES12C","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brain aneurysm repr simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61700","description":"Brain aneurysm repr simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"BCAT1 (Branched chain amino acid transaminase 1) or IKZF1 (IKAROS family zinc finger 1) (eg_ colorectal cancer) promoter methylation analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0229U","description":"BCAT1 (Branched chain amino acid transaminase 1) or IKZF1 (IKAROS family zinc finger 1) (eg_ colorectal cancer) promoter methylation analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB106","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGB0","description":"ICD-KGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial release of lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32225","description":"Partial release of lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPB0","description":"ICD-OAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX22","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01620","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01620","description":"CPT-01620","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBC1","description":"ICD-OFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMA0","description":"ICD-IGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft femur head/neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27170","description":"Repair/graft femur head/neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB5A","description":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig osteo screen measu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8401","description":"Pt inelig osteo screen measu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWF0","description":"ICD-DFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct entire forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21180","description":"Reconstruct entire forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUC0","description":"ICD-NFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB24A","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYF1","description":"ICD-KHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEA1","description":"ICD-IGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEME1","description":"ICD-IEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Jak2 (Janus Kinase 2) (Eg_ Myeloproliferative Disorder) Targeted Sequence Analysis (Eg_ Exons 12 And 13)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81279","description":"Jak2 (Janus Kinase 2) (Eg_ Myeloproliferative Disorder) Targeted Sequence Analysis (Eg_ Exons 12 And 13)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDD1","description":"ICD-JIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Itch severity assessment score was not reduced by at least 2 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1198","description":"Itch severity assessment score was not reduced by at least 2 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1414","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","description":"HCPCS-J1414","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ear and throat examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92502","description":"Ear and throat examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUF0","description":"ICD-AGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRE1","description":"ICD-LDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N block lumbar/thoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64520","description":"N block lumbar/thoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For Not Administering Pneumococcal Vaccine (E.G._ Adverse Reaction To Vaccine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9989","description":"Documentation Of Medical Reason(S) For Not Administering Pneumococcal Vaccine (E.G._ Adverse Reaction To Vaccine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOD1","description":"ICD-ODOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of rib fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21812","description":"Treatment of rib fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neurovascular pedicle flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15750","description":"Neurovascular pedicle flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDC1","description":"ICD-JCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOD1","description":"ICD-PBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFF1","description":"ICD-BIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8B","description":"High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAE0","description":"ICD-MHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMB1","description":"ICD-JGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHF1","description":"ICD-NGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release palm contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26123","description":"Release palm contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 3 std cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0849","description":"Pwc gp 3 std cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Locm 100-199mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9965","description":"Locm 100-199mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMD0","description":"ICD-GHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJA0","description":"ICD-OCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Relocate pocket for defib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33223","description":"Relocate pocket for defib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ isatuximab-irfc_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9227","description":"Injection_ isatuximab-irfc_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apply short leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29435","description":"Apply short leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUA0","description":"ICD-NAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0013","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","description":"HCPCS-J0013","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVE1","description":"ICD-OCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch clsd w/o bar w filtr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4418","description":"Ost pch clsd w/o bar w filtr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLD0","description":"ICD-ACLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX43","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of lip fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40806","description":"Incision of lip fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBE0","description":"ICD-MBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGB1","description":"ICD-GHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETE0","description":"ICD-NETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHC0","description":"ICD-JHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Presbyopia-correct function","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2788","description":"Presbyopia-correct function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mitomycin pyelocalyceal instillation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9281","description":"Mitomycin pyelocalyceal instillation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth ear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12451","description":"Anesth ear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLA1","description":"ICD-BBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUA0","description":"ICD-FBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHD0","description":"ICD-FDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAD1","description":"ICD-MEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTB1","description":"ICD-GFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXB0","description":"ICD-KFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCD1","description":"ICD-NLCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Gemcitabine Hydrochloride (Infugem)_ 200 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9199","description":"Injection_ Gemcitabine Hydrochloride (Infugem)_ 200 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of lidocaine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80176","description":"Assay of lidocaine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCD1","description":"ICD-GGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES106","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Red cell mass single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78120","description":"Red cell mass single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25350","description":"Revision of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"New lenses in pts old frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0595","description":"New lenses in pts old frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRE0","description":"ICD-OLRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNA1","description":"ICD-GGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPF1","description":"ICD-JHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repl batt silver oxide 1.5 v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0601","description":"Repl batt silver oxide 1.5 v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGB0","description":"ICD-BHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bia whole body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0358T","description":"Bia whole body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1495","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","description":"HCPCS-M1495","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA10C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of folic acid serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82746","description":"Assay of folic acid serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYC1","description":"ICD-OIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKE1","description":"ICD-OBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFID1","description":"ICD-EFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSD0","description":"ICD-HCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIC0","description":"ICD-BDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"SMN1 (survival of motor neuron 1_ telomeric) and SMN2 (survival of motor neuron 2_ centromeric) (eg_ spinal muscular atrophy) full gene analysis_ including small sequence chan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0236U","description":"SMN1 (survival of motor neuron 1_ telomeric) and SMN2 (survival of motor neuron 2_ centromeric) (eg_ spinal muscular atrophy) full gene analysis_ including small sequence chan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esoph lengthening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43338","description":"Esoph lengthening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular disease_ plasma_ analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populatio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0019M","description":"Cardiovascular disease_ plasma_ analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2865","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","description":"HCPCS-J2865","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFED0","description":"ICD-CFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVB0","description":"ICD-FEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHC0","description":"ICD-IAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJB0","description":"ICD-OBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPE1","description":"ICD-GHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWF1","description":"ICD-HGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (cervix)_ mRNA gene expression profiling of 14 biomarkers (E6 and E7 of the highest-risk human papillomavirus [HPV] types 16_ 18_ 31_ 33_ 45_ 52_ 58)_ by real-time nu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0463U","description":"Oncology (cervix)_ mRNA gene expression profiling of 14 biomarkers (E6 and E7 of the highest-risk human papillomavirus [HPV] types 16_ 18_ 31_ 33_ 45_ 52_ 58)_ by real-time nu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCC1","description":"ICD-IDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXD0","description":"ICD-BGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of foot joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28020","description":"Exploration of foot joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"R & l heart cath congenital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93533","description":"R & l heart cath congenital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE21C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"1 pc ost pou w built-in conv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5057","description":"1 pc ost pou w built-in conv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ meropenem (WG Critical Care)_ not therapeutically equivalent to J2185_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2183","description":"Injection_ meropenem (WG Critical Care)_ not therapeutically equivalent to J2185_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGA1","description":"ICD-BEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transtemporal approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61595","description":"Transtemporal approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Uvl sys panel 4 ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0692","description":"Uvl sys panel 4 ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRE1","description":"ICD-PCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj foramen epidural add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64480","description":"Inj foramen epidural add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMF0","description":"ICD-GFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB236","description":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intro/sheath_ non-laser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1894","description":"Intro/sheath_ non-laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYD0","description":"ICD-OAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDA1","description":"ICD-GEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTD0","description":"ICD-KHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUB0","description":"ICD-AFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48140","description":"Partial removal of pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE244","description":"Special Care Low _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERC0","description":"ICD-OERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFED0","description":"ICD-FFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sbrt delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77373","description":"Sbrt delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Off assis eol iss","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9380","description":"Off assis eol iss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHC0","description":"ICD-OJHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ldl-c <100 mg/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3048F","description":"Ldl-c <100 mg/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHB1","description":"ICD-IFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bortezomib (hospira)_ not therapeutically equivalent to j9041_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9049","description":"Injection_ bortezomib (hospira)_ not therapeutically equivalent to j9041_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr e/n/e/l addl 5cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13153","description":"Cmplx rpr e/n/e/l addl 5cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKA1","description":"ICD-CCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFD0","description":"ICD-CEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSA0","description":"ICD-KHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sgd w multi methods msg/accs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2510","description":"Sgd w multi methods msg/accs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Global eswl kidney","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0400","description":"Global eswl kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Swingaway detach footrest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0052","description":"Swingaway detach footrest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Six volt bat otto bock/eq ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7360","description":"Six volt bat otto bock/eq ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HER2-targeted therapies not administered during the initial course of treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9827","description":"HER2-targeted therapies not administered during the initial course of treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Supported housing_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0043","description":"Supported housing_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"TPMT (thiopurine S-methyltransferase)_ NUDT15 (nudix hydroxylase 15)(eg_ thiopurine metabolism)_ gene analysis_ common variants (ie_ TPMT *2_ *3A_ *3B_ *3C_ *4_ *5_ *6_ *8_ *1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0034U","description":"TPMT (thiopurine S-methyltransferase)_ NUDT15 (nudix hydroxylase 15)(eg_ thiopurine metabolism)_ gene analysis_ common variants (ie_ TPMT *2_ *3A_ *3B_ *3C_ *4_ *5_ *6_ *8_ *1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEB1","description":"ICD-MJEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urea-n clearance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84545","description":"Urea-n clearance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVD0","description":"ICD-JHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLC1","description":"ICD-ECLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDB1","description":"ICD-AIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1087T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1087T","description":"CPT-1087T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEID1","description":"ICD-BEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical repair of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43502","description":"Surgical repair of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACF0","description":"ICD-AACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBE1","description":"ICD-IDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBF0","description":"ICD-JFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A8006","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","description":"HCPCS-A8006","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged service inpatient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99356","description":"Prolonged service inpatient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFA0","description":"ICD-NGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gi tract capsule endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0355T","description":"Gi tract capsule endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDE1","description":"ICD-GGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCF1","description":"ICD-CBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tkr intent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9234","description":"Tkr intent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBD1","description":"ICD-FIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Whirlpool portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1300","description":"Whirlpool portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0915T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","description":"CPT-0915T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.00d/4.2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2205","description":"Lens sphcy bifocal 4.00d/4.2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Frontier extended stay demo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9140","description":"Frontier extended stay demo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8F","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVA1","description":"ICD-CAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Developmental test administration (including assessment of fine and/or gross motor_ language_ cognitive level_ social_ memory and/or executive functions by standardized develo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96112","description":"Developmental test administration (including assessment of fine and/or gross motor_ language_ cognitive level_ social_ memory and/or executive functions by standardized develo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEA1","description":"ICD-BAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Eac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95719","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Eac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neuromuscular stim for scoli","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0744","description":"Neuromuscular stim for scoli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOB0","description":"ICD-GCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Barrera sl or barrera dl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4281","description":"Barrera sl or barrera dl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4409","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","description":"HCPCS-Q4409","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Red cell mass multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78121","description":"Red cell mass multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCB0","description":"ICD-JDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27511","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAE0","description":"ICD-MGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Egd injection varices","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43243","description":"Egd injection varices","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1JC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JC21","description":"ICD-1JC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Detach non-adjus hght armrst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0015","description":"Detach non-adjus hght armrst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrical impedance spectroscopy of 1 or more skin lesions for automated melanoma risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0658T","description":"Electrical impedance spectroscopy of 1 or more skin lesions for automated melanoma risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m apcitide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9504","description":"Tc99m apcitide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair head rest extensi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0966","description":"Wheelchair head rest extensi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES254","description":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Collect sweat for test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89230","description":"Collect sweat for test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artificial cornea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8609","description":"Artificial cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assess vol mgmt not doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8958","description":"Assess vol mgmt not doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1801","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1801","description":"HCPCS-B1801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOF1","description":"ICD-OEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient screened for tobacco use and identified as a tobacco non-user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1282","description":"Patient screened for tobacco use and identified as a tobacco non-user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJC0","description":"ICD-NHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICA0","description":"ICD-BICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29820","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBD0","description":"ICD-JFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct neck spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72125","description":"Ct neck spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Polysom 6/> yrs 4/> param","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95810","description":"Polysom 6/> yrs 4/> param","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Emerge matrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4297","description":"Emerge matrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB55","description":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLB0","description":"ICD-CFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES245","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAA1","description":"ICD-CCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4380","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","description":"HCPCS-Q4380","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDE1","description":"ICD-FFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAC0","description":"ICD-NKAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bx breast 1st lesion mr imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19085","description":"Bx breast 1st lesion mr imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A6518","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","description":"HCPCS-A6518","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pos airway pressure cpap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94660","description":"Pos airway pressure cpap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD151","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNB1","description":"ICD-BBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUD1","description":"ICD-OAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"3-Dimensional Volumetric Imaging And Reconstruction Of Breast Or Axillary Lymph Node Tissue_ Each Excised Specimen_ 3-Dimensional Automatic Specimen Reorientation_ Interpretat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0694T","description":"3-Dimensional Volumetric Imaging And Reconstruction Of Breast Or Axillary Lymph Node Tissue_ Each Excised Specimen_ 3-Dimensional Automatic Specimen Reorientation_ Interpretat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDD1","description":"ICD-GIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-77438","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","description":"CPT-77438","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDF1","description":"ICD-MHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIC0","description":"ICD-CAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC22C","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCF0","description":"ICD-KGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUE0","description":"ICD-IDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rebuild eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69632","description":"Rebuild eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35458","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABE1","description":"ICD-AABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMB1","description":"ICD-MAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWF1","description":"ICD-LEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLD0","description":"ICD-FCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystatin c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82610","description":"Cystatin c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYE1","description":"ICD-GBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDF1","description":"ICD-JBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABA0","description":"ICD-OABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLD1","description":"ICD-MGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHD1","description":"ICD-NGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAF0","description":"ICD-NKAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABD1","description":"ICD-EABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVD0","description":"ICD-KCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0091A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Influenza Virus Vaccine_ Quadrivalent (Aiiv4)_ Inactivated_ Adjuvanted_ Preservative Free_ 0.5 Ml Dosage_ For Intramuscular Use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90694","description":"Influenza Virus Vaccine_ Quadrivalent (Aiiv4)_ Inactivated_ Adjuvanted_ Preservative Free_ 0.5 Ml Dosage_ For Intramuscular Use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIE1","description":"ICD-OAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Deep sedation/general anesthesia-first 30 minutes","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9220","description":"Deep sedation/general anesthesia-first 30 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELA0","description":"ICD-KELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insj subq impltbl dfb elctrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33271","description":"Insj subq impltbl dfb elctrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHB0","description":"ICD-IAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUA0","description":"ICD-KBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gr 34 nonsealed leadacid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2358","description":"Gr 34 nonsealed leadacid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGB0","description":"ICD-GFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"PABPN1 (poly[A] binding protein nuclear 1) (eg_ oculopharyngeal muscular dystrophy) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81312","description":"PABPN1 (poly[A] binding protein nuclear 1) (eg_ oculopharyngeal muscular dystrophy) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYB0","description":"ICD-LHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L1952","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","description":"HCPCS-L1952","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Each addtnl prefab post","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2957","description":"Each addtnl prefab post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQD1","description":"ICD-KEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX2C","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQA1","description":"ICD-OAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0203","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0203","description":"HCPCS-A0203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pediatric partial denture fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6985","description":"Pediatric partial denture fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Initial or subsequent psychiatric collaborative care management_ each additional 30 minutes in a calendar month of behavioral health care manager activities_ in consultation w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0504","description":"Initial or subsequent psychiatric collaborative care management_ each additional 30 minutes in a calendar month of behavioral health care manager activities_ in consultation w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of estrogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82672","description":"Assay of estrogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMB1","description":"ICD-JAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neg press wound tx >50 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97606","description":"Neg press wound tx >50 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLE1","description":"ICD-KGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMD1","description":"ICD-BHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAA0","description":"ICD-OGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUD0","description":"ICD-NHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGB0","description":"ICD-NHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient receiving an anti-TNF agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9914","description":"Patient receiving an anti-TNF agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hand restoration replacmnt g","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6915","description":"Hand restoration replacmnt g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of esophagus pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43130","description":"Removal of esophagus pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Control nose/throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42971","description":"Control nose/throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOE1","description":"ICD-DIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVD0","description":"ICD-FDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5277","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ONC MRNA 5 genes ur alg rish urothelial cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0012M","description":"ONC MRNA 5 genes ur alg rish urothelial cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAE0","description":"ICD-GCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace blood leak detector","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1560","description":"Replace blood leak detector","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx isodose complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77318","description":"Brachytx isodose complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC11B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUD0","description":"ICD-JEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 27 gene report_ with variant analysis_ including reported phenotypes and imp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0349U","description":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 27 gene report_ with variant analysis_ including reported phenotypes and imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEE1","description":"ICD-KBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release palm contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26045","description":"Release palm contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRF1","description":"ICD-LFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTE0","description":"ICD-CCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHE1","description":"ICD-BFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB1A","description":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYD0","description":"ICD-KCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQC1","description":"ICD-OCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"F emb trns canc case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4018","description":"F emb trns canc case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB110","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBD0","description":"ICD-OCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMC1","description":"ICD-AAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSA1","description":"ICD-HDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Afo supramalleolar custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1907","description":"Afo supramalleolar custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE101","description":"Special Care Low _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJD0","description":"ICD-BIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct angiography neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70498","description":"Ct angiography neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPB1","description":"ICD-NKPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interim abutment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6051","description":"Interim abutment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interro eval cardiac modulj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0418T","description":"Interro eval cardiac modulj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Part remove hip bone super","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27070","description":"Part remove hip bone super","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rotation wrst w/ cable lock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6625","description":"Rotation wrst w/ cable lock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bendamustine hydrochloride (vivimusta)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9056","description":"Injection_ bendamustine hydrochloride (vivimusta)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENF1","description":"ICD-BENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Indic for head ct valid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9531","description":"Indic for head ct valid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Attach bladder/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51840","description":"Attach bladder/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACE1","description":"ICD-OACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISA1","description":"ICD-GISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMB1","description":"ICD-KEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAC1","description":"ICD-NFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g._ cystic duct_ common bile duct and common hepatic duct) with intravenous administra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9776","description":"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g._ cystic duct_ common bile duct and common hepatic duct) with intravenous administra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUE1","description":"ICD-EAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMD1","description":"ICD-OIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVB0","description":"ICD-GGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUD1","description":"ICD-MJUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBD0","description":"ICD-OIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy adrenalectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60650","description":"Laparoscopy adrenalectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nursing fac discharge day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99315","description":"Nursing fac discharge day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ micafungin in sodium (Baxter)_ not therapeutically equivalent to J2248_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2246","description":"Injection_ micafungin in sodium (Baxter)_ not therapeutically equivalent to J2248_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD141","description":"Clinically Complex _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNE1","description":"ICD-CGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth vasectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92151","description":"Anesth vasectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8F","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mosunetuzumab-axgb_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9350","description":"Injection_ mosunetuzumab-axgb_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pmkr_ other than sing/dual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2621","description":"Pmkr_ other than sing/dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUA1","description":"ICD-BDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHE0","description":"ICD-FBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSC0","description":"ICD-CCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tub stool or bench","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0245","description":"Tub stool or bench","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc comm risk calc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9316","description":"Doc comm risk calc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neck spine disk surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63076","description":"Neck spine disk surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67141","description":"Treatment of retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA46","description":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elevated or hypertensive blood pressure reading documented_ and the indicated follow-up is documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1278","description":"Elevated or hypertensive blood pressure reading documented_ and the indicated follow-up is documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electronic elbow hosmer swit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7170","description":"Electronic elbow hosmer swit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOD0","description":"ICD-OJOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin barrier_ wipe or swab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5120","description":"Skin barrier_ wipe or swab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBB1","description":"ICD-MEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGE1","description":"ICD-KEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIF0","description":"ICD-BAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC42","description":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKF0","description":"ICD-KBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9129","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9129","description":"CDT-D9129","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGB0","description":"ICD-BAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNC0","description":"ICD-JGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elec hand ind art digits","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6880","description":"Elec hand ind art digits","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mitochondrial gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81440","description":"Mitochondrial gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduct simple facial bone fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7680","description":"Reduct simple facial bone fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSF1","description":"ICD-LHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUC0","description":"ICD-OCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWD1","description":"ICD-HEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARE1","description":"ICD-PARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sub pt/ot d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8995","description":"Sub pt/ot d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNF1","description":"ICD-NKNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHE0","description":"ICD-JDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB24C","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGC0","description":"ICD-JHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRC1","description":"ICD-DCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tantalum ring application","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8030","description":"Tantalum ring application","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endocrine surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60699","description":"Endocrine surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCD1","description":"ICD-MJCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABF1","description":"ICD-IABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBID0","description":"ICD-EBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPA0","description":"ICD-FIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAID0","description":"ICD-GAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPE0","description":"ICD-OBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPA0","description":"ICD-OHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj follitropin alfa 75 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0126","description":"Inj follitropin alfa 75 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tmj arthroscopy debridement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7877","description":"Tmj arthroscopy debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M0234","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","description":"HCPCS-M0234","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Other carot sten 120 days/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9007F","description":"Other carot sten 120 days/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX42","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB0C","description":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove eye/attach implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65105","description":"Remove eye/attach implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADF1","description":"ICD-OADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60220","description":"Partial removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit simple cath care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5498","description":"Hit simple cath care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCB1","description":"ICD-FCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam entire spi 4/5 vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72083","description":"X-ray exam entire spi 4/5 vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA21C","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVD1","description":"ICD-BCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQD1","description":"ICD-GEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plasma 1 donor frz w/in 8 hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9017","description":"Plasma 1 donor frz w/in 8 hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic Insertion Of New Or Replacement Of Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including An Implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0674T","description":"Laparoscopic Insertion Of New Or Replacement Of Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including An Implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRD0","description":"ICD-GHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILF0","description":"ICD-CILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIF1","description":"ICD-OKIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3EB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EB31","description":"ICD-3EB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMD1","description":"ICD-MCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMD0","description":"ICD-JDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIF1","description":"ICD-BFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALA0","description":"ICD-EALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB220","description":"Reduced Physical Function _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of skin tags 48 sq in w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6253","description":"Absorpt drg > 48 sq in w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAA0","description":"ICD-OJAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Denture reln part mand lab","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5761","description":"Denture reln part mand lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE141","description":"Special Care Low _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWE1","description":"ICD-CBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of tear sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68525","description":"Biopsy of tear sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Atten current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9165","description":"Atten current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who died from cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9846","description":"Patients who died from cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOB1","description":"ICD-PCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEED1","description":"ICD-OEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0206","description":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00630","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00630","description":"CPT-00630","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEA0","description":"ICD-JBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJF1","description":"ICD-NGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mandibular denture prosth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5935","description":"Mandibular denture prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKA1","description":"ICD-JBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIF0","description":"ICD-OKIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1170","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLF1","description":"ICD-NKLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEF0","description":"ICD-BHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB01","description":"Medium Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINB1","description":"ICD-BINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCC0","description":"ICD-BCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATD1","description":"ICD-GATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAA1","description":"ICD-NIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crutch substitute","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0118","description":"Crutch substitute","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0903T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","description":"CPT-0903T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNE0","description":"ICD-CBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx nsclc stgi no progres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9063","description":"Onc dx nsclc stgi no progres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antidepres rxthxpy not rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4063F","description":"Antidepres rxthxpy not rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMA1","description":"ICD-IHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic duct procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38382","description":"Thoracic duct procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise/graft eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68325","description":"Revise/graft eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILD1","description":"ICD-OILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXF0","description":"ICD-NAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1331","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETC0","description":"ICD-AETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVE1","description":"ICD-BIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWB1","description":"ICD-DFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDF1","description":"ICD-FHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOA0","description":"ICD-DAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQC1","description":"ICD-OBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDF1","description":"ICD-JCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC25B","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBME0","description":"ICD-FBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75741","description":"Artery x-rays lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTA1","description":"ICD-NJTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5141","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","description":"HCPCS-Q5141","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of salivary cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42408","description":"Excision of salivary cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWD0","description":"ICD-GBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEC1","description":"ICD-IGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35266","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWF0","description":"ICD-DGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFA0","description":"ICD-FEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNF0","description":"ICD-NJNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA20A","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27238","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of choroid lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67220","description":"Treatment of choroid lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision Of Chest Wall Tumor Involving Rib(S)_ With Plastic Reconstruction; Without Mediastinal Lymphadenectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21602","description":"Excision Of Chest Wall Tumor Involving Rib(S)_ With Plastic Reconstruction; Without Mediastinal Lymphadenectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAC1","description":"ICD-AAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wbc alkaline phosphatase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85540","description":"Wbc alkaline phosphatase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hgb quant transcutaneous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88738","description":"Hgb quant transcutaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGID1","description":"ICD-AGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFA1","description":"ICD-NFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWE0","description":"ICD-KIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig; scrn clin dep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8433","description":"Pt inelig; scrn clin dep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWB0","description":"ICD-ODWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKID0","description":"ICD-NKID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXE1","description":"ICD-JIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUE1","description":"ICD-OEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDF1","description":"ICD-NBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mra_ w/dye_ upper extremity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8934","description":"Mra_ w/dye_ upper extremity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Total knee arthroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27447","description":"Total knee arthroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1832","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","description":"HCPCS-E1832","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANE0","description":"ICD-BANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEC0","description":"ICD-OJEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair nonunion hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26546","description":"Repair nonunion hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9481","description":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYC1","description":"ICD-KIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDA0","description":"ICD-MEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneumococcal conjugate vaccine_ polyvalent_ intramuscular_ for children from five years to nine years of age who have not previously received the vaccine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0195","description":"Pneumococcal conjugate vaccine_ polyvalent_ intramuscular_ for children from five years to nine years of age who have not previously received the vaccine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB2C","description":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hip arthro w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29861","description":"Hip arthro w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54065","description":"Destruction penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Long qt synd gene full seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81280","description":"Long qt synd gene full seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALC0","description":"ICD-KALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skeletal muscle relaxant 1/2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80369","description":"Skeletal muscle relaxant 1/2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEB0","description":"ICD-MBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEE0","description":"ICD-NFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXD0","description":"ICD-OIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydromorphone 250 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0092","description":"Hydromorphone 250 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBF0","description":"ICD-MGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown full base metal cast","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6791","description":"Crown full base metal cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIB1","description":"ICD-FGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEA1","description":"ICD-ABEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETD1","description":"ICD-NETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYA1","description":"ICD-KDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair pul venous stenosis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33726","description":"Repair pul venous stenosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Us guide vascular access","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76937","description":"Us guide vascular access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUC1","description":"ICD-KFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUB1","description":"ICD-ECUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRD1","description":"ICD-CIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEB1","description":"ICD-OGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction tongue fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41520","description":"Reconstruction tongue fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00470","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00470","description":"CPT-00470","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mapcp demo state","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9151","description":"Mapcp demo state","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Self-adher band >=5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6455","description":"Self-adher band >=5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLC0","description":"ICD-MCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNA1","description":"ICD-FDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXF0","description":"ICD-OJXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIB0","description":"ICD-OAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAB1","description":"ICD-FAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOF0","description":"ICD-OHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOF0","description":"ICD-KHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphc trifo 7.25-12/.25-","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2311","description":"Lens sphc trifo 7.25-12/.25-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2IA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IA21","description":"ICD-2IA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient not screened for future fall risk_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1070","description":"Patient not screened for future fall risk_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implt/rpl crtd sns dev lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0267T","description":"Implt/rpl crtd sns dev lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatric symptoms not assessed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9743","description":"Psychiatric symptoms not assessed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1JA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JA11","description":"ICD-1JA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical prostatectomy_ simple subtotal (including control of postoperative bleeding_ vasectomy_ meatotomy_ urethral calibration and/or dilation_ and internal ure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55867","description":"Laparoscopy_ surgical prostatectomy_ simple subtotal (including control of postoperative bleeding_ vasectomy_ meatotomy_ urethral calibration and/or dilation_ and internal ure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLF0","description":"ICD-JDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVC0","description":"ICD-FGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUC0","description":"ICD-MJUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Norsn not first line amox","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9314","description":"Norsn not first line amox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28585","description":"Repair foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHE0","description":"ICD-OLHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOD0","description":"ICD-GCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIB1","description":"ICD-NLIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKB0","description":"ICD-GHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electromagntic tx for ulcers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0329","description":"Electromagntic tx for ulcers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBID1","description":"ICD-BBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGD1","description":"ICD-GAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFD0","description":"ICD-OGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX25","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGA1","description":"ICD-GFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX06","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C7563","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7563","description":"HCPCS-C7563","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67801","description":"Remove eyelid lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psy evaluation of records","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90885","description":"Psy evaluation of records","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASD1","description":"ICD-KASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHF1","description":"ICD-OAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXB0","description":"ICD-GEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATA1","description":"ICD-EATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01933","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01933","description":"CPT-01933","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSD1","description":"ICD-CFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Deluxe item","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1001","description":"Deluxe item","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27557","description":"Treat knee dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLA0","description":"ICD-CCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTE0","description":"ICD-NCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUA0","description":"ICD-MEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCF0","description":"ICD-NDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35221","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suction pump portab hom modl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0600","description":"Suction pump portab hom modl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBB1","description":"ICD-ECBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove impacted ear wax uni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69210","description":"Remove impacted ear wax uni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal donor liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47140","description":"Partial removal donor liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKB0","description":"ICD-NFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unspecified preventive proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1999","description":"Unspecified preventive proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crutch underarm each wood","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0113","description":"Crutch underarm each wood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYB1","description":"ICD-CHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam hips bi 2 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73521","description":"X-ray exam hips bi 2 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDB0","description":"ICD-GDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98003","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","description":"CPT-98003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLA0","description":"ICD-OGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE244","description":"Clinically Complex _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLE0","description":"ICD-GBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVF1","description":"ICD-NCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0992T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","description":"CPT-0992T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNA0","description":"ICD-JCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abutment Supported Crown - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6097","description":"Abutment Supported Crown - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGA1","description":"ICD-GCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBD1","description":"ICD-OGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPE0","description":"ICD-GIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eval appros surg thxpy epi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5200F","description":"Eval appros surg thxpy epi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEA1","description":"ICD-BBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt not elig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9629","description":"Pt not elig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVB1","description":"ICD-BGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAA1","description":"ICD-NEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Signs of melanoma absent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8749","description":"Signs of melanoma absent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01810","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01810","description":"CPT-01810","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES23A","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cranial remolding orthosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1040","description":"Cranial remolding orthosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXC1","description":"ICD-CHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00797","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00797","description":"CPT-00797","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0535","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","description":"HCPCS-G0535","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Allergen specific IgE; quantitative or semiquantitative_ crude allergen extract_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86003","description":"Allergen specific IgE; quantitative or semiquantitative_ crude allergen extract_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Somatosensory testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95938","description":"Somatosensory testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","description":"HCPCS-J0601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision or removal of integrated neurostimulation system for bladder dysfunction_ including analysis_ programming_ and imaging_ when performed_ posterior tibial nerve; subfas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0819T","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction_ including analysis_ programming_ and imaging_ when performed_ posterior tibial nerve; subfas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEA0","description":"ICD-FBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTB1","description":"ICD-NKTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq transcath closure pda","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93582","description":"Perq transcath closure pda","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPB1","description":"ICD-KAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC4A","description":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETF0","description":"ICD-EETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEA0","description":"ICD-MKEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAD1","description":"ICD-KAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inject spine lumbar/sacral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62311","description":"Inject spine lumbar/sacral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elbow mold outsid lock hinge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6200","description":"Elbow mold outsid lock hinge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Traction frame attach pelvic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0890","description":"Traction frame attach pelvic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Relocation of skin pocket with replacement of implanted aortic counterpulsation ventricular assist device_ mechano-electrical skin interface and electrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0459T","description":"Relocation of skin pocket with replacement of implanted aortic counterpulsation ventricular assist device_ mechano-electrical skin interface and electrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ampicillin 500 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0290","description":"Ampicillin 500 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Phone e/m phys/qhp 21-30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99443","description":"Phone e/m phys/qhp 21-30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ocular instrumnt screen bil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99174","description":"Ocular instrumnt screen bil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA5D","description":"Default_ /PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insitu hybridization manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88368","description":"Insitu hybridization manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRE1","description":"ICD-HDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJD0","description":"ICD-CAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHE0","description":"ICD-BGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUC0","description":"ICD-MEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Referral To Physical_ Occupational_ Speech_ Or Recreational Therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0042","description":"Referral To Physical_ Occupational_ Speech_ Or Recreational Therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33412","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pov group 2 hd 301-450 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0807","description":"Pov group 2 hd 301-450 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-38225","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","description":"CPT-38225","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIC1","description":"ICD-EGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLB1","description":"ICD-OGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHE0","description":"ICD-MJHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18H","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVA0","description":"ICD-CGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJE1","description":"ICD-GDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHF1","description":"ICD-MDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPB0","description":"ICD-FHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSE0","description":"ICD-PBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24400","description":"Revision of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEE0","description":"ICD-OCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cyclosporin parenteral 250mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7516","description":"Cyclosporin parenteral 250mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTB0","description":"ICD-CCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj magnesium sulfate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3475","description":"Inj magnesium sulfate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUF1","description":"ICD-NAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBB1","description":"ICD-NFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Us exam chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76604","description":"Us exam chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXB1","description":"ICD-KEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Upper ext fx orthosis wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3984","description":"Upper ext fx orthosis wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAA1","description":"ICD-KCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDB1","description":"ICD-AEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPF0","description":"ICD-OBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBF0","description":"ICD-MKBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFA1","description":"ICD-OLFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hep b vac series prev recvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4157F","description":"Hep b vac series prev recvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTE0","description":"ICD-CDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYD1","description":"ICD-PDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove mastoid air cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69670","description":"Remove mastoid air cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGC1","description":"ICD-FIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft leg bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27638","description":"Remove/graft leg bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUF0","description":"ICD-FFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18G","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEA1","description":"ICD-KDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTB1","description":"ICD-ACTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOA0","description":"ICD-CIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRA0","description":"ICD-PFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCE0","description":"ICD-AHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Breast Diagnostic Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0619","description":"Hospital Special Treatment Room Support Component (Hstrsc) Breast Diagnostic Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Paricalcitol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2501","description":"Paricalcitol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQF1","description":"ICD-GGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUB1","description":"ICD-BDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBD1","description":"ICD-IHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABC0","description":"ICD-GABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJB1","description":"ICD-OFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMB1","description":"ICD-EIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERD1","description":"ICD-DERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISC0","description":"ICD-DISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx rectal extent unknwn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9095","description":"Onc dx rectal extent unknwn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX12","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAE1","description":"ICD-NHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBB1","description":"ICD-ABBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXB1","description":"ICD-BBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCC1","description":"ICD-OBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERF1","description":"ICD-OERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALE0","description":"ICD-NALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Cervical (Cvemp) And Ocular (Ovemp)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92519","description":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Cervical (Cvemp) And Ocular (Ovemp)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTA0","description":"ICD-ICTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bethanechol chloride inject","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0520","description":"Bethanechol chloride inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX2B","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWE1","description":"ICD-LGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCD1","description":"ICD-IFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology (heart transplant)_ cell-free DNA_ PCR assay of 96 DNA target sequences (94 single nucleotide polymorphism targets and two control targets)_ plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0055U","description":"Cardiology (heart transplant)_ cell-free DNA_ PCR assay of 96 DNA target sequences (94 single nucleotide polymorphism targets and two control targets)_ plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Afo tib fx semi-rigid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2114","description":"Afo tib fx semi-rigid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAB0","description":"ICD-GEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIC1","description":"ICD-AGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX1A","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL4B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of neck artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37615","description":"Ligation of neck artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sc ther infusion reset pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96371","description":"Sc ther infusion reset pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL24","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant semi-imp hear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2230","description":"Implant semi-imp hear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUA1","description":"ICD-MLUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBF1","description":"ICD-FIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFC0","description":"ICD-FCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVC1","description":"ICD-NEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0632U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0632U","description":"CPT-0632U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQE1","description":"ICD-HBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLB0","description":"ICD-AHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBF0","description":"ICD-NJBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lung volume reduction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32491","description":"Lung volume reduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHF0","description":"ICD-OGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLB1","description":"ICD-AFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA2D","description":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1CA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CA11","description":"ICD-1CA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC10","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB240","description":"Clinically Complex _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRC1","description":"ICD-KFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Morphine sulfate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2270","description":"Morphine sulfate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of spinal herniation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63704","description":"Repair of spinal herniation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGD1","description":"ICD-OEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAD0","description":"ICD-FIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDA1","description":"ICD-CBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNC0","description":"ICD-NFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft leg bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27637","description":"Remove/graft leg bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQA0","description":"ICD-ODQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWE0","description":"ICD-DEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy wbx sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32604","description":"Thoracoscopy wbx sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWC1","description":"ICD-PLWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAA1","description":"ICD-BIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIF0","description":"ICD-JDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPB1","description":"ICD-OCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLF0","description":"ICD-FDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTC1","description":"ICD-JCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJC0","description":"ICD-NFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBC0","description":"ICD-CIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cabotegravir and rilpivirine_ 2 mg/3 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0741","description":"Injection_ cabotegravir and rilpivirine_ 2 mg/3 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEE0","description":"ICD-FFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"The MDPP b eneficiary achieved at least 9% weight loss (WL) from his/he r baseline weight in months 1-24 under the MDPP Expanded Model (EM). This is a one-time payment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9881","description":"The MDPP b eneficiary achieved at least 9% weight loss (WL) from his/he r baseline weight in months 1-24 under the MDPP Expanded Model (EM). This is a one-time payment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75962","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUD1","description":"ICD-FFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJE1","description":"ICD-NGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96934","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYF0","description":"ICD-KDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGF0","description":"ICD-NHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWA0","description":"ICD-PAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colon motility 6 hr study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91117","description":"Colon motility 6 hr study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFF0","description":"ICD-NDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient transferred directly from anesthetizing location to PACE or other non-ICU location","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9656","description":"Patient transferred directly from anesthetizing location to PACE or other non-ICU location","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27257","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLF1","description":"ICD-ADLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWC1","description":"ICD-ODWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38F","description":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHD0","description":"ICD-BBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Children who were screened for risk of developmental_ behavioral and social delays using a standardized tool with interpretation and report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9966","description":"Children who were screened for risk of developmental_ behavioral and social delays using a standardized tool with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPF1","description":"ICD-JFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95865","description":"Muscle test larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of System Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Other System Reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2095","description":"Documentation Of System Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Other System Reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair spec size w foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1221","description":"Wheelchair spec size w foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIC1","description":"ICD-NJIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUA0","description":"ICD-FFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMF1","description":"ICD-NKMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBA0","description":"ICD-FDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of Patient Pregnancy Anytime During The Measurement Period Prior To And Including The Current Encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9997","description":"Documentation Of Patient Pregnancy Anytime During The Measurement Period Prior To And Including The Current Encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Strattice tm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4130","description":"Strattice tm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX0D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"2d tee w or w/o fol w/con_in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8925","description":"2d tee w or w/o fol w/con_in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eval on foot not performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8415","description":"Eval on foot not performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPA1","description":"ICD-CGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDF0","description":"ICD-EGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDF1","description":"ICD-KHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVF1","description":"ICD-BFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC10","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17282","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB21C","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKF1","description":"ICD-NKKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"WoundEx Flow_ BioSkin Flow_ 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4162","description":"WoundEx Flow_ BioSkin Flow_ 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACB1","description":"ICD-JACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYF1","description":"ICD-KCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEB0","description":"ICD-KHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCA1","description":"ICD-FCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCC1","description":"ICD-OKCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft carotid-vertbrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35508","description":"Art byp grft carotid-vertbrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hast w/oxygen titrate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94453","description":"Hast w/oxygen titrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Continuous_ Real-Time Monitoring And Maintenance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95707","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Continuous_ Real-Time Monitoring And Maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDE1","description":"ICD-MFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGC1","description":"ICD-JIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNC1","description":"ICD-KFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTE0","description":"ICD-MDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3FB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FB21","description":"ICD-3FB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERC1","description":"ICD-KERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repl leath cuff kafo prox th","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4100","description":"Repl leath cuff kafo prox th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMF0","description":"ICD-IBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHE0","description":"ICD-NGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oral aprepitant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8501","description":"Oral aprepitant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iris Prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1839","description":"Iris Prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEB1","description":"ICD-AEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXD1","description":"ICD-CEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB245","description":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aud osseo dev_ abutment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8693","description":"Aud osseo dev_ abutment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPB0","description":"ICD-KIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQE0","description":"ICD-KIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neck spine disk surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63075","description":"Neck spine disk surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDB0","description":"ICD-FEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB10A","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percut thrombect av fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36870","description":"Percut thrombect av fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC42","description":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSD0","description":"ICD-PDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Post 3 srfc resinbased cmpst","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2393","description":"Post 3 srfc resinbased cmpst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lung lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32540","description":"Removal of lung lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of pelvic abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45000","description":"Drainage of pelvic abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAD0","description":"ICD-IGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LC31","description":"ICD-3LC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIB0","description":"ICD-FHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYB1","description":"ICD-OAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2FA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FA31","description":"ICD-2FA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exsufflation belt_ includes all supplies and accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1021","description":"Exsufflation belt_ includes all supplies and accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOD1","description":"ICD-LGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQA1","description":"ICD-OKQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWF1","description":"ICD-LFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXF1","description":"ICD-FCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/o pseudobulbaffect/als","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3757F","description":"Pt w/o pseudobulbaffect/als","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFA1","description":"ICD-JAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDF0","description":"ICD-OGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of facial bone(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21026","description":"Excision of facial bone(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Advancing cancer care mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0001","description":"Advancing cancer care mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Golimumab for iv use 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1602","description":"Golimumab for iv use 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ilr device interrogat remote","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93298","description":"Ilr device interrogat remote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialys sol fld vol > 1999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4722","description":"Dialys sol fld vol > 1999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWC0","description":"ICD-HDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ dostarlimab-gxly_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9272","description":"Injection_ dostarlimab-gxly_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23466","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude_ pulse duration_ configuration of wave form_ battery status_ electrode selec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95975","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude_ pulse duration_ configuration of wave form_ battery status_ electrode selec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65810","description":"Drainage of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX06","description":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of percutaneous electrode array_ spinal_ with integrated neurostimulator_ including imaging guidance_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0784T","description":"Insertion or replacement of percutaneous electrode array_ spinal_ with integrated neurostimulator_ including imaging guidance_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prostate ca screening; dre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0102","description":"Prostate ca screening; dre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRA0","description":"ICD-CFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB245","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILF1","description":"ICD-JILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-70471","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","description":"CPT-70471","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAB0","description":"ICD-MKAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Arthrodesis_ pre-sacral interbody technique_ disc space preparation_ discectomy_ without instrumentation_ with image guidance_ includes bone graft when performed; L5-S1 inters","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0195T","description":"Arthrodesis_ pre-sacral interbody technique_ disc space preparation_ discectomy_ without instrumentation_ with image guidance_ includes bone graft when performed; L5-S1 inters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ratchet assembly","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0050","description":"Ratchet assembly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVA1","description":"ICD-JHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2109","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove in/ex hem grp & fiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46257","description":"Remove in/ex hem grp & fiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYE0","description":"ICD-OIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIA1","description":"ICD-BHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6039","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","description":"HCPCS-L6039","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASE0","description":"ICD-GASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXD0","description":"ICD-JAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCC0","description":"ICD-CGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hep b vac injxn admin/recvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4149F","description":"Hep b vac injxn admin/recvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMB0","description":"ICD-KCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLE1","description":"ICD-NKLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX34","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including neuronavigation_ delivery and management_ subsequent treatment day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0891T","description":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including neuronavigation_ delivery and management_ subsequent treatment day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesthe <60 min as docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4256F","description":"Anesthe <60 min as docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA21","description":"Medium Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYD0","description":"ICD-LGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cabg arterial two","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33534","description":"Cabg arterial two","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATD0","description":"ICD-GATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95146","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXF0","description":"ICD-BCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sirolimus_ oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7520","description":"Sirolimus_ oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Int therapeutic restoration","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2941","description":"Int therapeutic restoration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFE0","description":"ICD-KBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIC1","description":"ICD-GGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69643","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATA1","description":"ICD-IATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug scrn quant oxcarbazepin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80183","description":"Drug scrn quant oxcarbazepin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Professional services for the administration of chemotherapy for each infusion drug administration calendar day in the individu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0070","description":"Professional services for the administration of chemotherapy for each infusion drug administration calendar day in the individu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJA1","description":"ICD-GBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAC0","description":"ICD-BAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE10B","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronch thermoplsty 2/> lobes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31661","description":"Bronch thermoplsty 2/> lobes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVB1","description":"ICD-OEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWD1","description":"ICD-KCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNB0","description":"ICD-KBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rem oct rta dev setup&educaj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0604T","description":"Rem oct rta dev setup&educaj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUF1","description":"ICD-BDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAA0","description":"ICD-NIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antiemetic rectal/supp nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8498","description":"Antiemetic rectal/supp nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUD1","description":"ICD-BEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast)_ mRNA_ gene expression profiling by next-generation sequencing of 101 genes_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as a tripl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0153U","description":"Oncology (breast)_ mRNA_ gene expression profiling by next-generation sequencing of 101 genes_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as a tripl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nursing fac care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99379","description":"Nursing fac care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQD0","description":"ICD-CHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Group mnt 2 or more 30 mins","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0271","description":"Group mnt 2 or more 30 mins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ire abltj 1+tumors open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0601T","description":"Ire abltj 1+tumors open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28F","description":"Special Care High _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAF1","description":"ICD-IFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5151","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","description":"HCPCS-Q5151","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brentuximab vedotin inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9042","description":"Brentuximab vedotin inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urinary rubber pouch w/o fp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4383","description":"Urinary rubber pouch w/o fp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11646","description":"Exc f/e/e/n/l mal+mrg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Prostate Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1100","description":"Radiation Therapy For Prostate Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote Afterloading High Dose Rate Radionuclide Brachytherapy; 2-12 Channels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77786","description":"Remote Afterloading High Dose Rate Radionuclide Brachytherapy; 2-12 Channels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27443","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMB1","description":"ICD-KIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTB0","description":"ICD-ADTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20604","description":"Drain/inj joint/bursa w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIC0","description":"ICD-CIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25425","description":"Repair/graft radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18E","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXC0","description":"ICD-NKXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Androgen deprivation therapy prescribed/administered in combination with external beam radiotherapy to the prostate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9894","description":"Androgen deprivation therapy prescribed/administered in combination with external beam radiotherapy to the prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ferumoxytol_ esrd use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0139","description":"Ferumoxytol_ esrd use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASF0","description":"ICD-DASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDE1","description":"ICD-MEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOE0","description":"ICD-LGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg_ array or leadless)_ and pulse generator or receiver_ in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0816T","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg_ array or leadless)_ and pulse generator or receiver_ in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCE1","description":"ICD-NJCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMC0","description":"ICD-OGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Levonorgestrel iu 52mg 3 yr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7297","description":"Levonorgestrel iu 52mg 3 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insitu hybridization (fish)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88366","description":"Insitu hybridization (fish)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj naloxone hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2310","description":"Inj naloxone hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI chest w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71551","description":"MRI chest w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mitochondrial Antibody (Eg_ M2)_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86381","description":"Mitochondrial Antibody (Eg_ M2)_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-49190","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","description":"CPT-49190","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPB1","description":"ICD-JIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYC1","description":"ICD-OHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method (list separately in addition to code for primary procedure)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9768","description":"Endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method (list separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRD1","description":"ICD-LIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No rec cortico>60d 1rx 600mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9470","description":"No rec cortico>60d 1rx 600mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient is undergoing palliative dialysis with a catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9747","description":"Patient is undergoing palliative dialysis with a catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATA1","description":"ICD-JATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVF0","description":"ICD-JEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair bowel opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44625","description":"Repair bowel opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anal pressure record","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91122","description":"Anal pressure record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOF1","description":"ICD-DIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC41","description":"Very High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUF0","description":"ICD-FGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sewho airplane w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3967","description":"Sewho airplane w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHA1","description":"ICD-MAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIC1","description":"ICD-OEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Candida antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86628","description":"Candida antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ non-str_yttrium-90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2616","description":"Brachytx_ non-str_yttrium-90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWA0","description":"ICD-LEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esoph scope w/sclerosis inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43204","description":"Esoph scope w/sclerosis inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_eptinezumab-jjmr_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9063","description":"Injection_eptinezumab-jjmr_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18F","description":"Special Care Low _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATD0","description":"ICD-BATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lamellas_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4292","description":"Lamellas_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood ketone test or strip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4252","description":"Blood ketone test or strip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB22D","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ant fusion 8/> vert seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22812","description":"Ant fusion 8/> vert seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDF1","description":"ICD-GIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFB0","description":"ICD-OBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTD1","description":"ICD-GGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTA1","description":"ICD-FFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCE0","description":"ICD-OFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTF0","description":"ICD-BGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31294","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPB1","description":"ICD-CBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKC1","description":"ICD-BDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWD1","description":"ICD-OCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOE0","description":"ICD-KCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIC0","description":"ICD-OJIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens hydrophilic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2520","description":"Contact lens hydrophilic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAF1","description":"ICD-GGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Group therapeutic procedures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97150","description":"Group therapeutic procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Asthma risk assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2016F","description":"Asthma risk assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIB0","description":"ICD-GIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1444","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","description":"HCPCS-M1444","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKD1","description":"ICD-BGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ped crit care age 2-5 subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99476","description":"Ped crit care age 2-5 subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nephrology (renal transplant)_ RNA expression by select transcriptome sequencing_ using posttransplant peripheral blood_ algorithm reported as a risk score for acute cellular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0320U","description":"Nephrology (renal transplant)_ RNA expression by select transcriptome sequencing_ using posttransplant peripheral blood_ algorithm reported as a risk score for acute cellular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc cath >90d for maint dia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9265","description":"Doc cath >90d for maint dia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFD0","description":"ICD-KAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPF1","description":"ICD-BBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ oliceridine_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9101","description":"Injection_ oliceridine_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrophoretic test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82664","description":"Electrophoretic test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGD1","description":"ICD-FIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGID1","description":"ICD-EGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB126","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous exchange of biliary drainage catheter (eg_ external_ internal-external_ or conversion of internal-external to external only)_ with removal of calculi/debris from","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7545","description":"Percutaneous exchange of biliary drainage catheter (eg_ external_ internal-external_ or conversion of internal-external to external only)_ with removal of calculi/debris from","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autoimmune (rheumatoid arthritis)_ next-generation sequencing (NGS)_ gene expression testing of 19 genes_ whole blood_ with analysis of anti-cyclic citrullinated peptides (CCP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0456U","description":"Autoimmune (rheumatoid arthritis)_ next-generation sequencing (NGS)_ gene expression testing of 19 genes_ whole blood_ with analysis of anti-cyclic citrullinated peptides (CCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCE0","description":"ICD-KCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA4D","description":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy_ flexible; proximal to splenic flexure; with ablation of tumor(s)_ polyp(s)_ or other lesion(s) not amenable to removal by hot biopsy forceps_ bipolar cautery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6024","description":"Colonoscopy_ flexible; proximal to splenic flexure; with ablation of tumor(s)_ polyp(s)_ or other lesion(s) not amenable to removal by hot biopsy forceps_ bipolar cautery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tongue mouth neck surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41153","description":"Tongue mouth neck surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoe heel sach cushion type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3450","description":"Shoe heel sach cushion type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUA1","description":"ICD-OBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIE0","description":"ICD-BFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl & rplcmt dfb gen 2 lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33263","description":"Rmvl & rplcmt dfb gen 2 lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Egd w/transmural drain cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43240","description":"Egd w/transmural drain cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGB1","description":"ICD-CEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suction lipectomy lwr extrem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15879","description":"Suction lipectomy lwr extrem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDF1","description":"ICD-CGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPB1","description":"ICD-KDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOC1","description":"ICD-PAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Etoposide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9181","description":"Etoposide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA11","description":"Default_ /5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pm device progr eval multi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93281","description":"Pm device progr eval multi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOF1","description":"ICD-HGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIB0","description":"ICD-GFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 30MCG/0.3 ML BST","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0004A","description":"ADM SARSCOV2 30MCG/0.3 ML BST","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD14A","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj paravert f jnt l/s 2 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64494","description":"Inj paravert f jnt l/s 2 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0205","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0205","description":"HCPCS-B0205","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insj iris prosth sec io lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0618T","description":"Insj iris prosth sec io lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUC0","description":"ICD-EGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90482","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","description":"CPT-90482","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETB0","description":"ICD-JETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIB1","description":"ICD-GAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENE0","description":"ICD-OENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plasmaprotein fract_5%_250ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9048","description":"Plasmaprotein fract_5%_250ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of jaw joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70330","description":"X-ray exam of jaw joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise urine flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50830","description":"Revise urine flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAD1","description":"ICD-MFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYF1","description":"ICD-LBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHB0","description":"ICD-CEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKA1","description":"ICD-FHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETE1","description":"ICD-CETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB53","description":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAD0","description":"ICD-NAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray of wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73115","description":"Contrast x-ray of wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPE1","description":"ICD-KGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHE0","description":"ICD-NJHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAA1","description":"ICD-NLAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Osa mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8759","description":"Osa mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepb vacc 3 dose ped/adol im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90744","description":"Hepb vacc 3 dose ped/adol im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNE1","description":"ICD-CFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOF1","description":"ICD-GAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology gynecologic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81536","description":"Oncology gynecologic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infusion pump_non-prog_ perm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1891","description":"Infusion pump_non-prog_ perm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFC1","description":"ICD-FHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWC0","description":"ICD-PJWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDB1","description":"ICD-GBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMF0","description":"ICD-NIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUB1","description":"ICD-IGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medical foods for noninborn errors of metabolism","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9432","description":"Medical foods for noninborn errors of metabolism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIF0","description":"ICD-BDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAF0","description":"ICD-AEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dermagraft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4106","description":"Dermagraft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bladder lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51525","description":"Removal of bladder lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSE1","description":"ICD-GGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mh svc plan dev by non-md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0032","description":"Mh svc plan dev by non-md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Scr c/v cyto_ autosys_ rescr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0148","description":"Scr c/v cyto_ autosys_ rescr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBA0","description":"ICD-NIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct maxillofacial w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70488","description":"Ct maxillofacial w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABD1","description":"ICD-FABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraop colon lavage add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44701","description":"Intraop colon lavage add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIC1","description":"ICD-NGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPC1","description":"ICD-KEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam l-2 spine 4/>vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72110","description":"X-ray exam l-2 spine 4/>vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTC1","description":"ICD-GBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"AmnioText_ per cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4245","description":"AmnioText_ per cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOF0","description":"ICD-LBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGB0","description":"ICD-BFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIF0","description":"ICD-JFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMC0","description":"ICD-CBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC145","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJC0","description":"ICD-CDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMB1","description":"ICD-AIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fuse esophagus & intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43341","description":"Fuse esophagus & intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHF1","description":"ICD-CIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lat retinacular release open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27425","description":"Lat retinacular release open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Island pedicle flap graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15740","description":"Island pedicle flap graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLC1","description":"ICD-AHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IA31","description":"ICD-1IA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bath tub wall rail","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0241","description":"Bath tub wall rail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQC1","description":"ICD-CIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L0720","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","description":"HCPCS-L0720","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KC11","description":"ICD-2KC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21267","description":"Revise eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA3D","description":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0102","description":"HCPCS-B0102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Supp maint employ_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2025","description":"Supp maint employ_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal neck/armpit lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38550","description":"Removal neck/armpit lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive mastoid surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69511","description":"Extensive mastoid surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOA1","description":"ICD-DDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXA1","description":"ICD-OJXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBB1","description":"ICD-JGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore/biopsy eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67450","description":"Explore/biopsy eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICC0","description":"ICD-FICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDB0","description":"ICD-OBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma plan of care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0517F","description":"Glaucoma plan of care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Whfo w/o joints pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3809","description":"Whfo w/o joints pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD117","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL30","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAB1","description":"ICD-NEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair liver wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47350","description":"Repair liver wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGA1","description":"ICD-OKGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAD1","description":"ICD-GHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKD0","description":"ICD-JDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTE1","description":"ICD-OBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj theophylline per 40 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2810","description":"Inj theophylline per 40 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDB1","description":"ICD-MGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nrv cndj test 13/> studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95913","description":"Nrv cndj test 13/> studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOB1","description":"ICD-LCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUF0","description":"ICD-NBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNB1","description":"ICD-FBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0672","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0672","description":"HCPCS-G0672","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAE0","description":"ICD-JDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAD0","description":"ICD-KHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who died from cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9855","description":"Patients who died from cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEC1","description":"ICD-NKEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing device_ monaural_ behind the ear (BTE)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5181","description":"Hearing aid_ contralateral routing device_ monaural_ behind the ear (BTE)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of fascia for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20920","description":"Removal of fascia for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBA1","description":"ICD-GGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHE0","description":"ICD-FDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ corticotropin (ANI)_ up to 40 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0802","description":"Injection_ corticotropin (ANI)_ up to 40 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj ceftolozane tazobactam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0695","description":"Inj ceftolozane tazobactam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC53","description":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apply multlay comprs upr arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29583","description":"Apply multlay comprs upr arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD205","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Int mam art used for cabg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4110F","description":"Int mam art used for cabg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXA1","description":"ICD-GIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRB1","description":"ICD-OFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASB0","description":"ICD-KASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTE0","description":"ICD-FHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation; wit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7552","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation; wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDA0","description":"ICD-FCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFF1","description":"ICD-FGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home care supervis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99339","description":"Domicil/r-home care supervis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASC0","description":"ICD-OASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBME0","description":"ICD-OBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpt pt cat and pt1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9428","description":"Rpt pt cat and pt1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMC1","description":"ICD-MCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRF1","description":"ICD-LHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQF1","description":"ICD-ODQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adjacent tissue transfer or rearrangement_ scalp_ arms and/or legs; defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2023F","description":"Adjacent tissue transfer or rearrangement_ scalp_ arms and/or legs; defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMC1","description":"ICD-EBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEC0","description":"ICD-CHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOD0","description":"ICD-PGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCD1","description":"ICD-OGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWC0","description":"ICD-KHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCME1","description":"ICD-NCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert endovasc prosth taa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33883","description":"Insert endovasc prosth taa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Helicobacter pylori detection and antibiotic resistance_ DNA_ 16S and 23S rRNA_ gyrA_ pbp1_ rdxA and rpoB_ next generation sequencing_ formalin-fixed paraffin embedded or fres","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0008U","description":"Helicobacter pylori detection and antibiotic resistance_ DNA_ 16S and 23S rRNA_ gyrA_ pbp1_ rdxA and rpoB_ next generation sequencing_ formalin-fixed paraffin embedded or fres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYC1","description":"ICD-LEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"SARSCOV2 VACCINE BIVALENT 30 MCG/0.3 ML IM USE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91312","description":"SARSCOV2 VACCINE BIVALENT 30 MCG/0.3 ML IM USE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMD0","description":"ICD-MEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTB1","description":"ICD-KGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADC1","description":"ICD-EADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAA1","description":"ICD-ADAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low- dose computed tomography for lung cancer screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8032","description":"Low- dose computed tomography for lung cancer screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Whole mitochondrial genome","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81465","description":"Whole mitochondrial genome","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGD1","description":"ICD-KGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surgery of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86051","description":"Anesth surgery of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJB1","description":"ICD-FCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sympathectomy supfc palmar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64823","description":"Sympathectomy supfc palmar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJF1","description":"ICD-NCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70200","description":"X-ray exam of eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of foot at ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27889","description":"Amputation of foot at ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esrd home pt serv p day 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90970","description":"Esrd home pt serv p day 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFD0","description":"ICD-JGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFE1","description":"ICD-CBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ spine_ thoracolumbar_ standing (scoliosis)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72069","description":"Radiologic examination_ spine_ thoracolumbar_ standing (scoliosis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ meropenem_ vaborbactam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2186","description":"Injection_ meropenem_ vaborbactam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Microdissection laser","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88380","description":"Microdissection laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADA0","description":"ICD-OADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66635","description":"Removal of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDD1","description":"ICD-BDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tot contact ak/knee disart s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5650","description":"Tot contact ak/knee disart s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA24D","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Postop ea cast chg & realign","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6386","description":"Postop ea cast chg & realign","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUE1","description":"ICD-FEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYA1","description":"ICD-PEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNA0","description":"ICD-NFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy_ high resolution (hra) (with magnification and chemical agent enhancement); with biopsy(ies)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6028","description":"Anoscopy_ high resolution (hra) (with magnification and chemical agent enhancement); with biopsy(ies)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJD1","description":"ICD-GIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Panoramic x-ray of jaws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70355","description":"Panoramic x-ray of jaws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cabazitaxel (Sandoz)_ not therapeutically equivalent to J9043_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9064","description":"Injection_ cabazitaxel (Sandoz)_ not therapeutically equivalent to J9043_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDB1","description":"ICD-JFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDE1","description":"ICD-GCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWF1","description":"ICD-OJWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABE1","description":"ICD-JABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0974T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","description":"CPT-0974T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (genetic platelet function disorder)_ genomic sequence analysis of 31 genes_ blood_ buccal swab_ or amniotic fluid (Versitiā„¢ Platelet Function Disorder Panel)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0277U","description":"Hematology (genetic platelet function disorder)_ genomic sequence analysis of 31 genes_ blood_ buccal swab_ or amniotic fluid (Versitiā„¢ Platelet Function Disorder Panel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTC0","description":"ICD-ABTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted molecular pathology","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81479","description":"Unlisted molecular pathology","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBC0","description":"ICD-NCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Known Familial Variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81353","description":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Known Familial Variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interdental wiring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21497","description":"Interdental wiring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSF1","description":"ICD-PDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBE1","description":"ICD-BFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient pressure wrap with adjustable straps_ full leg_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6586","description":"Gradient pressure wrap with adjustable straps_ full leg_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEF0","description":"ICD-NAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28F","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","description":"HCPCS-M1501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVF0","description":"ICD-OEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKA1","description":"ICD-KBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pm device eval in person","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93288","description":"Pm device eval in person","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAB1","description":"ICD-BFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCB1","description":"ICD-KBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWF0","description":"ICD-OJWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Devise bowel pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44316","description":"Devise bowel pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHE1","description":"ICD-ACHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUE0","description":"ICD-BHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTA0","description":"ICD-CCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA20D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28E","description":"Clinically Complex _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNB1","description":"ICD-NLNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Buprenorphine (Oral); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2068","description":"Medication Assisted Treatment_ Buprenorphine (Oral); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMB1","description":"ICD-CIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9172","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9172","description":"HCPCS-C9172","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rabies Immune Globulin_ Heat- And Solvent/Detergent-Treated (Rig-Ht S/D)_ Human_ For Intramuscular And/Or Subcutaneous Use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90377","description":"Rabies Immune Globulin_ Heat- And Solvent/Detergent-Treated (Rig-Ht S/D)_ Human_ For Intramuscular And/Or Subcutaneous Use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking waistlngth 30-40","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6540","description":"Gc stocking waistlngth 30-40","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXA0","description":"ICD-CHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFE1","description":"ICD-NIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLF0","description":"ICD-GCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOE0","description":"ICD-HIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"NuDYN DL or NuDYN DL MESH_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4285","description":"NuDYN DL or NuDYN DL MESH_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brucella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86622","description":"Brucella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative Ultrasound Tissue Characterization (Non-Elastographic)_ Including Interpretation And Report_ Obtained With Diagnostic Ultrasound Examination Of The Same Anatomy (","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0690T","description":"Quantitative Ultrasound Tissue Characterization (Non-Elastographic)_ Including Interpretation And Report_ Obtained With Diagnostic Ultrasound Examination Of The Same Anatomy (","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX4A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWF0","description":"ICD-LDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ binaural_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5249","description":"Hearing aid_ binaural_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ther/prop/diag inj/inf proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96379","description":"Ther/prop/diag inj/inf proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75966","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMF0","description":"ICD-ICMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDC0","description":"ICD-OIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAF1","description":"ICD-IIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCID1","description":"ICD-BCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJB0","description":"ICD-OHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastro/jejuno tube_ low-pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4088","description":"Gastro/jejuno tube_ low-pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALE1","description":"ICD-GALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCF1","description":"ICD-FBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYC0","description":"ICD-GHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCB1","description":"ICD-CGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIB1","description":"ICD-CAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQE1","description":"ICD-PHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEME0","description":"ICD-CEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTD0","description":"ICD-ICTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brca2 gene known fam variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81217","description":"Brca2 gene known fam variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBC0","description":"ICD-NJBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Other specified case mgmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9012","description":"Other specified case mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1159","description":"Hospice services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBE1","description":"ICD-MIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBC1","description":"ICD-KEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWF0","description":"ICD-GDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of tsi globulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84445","description":"Assay of tsi globulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Admin pneumococcal vaccine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0009","description":"Admin pneumococcal vaccine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRC1","description":"ICD-PHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGC1","description":"ICD-JAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral 50% dextrose solu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4164","description":"Parenteral 50% dextrose solu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 80 or more drugs or metabolites_ urine_ by quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitori","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0146U","description":"Drug assay_ definitive_ 80 or more drugs or metabolites_ urine_ by quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitori","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERA1","description":"ICD-OERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHA1","description":"ICD-MFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFID0","description":"ICD-KFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQC1","description":"ICD-OIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autoimmune diseases (systemic lupus erythematosus [SLE])_ analysis of 11 cytokine soluble mediator biomarkers by immunoassay_ plasma_ individual components reported with an al","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0447U","description":"Autoimmune diseases (systemic lupus erythematosus [SLE])_ analysis of 11 cytokine soluble mediator biomarkers by immunoassay_ plasma_ individual components reported with an al","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00530","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00530","description":"CPT-00530","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4037","description":"Urology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI fetal ea addl gestation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74713","description":"MRI fetal ea addl gestation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1749","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","description":"HCPCS-J1749","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQE0","description":"ICD-OLQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mobility goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8979","description":"Mobility goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWD1","description":"ICD-LCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat radius fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24665","description":"Treat radius fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0624T","description":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flowcytometry/ tc 1 marker","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88184","description":"Flowcytometry/ tc 1 marker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00566","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00566","description":"CPT-00566","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resin retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6549","description":"Resin retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ntrk2 (Neurotrophic Receptor Tyrosine Kinase 2) (Eg_ Solid Tumors) Translocation Analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81192","description":"Ntrk2 (Neurotrophic Receptor Tyrosine Kinase 2) (Eg_ Solid Tumors) Translocation Analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0044A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSE0","description":"ICD-CDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGD1","description":"ICD-NDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGB0","description":"ICD-FAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Applied Pathways_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1000","description":"Clinical Decision Support Mechanism Applied Pathways_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWF1","description":"ICD-GBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair Of Orthodontic Appliance - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8697","description":"Repair Of Orthodontic Appliance - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMA1","description":"ICD-AFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFF1","description":"ICD-NGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heart failure composite","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0001F","description":"Heart failure composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Back pain was measured by the visual analog scale (VAS) within three months preoperatively and at one year (9 to 15 months) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9944","description":"Back pain was measured by the visual analog scale (VAS) within three months preoperatively and at one year (9 to 15 months) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCA0","description":"ICD-JBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMB0","description":"ICD-MCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB254","description":"Clinically Complex _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAF0","description":"ICD-GDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8G","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES316","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEE0","description":"ICD-EFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE126","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replantation thumb complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20824","description":"Replantation thumb complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oct brst/node i&r per spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0352T","description":"Oct brst/node i&r per spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX05","description":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64474","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","description":"CPT-64474","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gross exam prep & report","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0472","description":"Gross exam prep & report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reusable rectal thermometer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4932","description":"Reusable rectal thermometer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Maintenance 5% WL from baseline weight in months 7-12","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9888","description":"Maintenance 5% WL from baseline weight in months 7-12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBC1","description":"ICD-OLBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUF1","description":"ICD-IBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noncontact near-infrared spectroscopy (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation)_ for screening for peripheral arterial disease_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0860T","description":"Noncontact near-infrared spectroscopy (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation)_ for screening for peripheral arterial disease_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB5B","description":"Low Rehab_ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDD1","description":"ICD-MDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0538","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","description":"HCPCS-G0538","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIF1","description":"ICD-MCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4338","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","description":"HCPCS-Q4338","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFF1","description":"ICD-NHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABA0","description":"ICD-NABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Path rpt malig cancer docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3317F","description":"Path rpt malig cancer docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSE0","description":"ICD-PCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHB0","description":"ICD-JCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of cloacal anomaly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46744","description":"Repair of cloacal anomaly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYE0","description":"ICD-DBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJE1","description":"ICD-FEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair bladder defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57288","description":"Repair bladder defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65265","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKA0","description":"ICD-CGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ elastography (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0346T","description":"Ultrasound_ elastography (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair esophagus and fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43305","description":"Repair esophagus and fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (genetic platelet disorders)_ genomic sequence analysis of 43 genes_ blood_ buccal swab_ or amniotic fluid (Versitiā„¢ Comprehensive Platelet Disorder Panel)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0274U","description":"Hematology (genetic platelet disorders)_ genomic sequence analysis of 43 genes_ blood_ buccal swab_ or amniotic fluid (Versitiā„¢ Comprehensive Platelet Disorder Panel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEF1","description":"ICD-GEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMD1","description":"ICD-GHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove rectal obstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45915","description":"Remove rectal obstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWD1","description":"ICD-HHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECC0","description":"ICD-BECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAD0","description":"ICD-IFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0826T","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone strength and fracture-risk assessment using digital X-ray radiogrammetry-bone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0750T","description":"Bone strength and fracture-risk assessment using digital X-ray radiogrammetry-bone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"One way chest drain valve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7040","description":"One way chest drain valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0796T","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not have a completed suicide safety plan initiated_ reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index cli","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1353","description":"Patients who did not have a completed suicide safety plan initiated_ reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index cli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHF0","description":"ICD-MKHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJC1","description":"ICD-NKJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adalimumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0135","description":"Adalimumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53210","description":"Removal of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXD1","description":"ICD-NEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFB0","description":"ICD-JHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair detached retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67110","description":"Repair detached retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Space maintainer_ removable bilateral_ mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1527","description":"Space maintainer_ removable bilateral_ mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGF1","description":"ICD-NKGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fixation of ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27860","description":"Fixation of ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB244","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair venous blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75978","description":"Repair venous blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neuroeltrd stim post tibial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64566","description":"Neuroeltrd stim post tibial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incis 1 vertebral seg lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22214","description":"Incis 1 vertebral seg lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUA0","description":"ICD-JBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CYP1A2 (cytochrome P450 family 1_ subfamily A_ member 2)(eg_ drug metabolism) gene analysis_ common variants (ie_ *1F_ *1K_ *6_ *7)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0031U","description":"CYP1A2 (cytochrome P450 family 1_ subfamily A_ member 2)(eg_ drug metabolism) gene analysis_ common variants (ie_ *1F_ *1K_ *6_ *7)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic prop tire tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2212","description":"Pneumatic prop tire tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVC1","description":"ICD-GIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDA0","description":"ICD-NIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQB1","description":"ICD-DBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPF1","description":"ICD-CCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRB1","description":"ICD-PFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATD1","description":"ICD-CATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of web finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26560","description":"Repair of web finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1402","description":"HCPCS-A1402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD210","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDB0","description":"ICD-NEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acupunct w/o stimul 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97810","description":"Acupunct w/o stimul 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCED1","description":"ICD-CCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIE1","description":"ICD-NLIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA22","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNF0","description":"ICD-NBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACD0","description":"ICD-JACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXC1","description":"ICD-BFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adult speech aid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5953","description":"Adult speech aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transfer of spinal muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27105","description":"Transfer of spinal muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1235","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert pessary/other device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57160","description":"Insert pessary/other device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No life asst 2x same/decr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9636","description":"No life asst 2x same/decr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconst lwr jaw w/o fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21195","description":"Reconst lwr jaw w/o fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGE1","description":"ICD-JGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAF1","description":"ICD-GAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXF1","description":"ICD-KIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct capture limited","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0380","description":"Cone beam ct capture limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEA0","description":"ICD-CFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1030T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1030T","description":"CPT-1030T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Med ind for induction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9361","description":"Med ind for induction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol 10 gm lipids","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4185","description":"Parenteral sol 10 gm lipids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0578U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","description":"CPT-0578U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Estradiol valerate 10 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1380","description":"Estradiol valerate 10 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARD1","description":"ICD-PARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA2A","description":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQC1","description":"ICD-DCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEE0","description":"ICD-AIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGD1","description":"ICD-JDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Peri-px device eval & prgr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93287","description":"Peri-px device eval & prgr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLA1","description":"ICD-JGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA and RNA)_ surgical wound pathogens_ 34 microorganisms and identification of 21 associated antibiotic-resistance genes_ multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0370U","description":"Infectious agent detection by nucleic acid (DNA and RNA)_ surgical wound pathogens_ 34 microorganisms and identification of 21 associated antibiotic-resistance genes_ multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 25MCG/0.25ML2ND","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0112A","description":"ADM SARSCOV2 25MCG/0.25ML2ND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQE1","description":"ICD-HHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair testis injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54670","description":"Repair testis injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIC0","description":"ICD-OCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: new onset headache in pre-school children or younger (<6 years of age)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2193","description":"Patients with clinical indications for imaging of the head: new onset headache in pre-school children or younger (<6 years of age)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHC0","description":"ICD-GAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx brst stg3-noprogress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9074","description":"Onc dx brst stg3-noprogress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59320","description":"Revision of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJD0","description":"ICD-JGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEA1","description":"ICD-JEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWA1","description":"ICD-DDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKC1","description":"ICD-KIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hfe gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81256","description":"Hfe gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX32","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leg Pain As Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 3.0 Or Leg Pain Measured By The Visual Analog Scal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2146","description":"Leg Pain As Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 3.0 Or Leg Pain Measured By The Visual Analog Scal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No eval opi use instr/intv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9585","description":"No eval opi use instr/intv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rigid ped wc adjustable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1235","description":"Rigid ped wc adjustable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise eyelashes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67825","description":"Revise eyelashes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Realignment of thigh bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27454","description":"Realignment of thigh bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam hip uni 2-3 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73502","description":"X-ray exam hip uni 2-3 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGC1","description":"ICD-FFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOA0","description":"ICD-CEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDA1","description":"ICD-ODDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJF1","description":"ICD-BIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUA0","description":"ICD-JEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHA1","description":"ICD-NCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBA1","description":"ICD-ACBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"DO GNOTYP ART4 EXON 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0184U","description":"DO GNOTYP ART4 EXON 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of sperm duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55400","description":"Repair of sperm duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transoral; with deployment of intragastric bariatric balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43290","description":"Esophagogastroduodenoscopy_ flexible_ transoral; with deployment of intragastric bariatric balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace tricuspid valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33465","description":"Replace tricuspid valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical splint","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5988","description":"Surgical splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKC1","description":"ICD-FCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogens_ identification of 21 bacterial and fungal organisms and identification of 21 associated antib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0374U","description":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogens_ identification of 21 bacterial and fungal organisms and identification of 21 associated antib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLE1","description":"ICD-MLLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28G","description":"Clinically Complex _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBE0","description":"ICD-BDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFD1","description":"ICD-NDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHD0","description":"ICD-KIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dtap-ipv-hib-hepb vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90697","description":"Dtap-ipv-hib-hepb vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD22C","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27040","description":"Biopsy of soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACE0","description":"ICD-EACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision/fixation of femur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27165","description":"Incision/fixation of femur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spontaneous nystagmus study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92531","description":"Spontaneous nystagmus study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mod sedat phys/qhp 5yrs/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99144","description":"Mod sedat phys/qhp 5yrs/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEC0","description":"ICD-GHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Phenylephrine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2370","description":"Phenylephrine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEC1","description":"ICD-FAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vit for macular pucker","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67041","description":"Vit for macular pucker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of arm artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35045","description":"Repair defect of arm artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDD0","description":"ICD-AEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt disch to home by day#7","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8818","description":"Pt disch to home by day#7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0402","description":"HCPCS-B0402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSC0","description":"ICD-PGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBD0","description":"ICD-OBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJB0","description":"ICD-FHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amphetamine or methamphetamine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6042","description":"Amphetamine or methamphetamine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJA1","description":"ICD-JCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of salivary stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42330","description":"Removal of salivary stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB140","description":"Clinically Complex _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALB0","description":"ICD-EALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Recording of fetal magnetic cardiac signal using at least 3 channels; patient recording_ data scanning_ with raw electronic signal transfer of data and storage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0476T","description":"Recording of fetal magnetic cardiac signal using at least 3 channels; patient recording_ data scanning_ with raw electronic signal transfer of data and storage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA136","description":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADC0","description":"ICD-IADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0109","description":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pressure support ventilator with volume control mode_ may include pressure control mode_ used with non-invasive interface (e.g. mask)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0464","description":"Pressure support ventilator with volume control mode_ may include pressure control mode_ used with non-invasive interface (e.g. mask)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEA1","description":"ICD-MCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHC0","description":"ICD-MEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0019","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTE1","description":"ICD-MLTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPD1","description":"ICD-CFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70328","description":"X-ray exam of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJD1","description":"ICD-FFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDE0","description":"ICD-MCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18E","description":"Special Care High _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63267","description":"Excise intrspinl lesion lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of knee cartilage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27332","description":"Removal of knee cartilage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKD1","description":"ICD-CDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVF0","description":"ICD-BCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBD0","description":"ICD-AHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQF0","description":"ICD-DIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETC1","description":"ICD-FETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC145","description":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQB0","description":"ICD-PBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25360","description":"Revision of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gluco mngmnt plan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0540F","description":"Gluco mngmnt plan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1408","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","description":"HCPCS-M1408","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28D","description":"Special Care Low _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bartonella dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87470","description":"Bartonella dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients on active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1268","description":"Patients on active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plt_ aph/pher_ l/r_ cmv-neg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9055","description":"Plt_ aph/pher_ l/r_ cmv-neg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; each additional single probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0852T","description":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; each additional single probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOD0","description":"ICD-LAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOA0","description":"ICD-KBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTB1","description":"ICD-FHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunotherapy one injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95120","description":"Immunotherapy one injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIB0","description":"ICD-CIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nebulizer w/ compressor & he","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0585","description":"Nebulizer w/ compressor & he","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWC1","description":"ICD-OEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17261","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOE0","description":"ICD-LEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD20D","description":"Special Care High _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTD1","description":"ICD-OHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01430","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01430","description":"CPT-01430","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ risperidone (uzedy)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2799","description":"Injection_ risperidone (uzedy)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95148","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIB0","description":"ICD-NLIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA52","description":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gold sodium thiomaleate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1600","description":"Gold sodium thiomaleate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBD1","description":"ICD-KCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 21 targets (adenovirus_ coronavirus 229E_ coronaviru","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0100U","description":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 21 targets (adenovirus_ coronavirus 229E_ coronaviru","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Complete ivf nos case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4015","description":"Complete ivf nos case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIF1","description":"ICD-MEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth testis exploration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92451","description":"Anesth testis exploration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECA1","description":"ICD-IECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Craniofacial approach skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61583","description":"Craniofacial approach skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0304","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0304","description":"HCPCS-C0304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neurobehavioral status exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96116","description":"Neurobehavioral status exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Facility-based respite_ 24-hour unit_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0531","description":"Facility-based respite_ 24-hour unit_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECE1","description":"ICD-GECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4440","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","description":"HCPCS-Q4440","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat craniofacial fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21435","description":"Treat craniofacial fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQD1","description":"ICD-LCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXB1","description":"ICD-OIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc leg/ankle les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27632","description":"Exc leg/ankle les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp3 hd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0858","description":"Pwc gp3 hd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSD1","description":"ICD-LGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQB0","description":"ICD-DDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFA0","description":"ICD-NLFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUF0","description":"ICD-JBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sgd prerec msg>20min <=40min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2504","description":"Sgd prerec msg>20min <=40min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTE0","description":"ICD-IDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBF0","description":"ICD-KEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt trans to hosp post d/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8914","description":"Pt trans to hosp post d/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVA0","description":"ICD-JFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of mesentery lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44820","description":"Excision of mesentery lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of shoulder cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29058","description":"Application of shoulder cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHME1","description":"ICD-GHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ATXN2 (ataxin 2) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81179","description":"ATXN2 (ataxin 2) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTF1","description":"ICD-FBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEB1","description":"ICD-ACEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBC1","description":"ICD-FIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dna/rna direct probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87149","description":"Dna/rna direct probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMB0","description":"ICD-OGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWD0","description":"ICD-OKWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAE1","description":"ICD-JIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial)_ strain typing by whole genome sequencing_ p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0115U","description":"Infectious disease (bacterial)_ strain typing by whole genome sequencing_ p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open red simp malar/zygom fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7650","description":"Open red simp malar/zygom fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL52","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTA1","description":"ICD-EFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFND0","description":"ICD-OFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXD0","description":"ICD-OKXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Microscopic exam of urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81015","description":"Microscopic exam of urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull/sutures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61557","description":"Incise skull/sutures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt scrn dysphag/wt loss/nutr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3759F","description":"Pt scrn dysphag/wt loss/nutr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJF1","description":"ICD-GDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPA0","description":"ICD-KIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASC0","description":"ICD-KASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMA1","description":"ICD-CCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPA0","description":"ICD-CDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPB1","description":"ICD-OBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Post op service lvrs min 6","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0305","description":"Post op service lvrs min 6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCME1","description":"ICD-GCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRE1","description":"ICD-OJRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1478","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","description":"HCPCS-M1478","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJF1","description":"ICD-NKJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPE0","description":"ICD-NBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"1 or more neuropsych","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8947","description":"1 or more neuropsych","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open tx post pelvic fxcture","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0415","description":"Open tx post pelvic fxcture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Grafix Core and GrafixPL Core_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4132","description":"Grafix Core and GrafixPL Core_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair by enlargement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33610","description":"Repair by enlargement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE22B","description":"Special Care High _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRF1","description":"ICD-KFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVA0","description":"ICD-OLVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJB1","description":"ICD-NHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient had history of immunocompromising conditions prior to or during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1158","description":"Patient had history of immunocompromising conditions prior to or during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISD0","description":"ICD-KISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICF0","description":"ICD-JICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWB1","description":"ICD-PIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup hip spica ped fbrgl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4028","description":"Cast sup hip spica ped fbrgl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0661U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0661U","description":"CPT-0661U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no rh-immuno","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8810","description":"Doc reas no rh-immuno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD113","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKE0","description":"ICD-CEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gs mg composite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9235","description":"Gs mg composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Upright gait trainer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E8001","description":"Upright gait trainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Analgesia","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9230","description":"Analgesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96931","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEB1","description":"ICD-KBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX5D","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMB1","description":"ICD-CCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4DA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DA11","description":"ICD-4DA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAE0","description":"ICD-KBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extra heavy duty wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0007","description":"Extra heavy duty wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28E","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCID0","description":"ICD-NCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5169","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5169","description":"HCPCS-Q5169","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWF1","description":"ICD-HIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wrist arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29845","description":"Wrist arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21242","description":"Reconstruction of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ betibeglogene autotemcel_ per treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3393","description":"Injection_ betibeglogene autotemcel_ per treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTF1","description":"ICD-MCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLA0","description":"ICD-BFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA07","description":"Low Rehab_ ADL Index 0-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMD0","description":"ICD-OJMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of vancomycin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80202","description":"Assay of vancomycin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome analysis 5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88261","description":"Chromosome analysis 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISE0","description":"ICD-GISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEF0","description":"ICD-KCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCE0","description":"ICD-FBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent observation care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99225","description":"Subsequent observation care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEC0","description":"ICD-EAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYF0","description":"ICD-CBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cabg arterial three","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33535","description":"Cabg arterial three","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJA1","description":"ICD-KIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hysterectomy/revise vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58275","description":"Hysterectomy/revise vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTE0","description":"ICD-OCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYE1","description":"ICD-PCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLD0","description":"ICD-NHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Language screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5363","description":"Language screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACE0","description":"ICD-BACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBE0","description":"ICD-JFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRF0","description":"ICD-CBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Storage/year embryo(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89342","description":"Storage/year embryo(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oral device/appliance cusfab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0486","description":"Oral device/appliance cusfab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJD0","description":"ICD-OHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-pneumatic sequential compression garment_ full leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0678","description":"Non-pneumatic sequential compression garment_ full leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA52","description":"Default_ /90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIE1","description":"ICD-CEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHD0","description":"ICD-OEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of phenytoin free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80186","description":"Assay of phenytoin free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKB0","description":"ICD-KCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown 3/4 porcelain/ceramic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2783","description":"Crown 3/4 porcelain/ceramic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHB0","description":"ICD-CDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCE1","description":"ICD-IFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB23B","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHB1","description":"ICD-FAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fluoro exam of g/colon tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49465","description":"Fluoro exam of g/colon tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMA1","description":"ICD-IBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAB1","description":"ICD-CFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELE1","description":"ICD-KELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGD1","description":"ICD-CDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACB0","description":"ICD-CACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alglucerase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0205","description":"Alglucerase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGED1","description":"ICD-BGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQB0","description":"ICD-PCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cortisol free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82530","description":"Cortisol free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQD0","description":"ICD-KIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES22B","description":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE226","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOF0","description":"ICD-CDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOA1","description":"ICD-ODOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTF0","description":"ICD-NCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65760","description":"Revision of cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPC0","description":"ICD-JIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove extra spine segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22103","description":"Remove extra spine segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOE1","description":"ICD-GGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNA0","description":"ICD-FDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICC0","description":"ICD-EICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERF0","description":"ICD-LERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Er/ip hosp =/>2 in 12 mos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9522","description":"Er/ip hosp =/>2 in 12 mos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA56","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flutter device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8185","description":"Flutter device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLA0","description":"ICD-ABLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC14D","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIA0","description":"ICD-GCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Induced abortion 32 or more","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2267","description":"Induced abortion 32 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBC0","description":"ICD-JGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII/von Willebrand factor complex_ recombinant (Altuviiio)_ per Factor VIII IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7214","description":"Injection_ Factor VIII/von Willebrand factor complex_ recombinant (Altuviiio)_ per Factor VIII IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYF1","description":"ICD-HCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0657U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0657U","description":"CPT-0657U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOF0","description":"ICD-HGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECA0","description":"ICD-IECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy fb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45307","description":"Proctosigmoidoscopy fb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1378","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","description":"HCPCS-M1378","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC156","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56633","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgicl dress hold non-reuse","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4461","description":"Surgicl dress hold non-reuse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy_ flexible; with ablation or destruction of lesion(s) with laser_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31572","description":"Laryngoscopy_ flexible; with ablation or destruction of lesion(s) with laser_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXE1","description":"ICD-FCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMB1","description":"ICD-GGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transportation costs to and","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9992","description":"Transportation costs to and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dwelling lead investigation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1029","description":"Dwelling lead investigation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL1B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEA1","description":"ICD-IAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8I","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28F","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQB0","description":"ICD-PKQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOE0","description":"ICD-GCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chimerism anal no cell selec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81267","description":"Chimerism anal no cell selec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iliac aneurysm endovas rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75954","description":"Iliac aneurysm endovas rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mohs addl stage t/a/l","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17314","description":"Mohs addl stage t/a/l","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGB0","description":"ICD-JGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone marrow imaging ltd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78102","description":"Bone marrow imaging ltd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDE1","description":"ICD-MDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB146","description":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLC0","description":"ICD-IHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIE0","description":"ICD-FHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repriza_ 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4143","description":"Repriza_ 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEC0","description":"ICD-FBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1802","description":"HCPCS-A1802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLC1","description":"ICD-IDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assessment Of Salivary Flow By Measurement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0419","description":"Assessment Of Salivary Flow By Measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGD0","description":"ICD-BDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWC1","description":"ICD-LCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWF1","description":"ICD-KGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGC0","description":"ICD-FIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPD0","description":"ICD-OIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXB0","description":"ICD-OBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES20B","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No urtr inj at surg/1ms post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9633","description":"No urtr inj at surg/1ms post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX53","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"W/ch access anti-rollback","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0974","description":"W/ch access anti-rollback","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove elbow joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24102","description":"Remove elbow joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA13","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Peak expiratory flow rate (p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8110","description":"Peak expiratory flow rate (p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGE1","description":"ICD-JFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of nucleotidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83915","description":"Assay of nucleotidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGB0","description":"ICD-GDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Arch suprt att to sho longit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3070","description":"Arch suprt att to sho longit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27495","description":"Reinforce thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEID1","description":"ICD-KEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXA0","description":"ICD-GCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54324","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXE0","description":"ICD-FFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKD1","description":"ICD-KAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lvf assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3020F","description":"Lvf assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHA0","description":"ICD-MLHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYB0","description":"ICD-KIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mltispectrl digital les alys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0401T","description":"Mltispectrl digital les alys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATE0","description":"ICD-NATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL31","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx esophageal t4 no prog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9097","description":"Onc dx esophageal t4 no prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMB1","description":"ICD-MBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rural health clinic or federally qualified health center (RHC or FQHC) only_ general care management_ 20 minutes or more of clinical staff time for chronic care management ser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0511","description":"Rural health clinic or federally qualified health center (RHC or FQHC) only_ general care management_ 20 minutes or more of clinical staff time for chronic care management ser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD226","description":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJC0","description":"ICD-GEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKB0","description":"ICD-JGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cmptr ophth img optic nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92133","description":"Cmptr ophth img optic nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRA0","description":"ICD-LBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAF0","description":"ICD-OAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Topotecan oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8705","description":"Topotecan oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDB1","description":"ICD-JGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Smokeless tobacco user","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1035F","description":"Smokeless tobacco user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRA0","description":"ICD-OHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPF0","description":"ICD-BBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1340","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDB0","description":"ICD-FFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0577U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","description":"CPT-0577U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIE0","description":"ICD-EFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Methylenedioxyamphetamines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80359","description":"Methylenedioxyamphetamines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCD1","description":"ICD-ODCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dry pressure pad for mattres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0199","description":"Dry pressure pad for mattres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chromatography_ qualitative; column (eg_ gas liquid or hplc)_ analyte not elsewhere specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82486","description":"Chromatography_ qualitative; column (eg_ gas liquid or hplc)_ analyte not elsewhere specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD10D","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reinforced solid stirrup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2260","description":"Reinforced solid stirrup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73620","description":"X-ray exam of foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHC0","description":"ICD-IEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQD0","description":"ICD-LFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWE1","description":"ICD-DFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insitu hybridization (fish)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88364","description":"Insitu hybridization (fish)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylindr 4.00d/12-2.00d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2103","description":"Spherocylindr 4.00d/12-2.00d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA30","description":"High Rehab _ ADL Index 0-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOE1","description":"ICD-HCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGA0","description":"ICD-FIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELC1","description":"ICD-CELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDD1","description":"ICD-ADDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISB0","description":"ICD-OISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYD1","description":"ICD-HBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUD0","description":"ICD-MIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of stomach and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43810","description":"Fusion of stomach and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHF0","description":"ICD-IHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXD1","description":"ICD-JFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALA0","description":"ICD-FALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHF0","description":"ICD-GEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX46","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHA1","description":"ICD-NAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSE1","description":"ICD-PCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAB0","description":"ICD-NHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ triamcinolone acetonide_ preservative-free_ extended-release_ microsphere formulation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9993","description":"Injection_ triamcinolone acetonide_ preservative-free_ extended-release_ microsphere formulation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJB1","description":"ICD-BAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcath occlusion cns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61624","description":"Transcath occlusion cns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath tbs c/v redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88165","description":"Cytopath tbs c/v redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD24B","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise/remove neuroelectrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64585","description":"Revise/remove neuroelectrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSD0","description":"ICD-OLSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIE1","description":"ICD-AHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohols biomarkers 1or 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80321","description":"Alcohols biomarkers 1or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGC1","description":"ICD-NEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEF0","description":"ICD-GGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trach/laryn tube non-cuffed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7520","description":"Trach/laryn tube non-cuffed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHME1","description":"ICD-FHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUF0","description":"ICD-MBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADD1","description":"ICD-MADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp ilioiliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35663","description":"Art byp ilioiliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES14C","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Test for g6pd enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82960","description":"Test for g6pd enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTA1","description":"ICD-CHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB14","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Egd us fine needle bx/aspir","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43238","description":"Egd us fine needle bx/aspir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXE1","description":"ICD-CFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGF1","description":"ICD-JFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRD0","description":"ICD-LFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac magnetic resonance imaging for morphology and function_ quantification of segmental dysfunction; with stress im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9763","description":"Cardiac magnetic resonance imaging for morphology and function_ quantification of segmental dysfunction; with stress im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mr angiography neck w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70548","description":"Mr angiography neck w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCB1","description":"ICD-NJCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIA0","description":"ICD-IGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETC0","description":"ICD-OETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUE1","description":"ICD-EEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Platelet pheresis irradiated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9036","description":"Platelet pheresis irradiated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBND0","description":"ICD-JBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFB0","description":"ICD-GDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMA0","description":"ICD-CFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIF0","description":"ICD-MDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Term dev mech hook vol close","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6707","description":"Term dev mech hook vol close","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFD0","description":"ICD-OHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diphtheria_ tetanus toxoids_ and acellular pertussis vaccine andhemophilus influenza b vaccine (dtap-hib)_ for intramsucular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90721","description":"Diphtheria_ tetanus toxoids_ and acellular pertussis vaccine andhemophilus influenza b vaccine (dtap-hib)_ for intramsucular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWC0","description":"ICD-GIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQE0","description":"ICD-DEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDB1","description":"ICD-CBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYD0","description":"ICD-GHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of brain tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61545","description":"Excision of brain tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of torus palatinus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7472","description":"Removal of torus palatinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBD0","description":"ICD-CDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skilled services of a registered nurse (RN)_ in the training and/or education of a patient or family member_ in the home health or hospice setting_ each 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0495","description":"Skilled services of a registered nurse (RN)_ in the training and/or education of a patient or family member_ in the home health or hospice setting_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHF1","description":"ICD-NBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFC0","description":"ICD-NAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGD0","description":"ICD-BBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETB1","description":"ICD-NETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9815","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9815","description":"HCPCS-C9815","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXA0","description":"ICD-FAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1GC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GC21","description":"ICD-1GC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Technetium tc99m arcitumomab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9568","description":"Technetium tc99m arcitumomab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTA1","description":"ICD-MJTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted px extraocular musc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67399","description":"Unlisted px extraocular musc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJB0","description":"ICD-CIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA246","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Performance Not Met: Multimodal Pain Management Was Not Used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2150","description":"Performance Not Met: Multimodal Pain Management Was Not Used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC50","description":"Medium Rehab _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHA1","description":"ICD-EEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4288","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","description":"HCPCS-A4288","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBC0","description":"ICD-EIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Subtalar arthro w/exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29905","description":"Subtalar arthro w/exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stk cabg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8573","description":"Stk cabg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGB0","description":"ICD-CBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELC1","description":"ICD-JELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Meg evoked each addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95967","description":"Meg evoked each addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25520","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CACNA1A (calcium voltage-gated channel subunit alpha 1A) (eg_ spinocerebellar ataxia)_ full gene analysis_ including small sequence changes in exonic and intronic regions_ del","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0231U","description":"CACNA1A (calcium voltage-gated channel subunit alpha 1A) (eg_ spinocerebellar ataxia)_ full gene analysis_ including small sequence changes in exonic and intronic regions_ del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0987T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","description":"CPT-0987T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA5A","description":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGB1","description":"ICD-KHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTA0","description":"ICD-GGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50360","description":"Transplantation of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHC1","description":"ICD-JFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Td vacc no presv 7 yrs+ im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90714","description":"Td vacc no presv 7 yrs+ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Upper Gi Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1102","description":"Radiation Therapy For Upper Gi Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLE1","description":"ICD-KBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Long chain fatty acids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82726","description":"Long chain fatty acids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Restorative foundation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2949","description":"Restorative foundation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE23C","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBB1","description":"ICD-GDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUD1","description":"ICD-MIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath smear other source","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88161","description":"Cytopath smear other source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1360","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIA1","description":"ICD-GIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJE0","description":"ICD-CAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDC0","description":"ICD-NJDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antithrombin recombinant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7196","description":"Antithrombin recombinant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of body section","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76100","description":"X-ray exam of body section","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUE0","description":"ICD-MDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOB0","description":"ICD-HIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXB0","description":"ICD-FHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC214","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKA0","description":"ICD-FGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADC0","description":"ICD-NADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device_ mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93590","description":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device_ mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise circulation to head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61705","description":"Revise circulation to head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL02","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEND1","description":"ICD-KEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft subclav-carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35506","description":"Art byp grft subclav-carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adapt/ext_ pacing/neuro lead","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1883","description":"Adapt/ext_ pacing/neuro lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBA1","description":"ICD-CBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N block inj fem cont inf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64448","description":"N block inj fem cont inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5135","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","description":"HCPCS-Q5135","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37259","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","description":"CPT-37259","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCC0","description":"ICD-OCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Principal illness navigation - peer support_ additional 30 minutes per calendar month (list separately in addition to g0140)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0146","description":"Principal illness navigation - peer support_ additional 30 minutes per calendar month (list separately in addition to g0140)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAD0","description":"ICD-GBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Augmentation of facial bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21208","description":"Augmentation of facial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Supported employ_ per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2023","description":"Supported employ_ per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce clavicle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23490","description":"Reinforce clavicle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEF0","description":"ICD-CHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMD0","description":"ICD-MLMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic control band & belt u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2630","description":"Pelvic control band & belt u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inject/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67515","description":"Inject/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92628","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","description":"CPT-92628","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nerve surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64859","description":"Nerve surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGC1","description":"ICD-OJGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHE0","description":"ICD-MGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQC1","description":"ICD-HFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMB0","description":"ICD-KHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No satisfy with care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0918","description":"No satisfy with care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ efgartigimod alfa-fcab_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9332","description":"Injection_ efgartigimod alfa-fcab_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01924","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01924","description":"CPT-01924","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITF0","description":"ICD-KITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1308","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","description":"HCPCS-J1308","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES340","description":"Extensive Services _ ADL Index 2-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOB1","description":"ICD-CCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSC1","description":"ICD-CHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFA1","description":"ICD-CFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc order given stop antibio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4049F","description":"Doc order given stop antibio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implantation of subcutaneous peritoneal ascites pump system_ percutaneous_ including pump-pocket creation_ insertion of tunneled indwelling bladder and peritoneal catheters wi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0870T","description":"Implantation of subcutaneous peritoneal ascites pump system_ percutaneous_ including pump-pocket creation_ insertion of tunneled indwelling bladder and peritoneal catheters wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEE0","description":"ICD-BEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0662U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0662U","description":"CPT-0662U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBB0","description":"ICD-MEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28I","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYD0","description":"ICD-LDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mwc acc_ wheelchair brake","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2228","description":"Mwc acc_ wheelchair brake","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urofollitropin_ 75 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3355","description":"Urofollitropin_ 75 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of aqueous drainage device_ without extraocular reservoir_ internal approach_ into the subconjunctival space; initial device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0449T","description":"Insertion of aqueous drainage device_ without extraocular reservoir_ internal approach_ into the subconjunctival space; initial device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOE0","description":"ICD-LAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEA0","description":"ICD-JHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD111","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISB0","description":"ICD-GISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYF0","description":"ICD-OHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTD0","description":"ICD-CHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of iron","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83540","description":"Assay of iron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDA0","description":"ICD-KEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise windpipe scar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31830","description":"Revise windpipe scar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC15B","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOA1","description":"ICD-CAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBE0","description":"ICD-GBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJC0","description":"ICD-OEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit hydra total diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9373","description":"Hit hydra total diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMA0","description":"ICD-EBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIA1","description":"ICD-EBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBD0","description":"ICD-NGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOE1","description":"ICD-LDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOE1","description":"ICD-CBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair forearm tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25275","description":"Repair forearm tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFF0","description":"ICD-JGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-2 dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87537","description":"Hiv-2 dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cxr doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3006F","description":"Cxr doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N block inj cervical plexus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64413","description":"N block inj cervical plexus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Provider who referred the patient to another provider received a report from the provider to whom the patient was referred","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9969","description":"Provider who referred the patient to another provider received a report from the provider to whom the patient was referred","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90481","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","description":"CPT-90481","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0641U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0641U","description":"CPT-0641U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Afo tibial fracture rigid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2116","description":"Afo tibial fracture rigid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUC0","description":"ICD-AAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate cancer)_ FISH analysis of 4 genes (ASAP1_ HDAC9_ CHD1 and PTEN)_ needle biopsy specimen_ algorithm reported as probability of higher tumor grade","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0053U","description":"Oncology (prostate cancer)_ FISH analysis of 4 genes (ASAP1_ HDAC9_ CHD1 and PTEN)_ needle biopsy specimen_ algorithm reported as probability of higher tumor grade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEF0","description":"ICD-ACEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology (coronary heart disease [CHD])_ DNA_ analysis of 10 single-nucleotide polymorphisms (SNPs) (rs710987 [LINC010019]_ rs1333048 [CDKN2B-AS1]_ rs12129789 [KCND3]_ rs942","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0440U","description":"Cardiology (coronary heart disease [CHD])_ DNA_ analysis of 10 single-nucleotide polymorphisms (SNPs) (rs710987 [LINC010019]_ rs1333048 [CDKN2B-AS1]_ rs12129789 [KCND3]_ rs942","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTF1","description":"ICD-BBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVD0","description":"ICD-KHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKF0","description":"ICD-GIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release palm & finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26442","description":"Release palm & finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pulm funct test oscillometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94728","description":"Pulm funct test oscillometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXC0","description":"ICD-NCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42205","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQC0","description":"ICD-GHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGC1","description":"ICD-NAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRF0","description":"ICD-CIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLF0","description":"ICD-KDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHC0","description":"ICD-EFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Most recent hemoblobin A1c (HbA1c) level greater than or equal to 7.0% and less than 8.0% (DM)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3051F","description":"Most recent hemoblobin A1c (HbA1c) level greater than or equal to 7.0% and less than 8.0% (DM)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCF1","description":"ICD-NCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDA0","description":"ICD-BCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gngvl flap w rootplan 1-3 th","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4241","description":"Gngvl flap w rootplan 1-3 th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQB0","description":"ICD-KBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXE0","description":"ICD-KDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINC1","description":"ICD-GINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1339","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHF0","description":"ICD-CHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLD1","description":"ICD-ACLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGA1","description":"ICD-FAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAA1","description":"ICD-IFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLE0","description":"ICD-MHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE134","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65260","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCF0","description":"ICD-OJCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIB1","description":"ICD-OAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOD1","description":"ICD-KCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKC1","description":"ICD-OLKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0930T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","description":"CPT-0930T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMA0","description":"ICD-FHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23145","description":"Removal of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap w/omentopexy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49326","description":"Lap w/omentopexy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA154","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVA0","description":"ICD-OCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIE1","description":"ICD-GDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral supp not othrws c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9999","description":"Parenteral supp not othrws c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Full Gene Sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81351","description":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Full Gene Sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ initial treatment_ with identification and marking of the treatment locat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0767T","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ initial treatment_ with identification and marking of the treatment locat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUB0","description":"ICD-BAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01402","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01402","description":"CPT-01402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67999","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat knuckle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26715","description":"Treat knuckle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27808","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRA1","description":"ICD-OBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2JC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JC11","description":"ICD-2JC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWD0","description":"ICD-KGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSA1","description":"ICD-KFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX56","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXA0","description":"ICD-CDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOB1","description":"ICD-OJOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ekg tracing for initial prev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0404","description":"Ekg tracing for initial prev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENC0","description":"ICD-NENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00540","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00540","description":"CPT-00540","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Re-evaluation of occupational therapy established plan of care_ requiring these components: An assessment of changes in patient functional or medical status with revised plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97168","description":"Re-evaluation of occupational therapy established plan of care_ requiring these components: An assessment of changes in patient functional or medical status with revised plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAB1","description":"ICD-AAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRD1","description":"ICD-DGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAC1","description":"ICD-FAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB2D","description":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove ventilating tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69424","description":"Remove ventilating tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXB0","description":"ICD-CGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28X","description":"Special Care High _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAE1","description":"ICD-MBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair & revise nerve add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64874","description":"Repair & revise nerve add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAD1","description":"ICD-MBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auditory function + 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92621","description":"Auditory function + 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYA0","description":"ICD-DFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMF1","description":"ICD-NGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB134","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCB1","description":"ICD-MCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOE1","description":"ICD-PJOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWD0","description":"ICD-CFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nuclr rx interstit colloid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79300","description":"Nuclr rx interstit colloid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair hallux rigidus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28289","description":"Repair hallux rigidus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wilate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7183","description":"Wilate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISC1","description":"ICD-PISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMA1","description":"ICD-CBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Initial observation care_ per day_ for the evaluation and management of a patient which requires these 3 key components: A detailed or comprehensive history; A detailed or com","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99218","description":"Initial observation care_ per day_ for the evaluation and management of a patient which requires these 3 key components: A detailed or comprehensive history; A detailed or com","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDB0","description":"ICD-BFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUC0","description":"ICD-NJUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3mL dosage_ diluent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91300","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3mL dosage_ diluent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of reti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1220","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of reti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDF1","description":"ICD-IEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKF1","description":"ICD-OIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fam-trastuzumab deruxtecan-nxki_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9358","description":"Injection_ fam-trastuzumab deruxtecan-nxki_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYF1","description":"ICD-OJYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic caster tire tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2215","description":"Pneumatic caster tire tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNA0","description":"ICD-GCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cephalin floculation test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P2028","description":"Cephalin floculation test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oct breast surg cavity i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0354T","description":"Oct breast surg cavity i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0980T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","description":"CPT-0980T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAF1","description":"ICD-KFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQF0","description":"ICD-KDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy & decompress","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45337","description":"Sigmoidoscopy & decompress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hyoid myotomy & suspension","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21685","description":"Hyoid myotomy & suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDC0","description":"ICD-NDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv 1 extrem 5/> ea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64645","description":"Chemodenerv 1 extrem 5/> ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKA1","description":"ICD-CAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/o fol w/cont_ pelvis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8920","description":"Mra w/o fol w/cont_ pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antibio rx w in 10d of sympt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9286","description":"Antibio rx w in 10d of sympt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDE0","description":"ICD-ABDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tezepelumab-ekko_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2356","description":"Injection_ tezepelumab-ekko_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTF0","description":"ICD-EDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ dexamethasone 9%_ intraocular_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9034","description":"Injection_ dexamethasone 9%_ intraocular_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB23A","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0906T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","description":"CPT-0906T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ligate oviduct(s) add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58611","description":"Ligate oviduct(s) add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Msh2 gene known variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81296","description":"Msh2 gene known variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rectum surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45999","description":"Rectum surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC251","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLA0","description":"ICD-MBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRC0","description":"ICD-DDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUC1","description":"ICD-MCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUB0","description":"ICD-CIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trilaciclib_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1448","description":"Injection_ trilaciclib_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPB0","description":"ICD-BGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hair trnspl >15 punch grafts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15776","description":"Hair trnspl >15 punch grafts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECE1","description":"ICD-BECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOB0","description":"ICD-DFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYE0","description":"ICD-GEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove intrauterine device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58301","description":"Remove intrauterine device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hf mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8551","description":"Hf mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB201","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prep bk ptb plaster molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5510","description":"Prep bk ptb plaster molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cysto/uretero w/lithotripsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52356","description":"Cysto/uretero w/lithotripsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOC0","description":"ICD-KAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amphetamines 3or 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80325","description":"Amphetamines 3or 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Filters elec/combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0500","description":"Filters elec/combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Florbetaben f18","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9458","description":"Florbetaben f18","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove abdomen lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38780","description":"Remove abdomen lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILD0","description":"ICD-GILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEE0","description":"ICD-BFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIA1","description":"ICD-FCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","description":"HCPCS-J3403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coma stimulation per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9056","description":"Coma stimulation per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBD1","description":"ICD-CDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shwr cov elec/combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0501","description":"Shwr cov elec/combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ster wd ifx 30 d postop","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8571","description":"Ster wd ifx 30 d postop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy irrigation set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4400","description":"Ostomy irrigation set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQF1","description":"ICD-CCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Face-To-Face Hh Nsg Vst Rhc/Fqhc Area Shtg Hha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0490","description":"Face-To-Face Hh Nsg Vst Rhc/Fqhc Area Shtg Hha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cabg artery-vein two","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33518","description":"Cabg artery-vein two","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee orth pos locking joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1831","description":"Knee orth pos locking joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALE1","description":"ICD-OALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKID1","description":"ICD-OKID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Corneal transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65755","description":"Corneal transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLA0","description":"ICD-JCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALE1","description":"ICD-AALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX1C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBB1","description":"ICD-MCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDB0","description":"ICD-JEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ligation upper jaw artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30920","description":"Ligation upper jaw artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPC0","description":"ICD-GIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ascent_ 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4213","description":"Ascent_ 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oscillating tracking test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92545","description":"Oscillating tracking test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLC0","description":"ICD-KBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWA1","description":"ICD-LFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aspirin or another antiplatelet therapy not used_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1057","description":"Aspirin or another antiplatelet therapy not used_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB32","description":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diab shoe w/metatarsal bar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5505","description":"Diab shoe w/metatarsal bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Team evaluation & management","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1024","description":"Team evaluation & management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert heart pm atrial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33206","description":"Insert heart pm atrial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Guided tiss regen nonresorb","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4267","description":"Guided tiss regen nonresorb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYF1","description":"ICD-OHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHE0","description":"ICD-GAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYF1","description":"ICD-PFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDB1","description":"ICD-IBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKD0","description":"ICD-FIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRA1","description":"ICD-PLRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJD1","description":"ICD-FCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB22B","description":"Special Care High _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKA0","description":"ICD-GAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHA1","description":"ICD-MLHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt edu re alcoh drnkng done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4158F","description":"Pt edu re alcoh drnkng done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psytx crisis ea addl 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90840","description":"Psytx crisis ea addl 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADA0","description":"ICD-BADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVF1","description":"ICD-JAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Custom grad sleeve heavy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8423","description":"Custom grad sleeve heavy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAME0","description":"ICD-AAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRD0","description":"ICD-HGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0103","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0103","description":"HCPCS-C0103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE11B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVC0","description":"ICD-CFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove forearm bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25145","description":"Remove forearm bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1129","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIB0","description":"ICD-GHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCB1","description":"ICD-EHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOE0","description":"ICD-HAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKA1","description":"ICD-FEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB216","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHC0","description":"ICD-AIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNC0","description":"ICD-KDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision Or Removal Of Integrated Single Device Neurostimulation System Including Electrode Array And Receiver Or Pulse Generator_ Including Analysis_ Programming_ And Imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0588T","description":"Revision Or Removal Of Integrated Single Device Neurostimulation System Including Electrode Array And Receiver Or Pulse Generator_ Including Analysis_ Programming_ And Imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINA1","description":"ICD-CINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACED0","description":"ICD-ACED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISF0","description":"ICD-PISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prosthesis_ breast_ imp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1789","description":"Prosthesis_ breast_ imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITC0","description":"ICD-OITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inpatient Respite Care - A flat per diem rate before area wage adjustment paid for each day on which the patient is in an inpatient facility and is receiving respite care.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0604","description":"Inpatient Respite Care - A flat per diem rate before area wage adjustment paid for each day on which the patient is in an inpatient facility and is receiving respite care.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAA1","description":"ICD-MKAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIA1","description":"ICD-KGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular Repair Of Iliac Artery_ Not Associated With Placement Of An Aorto-Iliac Artery Endograft At The Same Session_ By Deployment Of An Iliac Branched Endograft_ Includ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34718","description":"Endovascular Repair Of Iliac Artery_ Not Associated With Placement Of An Aorto-Iliac Artery Endograft At The Same Session_ By Deployment Of An Iliac Branched Endograft_ Includ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen system liquid portabl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0435","description":"Oxygen system liquid portabl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair cleft lip/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40720","description":"Repair cleft lip/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore epididymis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54865","description":"Explore epididymis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73100","description":"X-ray exam of wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9802","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Forceps esoph biopsy done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3150F","description":"Forceps esoph biopsy done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychia interven rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4526F","description":"Neuropsychia interven rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMC1","description":"ICD-AIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35103","description":"Repair artery rupture aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB13D","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sargramostim injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2820","description":"Sargramostim injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00940","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00940","description":"CPT-00940","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prefab glove for term device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6890","description":"Prefab glove for term device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q2057","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","description":"HCPCS-Q2057","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVE1","description":"ICD-OEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX3C","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect ovarian malignancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58952","description":"Resect ovarian malignancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQF1","description":"ICD-DCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE110","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap inc hernia repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49654","description":"Lap inc hernia repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin copper sulfate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83026","description":"Hemoglobin copper sulfate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAC1","description":"ICD-IFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBC0","description":"ICD-GHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect diaphragm complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39561","description":"Resect diaphragm complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEC1","description":"ICD-FCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRE0","description":"ICD-CHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIB0","description":"ICD-OBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB4A","description":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMB0","description":"ICD-ACMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSE1","description":"ICD-PFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB5B","description":"High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44238","description":"Laparoscope proc intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elbow fair lead cable molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6584","description":"Elbow fair lead cable molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVB0","description":"ICD-OFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 6 central carbon metabolites (ie_ a-ketoglutarate_ alanine_ lactate_ phenylalanine_ pyruvate_ and succ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0139U","description":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 6 central carbon metabolites (ie_ a-ketoglutarate_ alanine_ lactate_ phenylalanine_ pyruvate_ and succ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dyspnea mngmnt plan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0535F","description":"Dyspnea mngmnt plan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAD1","description":"ICD-GBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0660U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0660U","description":"CPT-0660U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28F","description":"Clinically Complex _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYE0","description":"ICD-DEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATE1","description":"ICD-GATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Canalith repositioning proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95992","description":"Canalith repositioning proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOD0","description":"ICD-LBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy pneumonectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32671","description":"Thoracoscopy pneumonectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVD0","description":"ICD-BHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Minor blunt trauma w/head ct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9529","description":"Minor blunt trauma w/head ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKF1","description":"ICD-OEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v select","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88154","description":"Cytopath c/v select","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ntrk (Neurotrophic-Tropomyosin Receptor Tyrosine Kinase 1_ 2_ And 3) (Eg_ Solid Tumors) Translocation Analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81194","description":"Ntrk (Neurotrophic-Tropomyosin Receptor Tyrosine Kinase 1_ 2_ And 3) (Eg_ Solid Tumors) Translocation Analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac shunt imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78428","description":"Cardiac shunt imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Manual semi-reclining back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1225","description":"Manual semi-reclining back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAB0","description":"ICD-AHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDF0","description":"ICD-EDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove tear gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68550","description":"Remove tear gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPC0","description":"ICD-OBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOF0","description":"ICD-LDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt_ pn_ hist grade not doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8724","description":"Pt_ pn_ hist grade not doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVB0","description":"ICD-JHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQC1","description":"ICD-KIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spin/brain pump refil & main","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95990","description":"Spin/brain pump refil & main","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSC0","description":"ICD-DGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDTB&VINCULIN IGG ANTB IA","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0176U","description":"CDTB&VINCULIN IGG ANTB IA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JB21","description":"ICD-3JB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEA1","description":"ICD-NDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQA0","description":"ICD-GEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tte w/o doppler complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93307","description":"Tte w/o doppler complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Str markers specimen anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81265","description":"Str markers specimen anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Specimen fat stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89125","description":"Specimen fat stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputate hand at wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25920","description":"Amputate hand at wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCC1","description":"ICD-AGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYE1","description":"ICD-GCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0917T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","description":"CPT-0917T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC15D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALF1","description":"ICD-KALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAA0","description":"ICD-MBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plate pheres leukoredu irrad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9037","description":"Plate pheres leukoredu irrad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB17","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITC0","description":"ICD-IITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQE1","description":"ICD-GFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Porc/ceram inlay >= 3 surfac","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6601","description":"Porc/ceram inlay >= 3 surfac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWB0","description":"ICD-KIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB217","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHC1","description":"ICD-KEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESF0","description":"ICD-OESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDA1","description":"ICD-EHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYF1","description":"ICD-DCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAF1","description":"ICD-AFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of eardrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69420","description":"Incision of eardrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ non-stranded_p-103","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2641","description":"Brachytx_ non-stranded_p-103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of tibia fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27752","description":"Treatment of tibia fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFC1","description":"ICD-CHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0643U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0643U","description":"CPT-0643U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (lung)_ enzyme-linked immunosorbent assay (ELISA) of 7 autoantibodies (p53_ NY-ESO-1_ CAGE_ GBU4-5_ SOX2_ MAGE A4_ and HuD)_ plasma_ algorithm reported as a categoric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0360U","description":"Oncology (lung)_ enzyme-linked immunosorbent assay (ELISA) of 7 autoantibodies (p53_ NY-ESO-1_ CAGE_ GBU4-5_ SOX2_ MAGE A4_ and HuD)_ plasma_ algorithm reported as a categoric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chylmd pneum dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87485","description":"Chylmd pneum dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMB0","description":"ICD-OKMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Driver pneumatic vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0480","description":"Driver pneumatic vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Us exam k transpl w/doppler","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76776","description":"Us exam k transpl w/doppler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITB0","description":"ICD-OITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUD1","description":"ICD-IDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vertebral axial decompressio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9090","description":"Vertebral axial decompressio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJC0","description":"ICD-NDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRC0","description":"ICD-CFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKD0","description":"ICD-BFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTB1","description":"ICD-MCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mpl (Mpl Proto-Oncogene_ Thrombopoietin Receptor) (Eg_ Myeloproliferative Disorder) Gene Analysis; Sequence Analysis_ Exon 10","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81339","description":"Mpl (Mpl Proto-Oncogene_ Thrombopoietin Receptor) (Eg_ Myeloproliferative Disorder) Gene Analysis; Sequence Analysis_ Exon 10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gross pulpal debridement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3221","description":"Gross pulpal debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUE1","description":"ICD-FHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRE0","description":"ICD-GCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOF1","description":"ICD-GIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBD1","description":"ICD-GCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNA0","description":"ICD-GGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBB1","description":"ICD-BFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemipelvectomy canadian sach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5341","description":"Hemipelvectomy canadian sach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLF0","description":"ICD-KGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28725","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Children who were not screened for risk of developmental_ behavioral and social delays using a standardized tool with interpretation and report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9967","description":"Children who were not screened for risk of developmental_ behavioral and social delays using a standardized tool with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ plasminogen_ human-tvmh_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2998","description":"Injection_ plasminogen_ human-tvmh_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJA1","description":"ICD-CHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ranibizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2778","description":"Ranibizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIB1","description":"ICD-NFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLC1","description":"ICD-JDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC201","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRF1","description":"ICD-KCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx head/neck ext unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9112","description":"Onc dx head/neck ext unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Percutaneous Right Heart Ventricular Assist Device_ Venous Cannula_ At Separate And Distinct Session From Insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33997","description":"Removal Of Percutaneous Right Heart Ventricular Assist Device_ Venous Cannula_ At Separate And Distinct Session From Insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEE1","description":"ICD-AIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJE1","description":"ICD-OEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQA1","description":"ICD-KEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPB0","description":"ICD-BAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC16","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hhs/hospice of lpn ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0300","description":"Hhs/hospice of lpn ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUC1","description":"ICD-IFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amnioamp-mp_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4250","description":"Amnioamp-mp_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGF0","description":"ICD-JFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA)_ Chlamydia trachomatis and Neisseria gonorrhoeae_ multiplex amplified probe technique_ urine_ vaginal_ pharyngeal_ or rectal_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0353U","description":"Infectious agent detection by nucleic acid (DNA)_ Chlamydia trachomatis and Neisseria gonorrhoeae_ multiplex amplified probe technique_ urine_ vaginal_ pharyngeal_ or rectal_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc (ovarian) biocheml assays of five proteins (apolipoprotein A-1_ CA 125 II_ follicle stimulating hormone_ human epididymis protein 4_ transferrin)_ utilizing serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0003U","description":"Onc (ovarian) biocheml assays of five proteins (apolipoprotein A-1_ CA 125 II_ follicle stimulating hormone_ human epididymis protein 4_ transferrin)_ utilizing serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE145","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp carotid-vertebral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35642","description":"Art byp carotid-vertebral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLC0","description":"ICD-AHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Occlusive eye patch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6412","description":"Occlusive eye patch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystourethroscopy_ with insertion of temporary prostatic implant/stent with fixation/anchor and incisional struts","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9769","description":"Cystourethroscopy_ with insertion of temporary prostatic implant/stent with fixation/anchor and incisional struts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24110","description":"Remove humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LB31","description":"ICD-3LB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1165","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFME0","description":"ICD-GFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0570U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","description":"CPT-0570U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA10D","description":"Clinically Complex _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immntx 5 sting insects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95134","description":"Immntx 5 sting insects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nitroblue tetrazolium dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86384","description":"Nitroblue tetrazolium dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVF0","description":"ICD-OIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMC0","description":"ICD-JAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO knee intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an adequ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9727","description":"Patient unable to complete the FOTO knee intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an adequ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients receiving high doses of immunosuppressive therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1063","description":"Patients receiving high doses of immunosuppressive therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBF1","description":"ICD-JCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECC1","description":"ICD-EECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35092","description":"Repair artery rupture aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE20A","description":"Special Care High _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of sciatic nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64712","description":"Revision of sciatic nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJD1","description":"ICD-FGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ped home apnea rec report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94777","description":"Ped home apnea rec report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ gemtuzumab ozogamicin_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9203","description":"Injection_ gemtuzumab ozogamicin_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLE0","description":"ICD-OHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical_ ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring_ radiofrequency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58674","description":"Laparoscopy_ surgical_ ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring_ radiofrequency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPE0","description":"ICD-GHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUA0","description":"ICD-MFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal fluid drainage w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59074","description":"Fetal fluid drainage w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cisplatin 10 mg injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9060","description":"Cisplatin 10 mg injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMF1","description":"ICD-FFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOF1","description":"ICD-KIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0402","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0402","description":"CDT-D0402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX3D","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD126","description":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55845","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB3C","description":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC3A","description":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHC1","description":"ICD-ODHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDND1","description":"ICD-CDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBF1","description":"ICD-NLBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tis trnfr f/c/c/m/n/a/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14040","description":"Tis trnfr f/c/c/m/n/a/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intradermal Cancer Immunotherapy; Preparation And Initial Injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0708T","description":"Intradermal Cancer Immunotherapy; Preparation And Initial Injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBA1","description":"ICD-FCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Influenza virus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86710","description":"Influenza virus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mens shoes hightop depth inl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3222","description":"Mens shoes hightop depth inl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUD1","description":"ICD-KHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy/removal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38525","description":"Biopsy/removal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cough stimulating device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0482","description":"Cough stimulating device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antinuclear antibodies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86038","description":"Antinuclear antibodies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYC1","description":"ICD-PBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX4A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFC0","description":"ICD-FBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQF1","description":"ICD-PFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEB1","description":"ICD-BFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21452","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason for not conducting a search for DICOM format images for prior patient CT imaging studies completed at non-affiliated external healthcare facili","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9753","description":"Documentation of medical reason for not conducting a search for DICOM format images for prior patient CT imaging studies completed at non-affiliated external healthcare facili","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bone for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20900","description":"Removal of bone for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE206","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gi prophylaxis for nsaid rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4017F","description":"Gi prophylaxis for nsaid rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHB0","description":"ICD-NGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a medication dispensing event indicator of a history of asthma any time during the patient_s history through the end of the measure period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9799","description":"Patients with a medication dispensing event indicator of a history of asthma any time during the patient_s history through the end of the measure period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release palm contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26125","description":"Release palm contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mycobacteria dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87552","description":"Mycobacteria dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJA0","description":"ICD-CIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSE1","description":"ICD-OFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQA0","description":"ICD-LDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEA0","description":"ICD-CCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA13B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUF0","description":"ICD-OAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSC1","description":"ICD-GGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilate urethra stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53600","description":"Dilate urethra stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mediastinoscpy w/lmph nod bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39402","description":"Mediastinoscpy w/lmph nod bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUD0","description":"ICD-IAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHD0","description":"ICD-OLHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat penis lesion graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54112","description":"Treat penis lesion graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTF0","description":"ICD-AHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHND1","description":"ICD-NHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not respond to the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1241","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWB0","description":"ICD-HBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bridge repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6980","description":"Bridge repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES114","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Fluoroscopy And/Or Ultrasound Guidance_ When Performed; Birth Through 5 Years Of Age Or Any","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33018","description":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Fluoroscopy And/Or Ultrasound Guidance_ When Performed; Birth Through 5 Years Of Age Or Any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHB1","description":"ICD-OGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cannula nasal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4615","description":"Cannula nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7530","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7530","description":"HCPCS-J7530","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDID0","description":"ICD-JDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onsite nursing facility conference_ that is separate and distinct from an Evaluation and Management visit_ including qualified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9686","description":"Onsite nursing facility conference_ that is separate and distinct from an Evaluation and Management visit_ including qualified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise/implant finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26536","description":"Revise/implant finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLD1","description":"ICD-CHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD22A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKC0","description":"ICD-OIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoe molded plastazote cust","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3253","description":"Shoe molded plastazote cust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCF1","description":"ICD-KGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSD1","description":"ICD-PFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWC1","description":"ICD-PIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"FMRI brain by phys/psych","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70555","description":"FMRI brain by phys/psych","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBF0","description":"ICD-GCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flt3 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81245","description":"Flt3 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exhaled nitric oxide meas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95012","description":"Exhaled nitric oxide meas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB1A","description":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1049T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1049T","description":"CPT-1049T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cellesta cord_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4214","description":"Cellesta cord_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVA1","description":"ICD-NCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (acute myelogenous leukemia)_ DNA_ whole genome next-generation sequencing to detect gene rearrangement(s)_ blood or bone marrow_ report of specific gene rearrangem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0056U","description":"Hematology (acute myelogenous leukemia)_ DNA_ whole genome next-generation sequencing to detect gene rearrangement(s)_ blood or bone marrow_ report of specific gene rearrangem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure)_ in the office or other outpatient setting requiring direct patient contact beyond t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0513","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure)_ in the office or other outpatient setting requiring direct patient contact beyond t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTC1","description":"ICD-ICTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUE0","description":"ICD-MHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pulpal regeneration interim","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3356","description":"Pulpal regeneration interim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBC1","description":"ICD-OCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of head of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24130","description":"Removal of head of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJC0","description":"ICD-KIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMB1","description":"ICD-BBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion >2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11313","description":"Shave skin lesion >2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sbsq Plmt Drug Eluting Ocular Insert Uni/Bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0445T","description":"Sbsq Plmt Drug Eluting Ocular Insert Uni/Bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Certolizumab pegol inj 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0717","description":"Certolizumab pegol inj 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWD0","description":"ICD-CAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXC1","description":"ICD-JGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6032","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","description":"HCPCS-L6032","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC217","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQE0","description":"ICD-GDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Position wc cush wdth <22 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2605","description":"Position wc cush wdth <22 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX0C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Emr pwr source combo vad rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0491","description":"Emr pwr source combo vad rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doxorubicin hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9000","description":"Doxorubicin hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUC1","description":"ICD-IAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLE0","description":"ICD-FFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXA1","description":"ICD-JGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58285","description":"Extensive hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPE1","description":"ICD-NIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lung lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32140","description":"Removal of lung lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMC1","description":"ICD-EAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD114","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBF0","description":"ICD-NCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ko w adj flex/ext rotat mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1846","description":"Ko w adj flex/ext rotat mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A5102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","description":"HCPCS-A5102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23545","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECF0","description":"ICD-GECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36560","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIA0","description":"ICD-EBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth trachea bronchi surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54851","description":"Anesth trachea bronchi surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hep b ig im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90371","description":"Hep b ig im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-60660","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","description":"CPT-60660","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMB0","description":"ICD-NFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 25MCG/0.25ML1ST","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0111A","description":"ADM SARSCOV2 25MCG/0.25ML1ST","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE250","description":"Reduced Physical Function _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYC1","description":"ICD-HFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shldr disar prosth tiss shap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6550","description":"Shldr disar prosth tiss shap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx head/neck t3-4 noprog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9110","description":"Onc dx head/neck t3-4 noprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Qual life tool 2x same/impr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9634","description":"Qual life tool 2x same/impr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81188","description":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6075","description":"Implant supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy bilobectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32670","description":"Thoracoscopy bilobectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBE0","description":"ICD-KFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr ing hernia baby blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49496","description":"Rpr ing hernia baby blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYD1","description":"ICD-GBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB10B","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skn sub grft f/n/hf/g ch add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15278","description":"Skn sub grft f/n/hf/g ch add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJF1","description":"ICD-BFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGF1","description":"ICD-JIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Splint - extra-coronal; natural teeth or prosthetic crowns","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4323","description":"Splint - extra-coronal; natural teeth or prosthetic crowns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mycophenolate mofetil_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7519","description":"Injection_ mycophenolate mofetil_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of anal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46050","description":"Incision of anal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert non-tunnel cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36556","description":"Insert non-tunnel cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUD1","description":"ICD-GAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Csf shunt evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78645","description":"Csf shunt evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disease mgmt per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0317","description":"Disease mgmt per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSB1","description":"ICD-KFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEC0","description":"ICD-OEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBB1","description":"ICD-IHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHF0","description":"ICD-OEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLD1","description":"ICD-EDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPC1","description":"ICD-BEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0701","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0701","description":"HCPCS-C0701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMB1","description":"ICD-OEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRC0","description":"ICD-OGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy volvul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45321","description":"Proctosigmoidoscopy volvul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal)_ quantitative assessment of three urine metabolites","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0107U","description":"Oncology (colorectal)_ quantitative assessment of three urine metabolites","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBD0","description":"ICD-JBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERD1","description":"ICD-OERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colon ca scrn; barium enema","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0120","description":"Colon ca scrn; barium enema","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIF0","description":"ICD-BBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLD1","description":"ICD-MJLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIE0","description":"ICD-OKIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETF1","description":"ICD-IETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sysrsn no dicom srch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9344","description":"Sysrsn no dicom srch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRD1","description":"ICD-LGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCE1","description":"ICD-JCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJE1","description":"ICD-GCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24125","description":"Remove/graft bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8000","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8000","description":"HCPCS-C8000","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCE0","description":"ICD-NGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDA0","description":"ICD-CCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of thigh tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27390","description":"Incision of thigh tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL42","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVA1","description":"ICD-BAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNE0","description":"ICD-KHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2002","description":"HCPCS-A2002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast cancer)_ S100A8 and S100A9_ by enzyme-linked immunosorbent assay (ELISA)_ tear fluid with age_ algorithm reported as a risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0458U","description":"Oncology (breast cancer)_ S100A8 and S100A9_ by enzyme-linked immunosorbent assay (ELISA)_ tear fluid with age_ algorithm reported as a risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fit spectacles bifocal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92341","description":"Fit spectacles bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abduction rotation bar shoe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3140","description":"Abduction rotation bar shoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXB1","description":"ICD-KCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0264U","description":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plastic Surgery Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4027","description":"Plastic Surgery Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove uro sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53446","description":"Remove uro sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQE0","description":"ICD-GAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRF1","description":"ICD-CIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMA0","description":"ICD-JAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAA0","description":"ICD-IAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJC0","description":"ICD-OBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYC1","description":"ICD-GBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQC0","description":"ICD-HDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDD0","description":"ICD-OEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54205","description":"Treatment of penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood_ l/r_ cmv-neg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9051","description":"Blood_ l/r_ cmv-neg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exclusion Of Left Atrial Appendage_ Thoracoscopic_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_ Ligation_ Plication_ Clip)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33269","description":"Exclusion Of Left Atrial Appendage_ Thoracoscopic_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_ Ligation_ Plication_ Clip)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAE0","description":"ICD-BGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Post fusion /=1.5kcal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4152","description":"Ef calorie dense>/=1.5kcal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETE1","description":"ICD-AETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score hip pt no elg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8653","description":"Fun stat score hip pt no elg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sphyg/bp app w cuff and stet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4660","description":"Sphyg/bp app w cuff and stet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab-dkst_ biosimilar_ (Ogivri)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5114","description":"Injection_ trastuzumab-dkst_ biosimilar_ (Ogivri)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj progesterone per 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2675","description":"Inj progesterone per 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEE0","description":"ICD-KHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAE0","description":"ICD-AGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Cns Tumors Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1084","description":"Radiation Therapy For Cns Tumors Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLD0","description":"ICD-FGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGC1","description":"ICD-KDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc thigh/knee tum dep 5cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27339","description":"Exc thigh/knee tum dep 5cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"History aids-defining cond","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3490F","description":"History aids-defining cond","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (cutaneous melanoma)_ mRNA gene expression profiling by RT-PCR of 23 genes (14 content and 9 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0090U","description":"Oncology (cutaneous melanoma)_ mRNA gene expression profiling by RT-PCR of 23 genes (14 content and 9 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHC0","description":"ICD-ICHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPD0","description":"ICD-CEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKF1","description":"ICD-BBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUB0","description":"ICD-GDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAC0","description":"ICD-AHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPD0","description":"ICD-JIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Truss add to std pad scrotal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8330","description":"Truss add to std pad scrotal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLC1","description":"ICD-KCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYE0","description":"ICD-GGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPB1","description":"ICD-GEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYD1","description":"ICD-KBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC34","description":"High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFC0","description":"ICD-GFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKE0","description":"ICD-BCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEC1","description":"ICD-IDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBE1","description":"ICD-MCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYC1","description":"ICD-CDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc rspse chmotx rx motility cntrst tomography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0083U","description":"Onc rspse chmotx rx motility cntrst tomography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"TGFBI (transforming growth factor beta-induced) (eg_ corneal dystrophy) gene analysis_ common variants (eg_ R124H_ R124C_ R124L_ R555W_ R555Q)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81333","description":"TGFBI (transforming growth factor beta-induced) (eg_ corneal dystrophy) gene analysis_ common variants (eg_ R124H_ R124C_ R124L_ R555W_ R555Q)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cognitive test by hc pro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96125","description":"Cognitive test by hc pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFA0","description":"ICD-KCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rb82 rubidium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9555","description":"Rb82 rubidium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35013","description":"Repair artery rupture arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Musc test done w/n test comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95886","description":"Musc test done w/n test comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroconvulsive therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90870","description":"Electroconvulsive therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcv <10mg daily predniso","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4193F","description":"Pt rcv <10mg daily predniso","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINA0","description":"ICD-KINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23470","description":"Reconstruct shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heart first pass multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78483","description":"Heart first pass multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQC1","description":"ICD-GGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"SUPRATHEL_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2012","description":"SUPRATHEL_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of stomach lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43840","description":"Repair of stomach lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hsv dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87529","description":"Hsv dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEE1","description":"ICD-EFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair cleft lip/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40761","description":"Repair cleft lip/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAA1","description":"ICD-GDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eeg monitoring/videorecord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95951","description":"Eeg monitoring/videorecord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYB1","description":"ICD-PJYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFE0","description":"ICD-NGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKC1","description":"ICD-JHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWE1","description":"ICD-KIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUF1","description":"ICD-MDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28A","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement nasal pillows","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7033","description":"Replacement nasal pillows","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLC1","description":"ICD-KDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOA1","description":"ICD-LDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXE1","description":"ICD-FIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection Hpc 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9986","description":"Injection Hpc 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auricular prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8045","description":"Auricular prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILA0","description":"ICD-EILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; first 100 cm2 or part thereof_ or 1% of body surface area of infants and childre","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0479T","description":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; first 100 cm2 or part thereof_ or 1% of body surface area of infants and childre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWE1","description":"ICD-KBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILE0","description":"ICD-EILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDD0","description":"ICD-CCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect mediastinal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39220","description":"Resect mediastinal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETD1","description":"ICD-BETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDID0","description":"ICD-MDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63650","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transoral; with removal of intragastric bariatric balloon(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43291","description":"Esophagogastroduodenoscopy_ flexible_ transoral; with removal of intragastric bariatric balloon(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDA0","description":"ICD-IHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis a antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86708","description":"Hepatitis a antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDD0","description":"ICD-FCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTC1","description":"ICD-IBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTD1","description":"ICD-JGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brief communication technology-based service_ e.g. virtual check-in_ by a physician or other qualified health care professional who can report evaluation and management servic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2252","description":"Brief communication technology-based service_ e.g. virtual check-in_ by a physician or other qualified health care professional who can report evaluation and management servic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEC0","description":"ICD-BGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastric emptying imag study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78266","description":"Gastric emptying imag study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4BB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BB31","description":"ICD-4BB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUD0","description":"ICD-IIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMC0","description":"ICD-IIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place ndl musc/tis for rt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20555","description":"Place ndl musc/tis for rt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pertussis ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87265","description":"Pertussis ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foot external keel sach foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5970","description":"Foot external keel sach foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44372","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJE1","description":"ICD-GFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUC0","description":"ICD-GCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lengthening of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27395","description":"Lengthening of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB52","description":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXF1","description":"ICD-NIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0702","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0702","description":"HCPCS-A0702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXB1","description":"ICD-FFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPA1","description":"ICD-BCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRE1","description":"ICD-DHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSB1","description":"ICD-LFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBC1","description":"ICD-GGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast)_ mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81520","description":"Oncology (breast)_ mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tactile breast img uni/bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0422T","description":"Tactile breast img uni/bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUD1","description":"ICD-ICUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALD1","description":"ICD-GALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWD0","description":"ICD-LCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC46","description":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove lung artery emboli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33910","description":"Remove lung artery emboli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKB0","description":"ICD-GIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXB0","description":"ICD-CCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Performance Not Met: The Residual Change Score Is Less Than 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2167","description":"Performance Not Met: The Residual Change Score Is Less Than 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDD1","description":"ICD-JEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICA1","description":"ICD-GICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIA1","description":"ICD-MEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX5B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMB0","description":"ICD-CHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25628","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAB1","description":"ICD-BCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis one evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90945","description":"Dialysis one evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45505","description":"Repair of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystouretero w/biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52354","description":"Cystouretero w/biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUE0","description":"ICD-KEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gravity assisted traction de","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0941","description":"Gravity assisted traction de","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVF0","description":"ICD-NLVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Venous mech thrombectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37187","description":"Venous mech thrombectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bekesy audiometry diagnosis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92561","description":"Bekesy audiometry diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHA1","description":"ICD-NDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endo knee-shin hydral swg ph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5814","description":"Endo knee-shin hydral swg ph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cst noble mtl inlay >=3 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6607","description":"Cst noble mtl inlay >=3 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33417","description":"Repair of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIB0","description":"ICD-BHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWB1","description":"ICD-OKWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28F","description":"Clinically Complex _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWC0","description":"ICD-CDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQD0","description":"ICD-DAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revis reconst shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23473","description":"Revis reconst shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUE1","description":"ICD-MJUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD136","description":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Expiratory positive airway pressure intranasal resistance valve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7049","description":"Expiratory positive airway pressure intranasal resistance valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA255","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDC1","description":"ICD-NLDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAC0","description":"ICD-KAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29892","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXB1","description":"ICD-BIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepa vaccine adult im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90632","description":"Hepa vaccine adult im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dentures adjust part mandbl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5422","description":"Dentures adjust part mandbl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ elranatamab-bcmm_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9165","description":"Injection_ elranatamab-bcmm_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC245","description":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apply srs headframe add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61800","description":"Apply srs headframe add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52214","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYA1","description":"ICD-PHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUC0","description":"ICD-OAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX0D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX13","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRB0","description":"ICD-OBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERA0","description":"ICD-LERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inpatient consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99251","description":"Inpatient consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Whelchr fxd full length arms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1050","description":"Whelchr fxd full length arms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIF1","description":"ICD-KEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj nalbuphine hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2300","description":"Inj nalbuphine hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx orbit periorbt w/grft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21395","description":"Opn tx orbit periorbt w/grft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEE0","description":"ICD-OHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocortisone acetate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1700","description":"Hydrocortisone acetate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short sta","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX03","description":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATF0","description":"ICD-GATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin full graft sclp/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15220","description":"Skin full graft sclp/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagosc flex trnsn biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43198","description":"Esophagosc flex trnsn biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEE1","description":"ICD-KHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAC0","description":"ICD-IGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"O shoe add instep velcro clo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3580","description":"O shoe add instep velcro clo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0698U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698U","description":"CPT-0698U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGD1","description":"ICD-KHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFE1","description":"ICD-OIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"L ventric pacing lead add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33225","description":"L ventric pacing lead add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELF1","description":"ICD-FELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"R&l hrt cath w/ventriclgrphy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93453","description":"R&l hrt cath w/ventriclgrphy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVB0","description":"ICD-NLVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDB0","description":"ICD-MIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXF1","description":"ICD-JBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ nivolumab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9299","description":"Injection_ nivolumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYA0","description":"ICD-KCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51570","description":"Removal of bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHA0","description":"ICD-FFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPF1","description":"ICD-NFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAND1","description":"ICD-NAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXD1","description":"ICD-KBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Placement of drain pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48001","description":"Placement of drain pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFA0","description":"ICD-JCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tray","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0950","description":"Tray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALA1","description":"ICD-NALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLC1","description":"ICD-MFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVE0","description":"ICD-KHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiology Cardiac Specialist Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4002","description":"Electrophysiology Cardiac Specialist Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIE0","description":"ICD-CCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYC1","description":"ICD-CEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILC1","description":"ICD-EILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTE0","description":"ICD-EGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cranial electrotherapy stimulation (ces) system_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0732","description":"Cranial electrotherapy stimulation (ces) system_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion_ casirivimab and imdevimab includes infusion and post administration monitoring in the home or residence.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0244","description":"Intravenous infusion_ casirivimab and imdevimab includes infusion and post administration monitoring in the home or residence.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocolld drg <=16 w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6234","description":"Hydrocolld drg <=16 w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB25D","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCE1","description":"ICD-FCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWB0","description":"ICD-LDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABB1","description":"ICD-MABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHF1","description":"ICD-IBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWE1","description":"ICD-GCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45112","description":"Removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC134","description":"Special Care Low _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrst x-ray uppr gi tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74247","description":"Contrst x-ray uppr gi tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab_ 10 mg and hyaluronidase-oysk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9356","description":"Injection_ trastuzumab_ 10 mg and hyaluronidase-oysk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01931","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01931","description":"CPT-01931","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00862","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00862","description":"CPT-00862","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCB0","description":"ICD-OGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fol","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA60","description":"Very High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Theraskin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4121","description":"Theraskin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vein byp fem-tibial peroneal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35585","description":"Vein byp fem-tibial peroneal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD11C","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reposition gastrostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43761","description":"Reposition gastrostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOD0","description":"ICD-OBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8I","description":"Medium Rehab _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINF1","description":"ICD-OINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJC0","description":"ICD-OJJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cmprsburngarment glove-wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6504","description":"Cmprsburngarment glove-wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSD1","description":"ICD-CBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRC1","description":"ICD-GCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGE0","description":"ICD-JEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSD0","description":"ICD-KHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"RegeneLink Amniotic Membrane Allograft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4315","description":"RegeneLink Amniotic Membrane Allograft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Protect body sock ea pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0984","description":"Protect body sock ea pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ CROS_ behind the ear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5180","description":"Hearing aid_ CROS_ behind the ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.00d/2.1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2204","description":"Lens sphcy bifocal 4.00d/2.1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFD0","description":"ICD-CBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection for elbow x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24220","description":"Injection for elbow x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC20D","description":"Special Care High _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB15C","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGE0","description":"ICD-GGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Micro w exam of surg margins","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0474","description":"Micro w exam of surg margins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOF1","description":"ICD-GBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJA1","description":"ICD-BCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onco (ovar) two proteins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81500","description":"Onco (ovar) two proteins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOD1","description":"ICD-DCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC256","description":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bpci home visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9187","description":"Bpci home visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm 5.1-7.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12053","description":"Intmd rpr face/mm 5.1-7.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUB1","description":"ICD-NGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0949T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","description":"CPT-0949T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSD1","description":"ICD-KGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAF1","description":"ICD-CCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQD1","description":"ICD-DBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANA1","description":"ICD-CANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise spine eltrd plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63664","description":"Revise spine eltrd plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPE1","description":"ICD-FHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Umbilical cord occlud w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59072","description":"Umbilical cord occlud w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWB1","description":"ICD-CHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous arteriovenous fistula creation (AVF)_ direct_ any site_ using magnetic-guided arterial and venous catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2171","description":"Percutaneous arteriovenous fistula creation (AVF)_ direct_ any site_ using magnetic-guided arterial and venous catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMC1","description":"ICD-CAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8A","description":"Medium Rehab _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWC1","description":"ICD-LAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQE1","description":"ICD-PEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITD1","description":"ICD-AITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc prostate prob score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0010M","description":"Onc prostate prob score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB23","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resin one surface-anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2330","description":"Resin one surface-anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant ventricular device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33976","description":"Implant ventricular device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATD0","description":"ICD-JATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDE0","description":"ICD-IEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE235","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilate ic vasospasm init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61640","description":"Dilate ic vasospasm init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"End of life counseling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0257","description":"End of life counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2374","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2374","description":"HCPCS-J2374","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0503T","description":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVB0","description":"ICD-NJVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj olanzapine 2.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0166","description":"Inj olanzapine 2.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEC1","description":"ICD-MAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation therapy management","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77499","description":"Radiation therapy management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3HB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HB11","description":"ICD-3HB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj codeine phosphate /30 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0745","description":"Inj codeine phosphate /30 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNC1","description":"ICD-NHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Afo sing bar clasp attach sh","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1910","description":"Afo sing bar clasp attach sh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUA1","description":"ICD-GHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDF1","description":"ICD-AGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infrared heating pad system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0221","description":"Infrared heating pad system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQB0","description":"ICD-OEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69745","description":"Repair facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq art m-thrombect &/nfs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61645","description":"Perq art m-thrombect &/nfs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18E","description":"Special Care Low _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA124","description":"Clinically Complex _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNB1","description":"ICD-OKNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of rib(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32900","description":"Removal of rib(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove bladder stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52317","description":"Remove bladder stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBA0","description":"ICD-AFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUD0","description":"ICD-ECUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ alfentanil hydrochloride_ 500 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0216","description":"Injection_ alfentanil hydrochloride_ 500 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNF0","description":"ICD-BDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAED1","description":"ICD-CAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of adrenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86651","description":"Anesth removal of adrenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMA1","description":"ICD-NBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAD1","description":"ICD-ABAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVC1","description":"ICD-NFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prim art m-thrmbc 1st vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37184","description":"Prim art m-thrmbc 1st vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter therapy_ infusion_ any method (eg_ thrombolysis other than coronary)_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75896","description":"Transcatheter therapy_ infusion_ any method (eg_ thrombolysis other than coronary)_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tobramycin sulfate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3260","description":"Tobramycin sulfate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIA0","description":"ICD-KEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJB0","description":"ICD-NJJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Observ/hosp same date","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99235","description":"Observ/hosp same date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEC0","description":"ICD-OCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHE0","description":"ICD-EIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB20C","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N block inj lumbar plexus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64449","description":"N block inj lumbar plexus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMD1","description":"ICD-ECMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion 1.1-2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11312","description":"Shave skin lesion 1.1-2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAA1","description":"ICD-KEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHID0","description":"ICD-FHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGD1","description":"ICD-GGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0971T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","description":"CPT-0971T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQE0","description":"ICD-OCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEE0","description":"ICD-NIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE116","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21261","description":"Revise eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Syphilis test non-trep quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86593","description":"Syphilis test non-trep quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diab manage trn per indiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0108","description":"Diab manage trn per indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI abdomen w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74183","description":"MRI abdomen w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRE0","description":"ICD-LFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 3 xhd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0854","description":"Pwc gp 3 xhd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kidney function study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78725","description":"Kidney function study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24147","description":"Partial removal of elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vim_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4251","description":"Vim_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrde addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61864","description":"Implant neuroelectrde addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOF1","description":"ICD-GHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUE0","description":"ICD-JEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENC1","description":"ICD-FENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC20A","description":"Special Care High _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJA0","description":"ICD-JHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUC0","description":"ICD-JDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls initiation venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33946","description":"Ecmo/ecls initiation venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1JC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JC11","description":"ICD-1JC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIE0","description":"ICD-MHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove sympathetic nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64822","description":"Remove sympathetic nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0163","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","description":"HCPCS-J0163","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50240","description":"Partial removal of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4649","description":"Surgical supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst w/uro repair compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58293","description":"Vag hyst w/uro repair compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4BB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BB11","description":"ICD-4BB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8X","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suction lipectomy trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15877","description":"Suction lipectomy trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Otolaryngology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4022","description":"Otolaryngology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGA1","description":"ICD-FCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRD0","description":"ICD-DGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNE1","description":"ICD-BGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGF1","description":"ICD-OCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUA1","description":"ICD-OHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac rehab/monitor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93798","description":"Cardiac rehab/monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1801","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1801","description":"HCPCS-A1801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEC0","description":"ICD-KAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bordetella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86615","description":"Bordetella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Soft interface material","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1820","description":"Soft interface material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLD0","description":"ICD-MJLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of pulmonary valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33474","description":"Revision of pulmonary valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0659U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0659U","description":"CPT-0659U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trabectedin_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9352","description":"Injection_ trabectedin_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA05","description":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ prothrombin complex concentrate_ human-lans_ per i.u. of factor ix activity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7165","description":"Injection_ prothrombin complex concentrate_ human-lans_ per i.u. of factor ix activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transition service coordination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7337","description":"Transition service coordination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brake for wheeled walker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0159","description":"Brake for wheeled walker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pvb thoracic 2nd+ inj site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64462","description":"Pvb thoracic 2nd+ inj site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ lower leg and foot_ padded_ for nighttime use_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6525","description":"Gradient compression garment_ lower leg and foot_ padded_ for nighttime use_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB11B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic appliance half leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0666","description":"Pneumatic appliance half leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOF0","description":"ICD-DIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0559U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","description":"CPT-0559U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNC1","description":"ICD-GGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVE1","description":"ICD-NEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for blood smear_ peripheral_ interpretation by physician with written report (List separately in addition to code for primary procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0854T","description":"Digitization of glass microscope slides for blood smear_ peripheral_ interpretation by physician with written report (List separately in addition to code for primary procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQF0","description":"ICD-CHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3HA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HA21","description":"ICD-3HA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDF1","description":"ICD-MJDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTF1","description":"ICD-FGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOF1","description":"ICD-GGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMC1","description":"ICD-BEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1313","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTC0","description":"ICD-CCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2038","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","description":"HCPCS-A2038","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEE1","description":"ICD-FCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGA1","description":"ICD-CAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWB0","description":"ICD-PHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAF1","description":"ICD-EGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHB1","description":"ICD-GAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVE1","description":"ICD-FGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hook/hand_ hvy dty_ vol open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6721","description":"Hook/hand_ hvy dty_ vol open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28B","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92634","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","description":"CPT-92634","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJC1","description":"ICD-BIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDC0","description":"ICD-CEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRF0","description":"ICD-GDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFF1","description":"ICD-BBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKF0","description":"ICD-OFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv 1 extrem 5/> mus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64644","description":"Chemodenerv 1 extrem 5/> mus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUF1","description":"ICD-BHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTD0","description":"ICD-IDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Osteopath manj 9-10 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98929","description":"Osteopath manj 9-10 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWD0","description":"ICD-LHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagomyotomy abdominal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43330","description":"Esophagomyotomy abdominal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNC1","description":"ICD-KCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBE0","description":"ICD-AHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJE0","description":"ICD-JCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rbc antibody elution","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86860","description":"Rbc antibody elution","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRD0","description":"ICD-DIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ald unspecified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5274","description":"Ald unspecified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLF0","description":"ICD-EDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Indiv pdc > 0.8","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9512","description":"Indiv pdc > 0.8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Financial Management Services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7341","description":"Financial Management Services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Angiotensin Converting Enzyme (Ace) Inhibitor Or Angiotensin Receptor Blocker (Arb) Or Angiotensin Receptor-Neprilysin Inhibitor (Arni) Therapy Was Not Prescribed_ Reason Not","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2096","description":"Angiotensin Converting Enzyme (Ace) Inhibitor Or Angiotensin Receptor Blocker (Arb) Or Angiotensin Receptor-Neprilysin Inhibitor (Arni) Therapy Was Not Prescribed_ Reason Not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exoskel hip ultra-light mate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5795","description":"Exoskel hip ultra-light mate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone imaging (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78320","description":"Bone imaging (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (lung)_ multi-omics (microbial DNA by shotgun next-generation sequencing and carcinoembryonic antigen and osteopontin by immunoassay)_ plasma_ algorithm reported as m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0395U","description":"Oncology (lung)_ multi-omics (microbial DNA by shotgun next-generation sequencing and carcinoembryonic antigen and osteopontin by immunoassay)_ plasma_ algorithm reported as m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIF1","description":"ICD-JEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Promethazine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2550","description":"Promethazine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bed accessory brd/tbl/supprt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0315","description":"Bed accessory brd/tbl/supprt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBC0","description":"ICD-MCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXC1","description":"ICD-CIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWD1","description":"ICD-KBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00190","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00190","description":"CPT-00190","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enter infusion pump w/o alrm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9000","description":"Enter infusion pump w/o alrm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFE1","description":"ICD-OAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Qualified Healthcare Professional Assessment Service_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 21 Or More Mi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2063","description":"Qualified Nonphysician Qualified Healthcare Professional Assessment Service_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 21 Or More Mi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit anti-hemophil diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9345","description":"Hit anti-hemophil diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ear protector evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92596","description":"Ear protector evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE212","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise additional leg tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27692","description":"Revise additional leg tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1602","description":"HCPCS-B1602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69552","description":"Remove ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD110","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFF1","description":"ICD-FIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4424","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","description":"HCPCS-Q4424","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUB1","description":"ICD-OEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYB0","description":"ICD-DGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYE0","description":"ICD-OKYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8010","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8010","description":"HCPCS-C8010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9011","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","description":"HCPCS-J9011","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg 2.1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11643","description":"Exc f/e/e/n/l mal+mrg 2.1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Arm trough each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2209","description":"Arm trough each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21089","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNB0","description":"ICD-OBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat pelvic ring fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27194","description":"Treat pelvic ring fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy or excision of lymph node(s); open_ inguinofemoral node(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38531","description":"Biopsy or excision of lymph node(s); open_ inguinofemoral node(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 2ND DOSE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0002A","description":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 2ND DOSE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXD0","description":"ICD-OCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYB1","description":"ICD-LFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28C","description":"Clinically Complex _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray bile/panc endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74330","description":"X-ray bile/panc endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB13D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC23","description":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSC1","description":"ICD-PCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX3D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJB0","description":"ICD-NEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA23C","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","description":"HCPCS-J2002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPF0","description":"ICD-NIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCD1","description":"ICD-NGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBA0","description":"ICD-JBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUA0","description":"ICD-ECUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXD0","description":"ICD-KBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADC1","description":"ICD-OADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEF0","description":"ICD-OKEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAC1","description":"ICD-NAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMF1","description":"ICD-AAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIC0","description":"ICD-EHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bx breast add lesion mr imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19086","description":"Bx breast add lesion mr imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFB0","description":"ICD-BEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy/biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44361","description":"Small bowel endoscopy/biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSE0","description":"ICD-LHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19369","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA13B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay nephelometry not spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83883","description":"Assay nephelometry not spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDC0","description":"ICD-NKDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Viral culture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0416","description":"Viral culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNC0","description":"ICD-FGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAB1","description":"ICD-GCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAA1","description":"ICD-KDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Administration of home sleep apnea test","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9956","description":"Administration of home sleep apnea test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEB1","description":"ICD-MIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ hip_ unilateral; complete_ minimum of two views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73510","description":"Radiologic examination_ hip_ unilateral; complete_ minimum of two views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAE1","description":"ICD-AIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDA0","description":"ICD-BIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDA1","description":"ICD-IGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine lamina 1 lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63047","description":"Remove spine lamina 1 lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLC1","description":"ICD-CCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKA1","description":"ICD-OIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder universal joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6650","description":"Shoulder universal joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQB0","description":"ICD-KIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEF1","description":"ICD-KIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSC1","description":"ICD-HDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHC1","description":"ICD-OCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of knee cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27345","description":"Removal of knee cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC235","description":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOA0","description":"ICD-OHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB225","description":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPB0","description":"ICD-BEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ldl-c 100-129 mg/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3049F","description":"Ldl-c 100-129 mg/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYE1","description":"ICD-KGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lang express d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9164","description":"Lang express d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Solid caster integrated whl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2222","description":"Solid caster integrated whl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPB0","description":"ICD-GAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYE0","description":"ICD-GCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX22","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrst x-ray urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74410","description":"Contrst x-ray urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Medication Not Otherwise Specified; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group The","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2075","description":"Medication Assisted Treatment_ Medication Not Otherwise Specified; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group The","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJD1","description":"ICD-NKJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALA1","description":"ICD-BALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD160","description":"Clinically Complex _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score knee >= 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8647","description":"Fun stat score knee >= 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eval self-assess depression","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3005","description":"Eval self-assess depression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19350","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKF0","description":"ICD-CHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown-indirect resin based","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6710","description":"Crown-indirect resin based","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0633U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0633U","description":"CPT-0633U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJE1","description":"ICD-JAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEE0","description":"ICD-FCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pap oral interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7044","description":"Pap oral interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC31","description":"High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chest x-ray frnt lat lordotc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71021","description":"Chest x-ray frnt lat lordotc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fluzone vacc_ 3 yrs & >_ im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2038","description":"Fluzone vacc_ 3 yrs & >_ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDC1","description":"ICD-NDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression arm sleeve_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6578","description":"Gradient compression arm sleeve_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pathogen reduced plasma sing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9071","description":"Pathogen reduced plasma sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx orbit w/manipulj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21401","description":"Closed tx orbit w/manipulj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOB1","description":"ICD-PIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB33","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bis xtracell fluid analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93702","description":"Bis xtracell fluid analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLD1","description":"ICD-MHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJB1","description":"ICD-CCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBED0","description":"ICD-JBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prim art m-thrmbc sbsq vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37185","description":"Prim art m-thrmbc sbsq vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB14D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Consult slides prep elsewher","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0484","description":"Consult slides prep elsewher","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMA1","description":"ICD-MEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFE0","description":"ICD-FDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bortezomib (MAIA)_ not therapeutically equivalent to J9041_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9051","description":"Injection_ bortezomib (MAIA)_ not therapeutically equivalent to J9041_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"SARSCOV2 VACCINE BIVALENT 10 MCG/0.2 ML IM USE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91315","description":"SARSCOV2 VACCINE BIVALENT 10 MCG/0.2 ML IM USE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plasma protein fract_5%_50ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9043","description":"Plasma protein fract_5%_50ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69955","description":"Release facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD244","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRC0","description":"ICD-GHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKD1","description":"ICD-OFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0957T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","description":"CPT-0957T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENF1","description":"ICD-OENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC121","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esano ac_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4274","description":"Esano ac_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Imm counseling by a physician or other qualified health care prof for COVID-19_ ages under 21_ 16-30 minutes time (This code is used for the Medicaid EPSDT)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0314","description":"Imm counseling by a physician or other qualified health care prof for COVID-19_ ages under 21_ 16-30 minutes time (This code is used for the Medicaid EPSDT)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCC1","description":"ICD-IGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rerepair ing hernia blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49521","description":"Rerepair ing hernia blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBD0","description":"ICD-MGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKE0","description":"ICD-GFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of urethra injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53502","description":"Repair of urethra injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Culture anaerobe ident each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87076","description":"Culture anaerobe ident each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shldr disartic myoelectronic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6965","description":"Shldr disartic myoelectronic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ven thrombosis images bilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78458","description":"Ven thrombosis images bilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx orbit fx combined","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21387","description":"Opn tx orbit fx combined","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCE0","description":"ICD-BHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vascular flow imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78445","description":"Vascular flow imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ amplified probe techniq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87635","description":"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ amplified probe techniq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITA0","description":"ICD-AITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bcr/abl1 gene major bp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81206","description":"Bcr/abl1 gene major bp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEB1","description":"ICD-OBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology gynecologic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81535","description":"Oncology gynecologic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHD0","description":"ICD-NIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBD1","description":"ICD-IDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKE1","description":"ICD-NEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBME1","description":"ICD-OBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove electrode/thoracotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33236","description":"Remove electrode/thoracotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIA0","description":"ICD-BEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEC0","description":"ICD-CAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat uterus infection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59830","description":"Treat uterus infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place stereo cath brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0169T","description":"Place stereo cath brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHA0","description":"ICD-AFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bile duct revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47701","description":"Bile duct revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD125","description":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIA1","description":"ICD-OKIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFA0","description":"ICD-JIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB41","description":"Medium Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBF0","description":"ICD-EGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEE0","description":"ICD-OGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUF1","description":"ICD-CHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Detect agent nos dna dir","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87797","description":"Detect agent nos dna dir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNE1","description":"ICD-CHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPA1","description":"ICD-KHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHC1","description":"ICD-IBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic myomectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58545","description":"Laparoscopic myomectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXE0","description":"ICD-CHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMA0","description":"ICD-NDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Punch biopsy of skin (including simple closure_ when performed); each separate/additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11105","description":"Punch biopsy of skin (including simple closure_ when performed); each separate/additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cemiplimab-rwlc_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9119","description":"Injection_ cemiplimab-rwlc_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJE1","description":"ICD-NFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAID1","description":"ICD-BAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIC0","description":"ICD-GDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGB0","description":"ICD-KEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJB1","description":"ICD-GGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Afo molded to patient plasti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1940","description":"Afo molded to patient plasti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAF1","description":"ICD-KAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELF0","description":"ICD-IELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Initial custom socket insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5683","description":"Initial custom socket insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA206","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEB1","description":"ICD-KDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foot joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28070","description":"Removal of foot joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; capable of being read by direct optical observation only (eg_ utilizing immunoassay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80305","description":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; capable of being read by direct optical observation only (eg_ utilizing immunoassay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQA0","description":"ICD-KDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQF1","description":"ICD-GEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFF0","description":"ICD-JCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBA1","description":"ICD-ODBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Procedure-Related Bp_S Not Taken During An Outpatient Visit. Examples Include Same Day Surgery_ Ambulatory Service Center_ G.I. Lab_ Dialysis_ Infusion Center_ Chemotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2129","description":"Procedure-Related Bp_S Not Taken During An Outpatient Visit. Examples Include Same Day Surgery_ Ambulatory Service Center_ G.I. Lab_ Dialysis_ Infusion Center_ Chemotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUB0","description":"ICD-CHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transabdom amnioinfus w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59070","description":"Transabdom amnioinfus w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Swallow d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8998","description":"Swallow d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGE1","description":"ICD-CCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls initiation artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33947","description":"Ecmo/ecls initiation artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Phleb veins - extrem 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37766","description":"Phleb veins - extrem 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4BA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BA21","description":"ICD-4BA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB25B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPE1","description":"ICD-CIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDF1","description":"ICD-OBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEB0","description":"ICD-IEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIE1","description":"ICD-GHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPC0","description":"ICD-JBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB101","description":"Clinically Complex _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUB1","description":"ICD-MLUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment by protocol_ administered by technician_ face-to-face with one patient; each additional 30 minutes of technician time (List separately in addition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0365T","description":"Adaptive behavior treatment by protocol_ administered by technician_ face-to-face with one patient; each additional 30 minutes of technician time (List separately in addition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fuse gallbladder & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47720","description":"Fuse gallbladder & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure_ including separate incision(s) and closure_ when performed; each additional 30 minutes (List separa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96548","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure_ including separate incision(s) and closure_ when performed; each additional 30 minutes (List separa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOC1","description":"ICD-LCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair rectum & vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57250","description":"Repair rectum & vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55815","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEA1","description":"ICD-EAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPB1","description":"ICD-NIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL02","description":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of fibula fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27780","description":"Treatment of fibula fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of diaphragm hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39503","description":"Repair of diaphragm hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHB1","description":"ICD-NHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC44","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUB1","description":"ICD-OHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGD0","description":"ICD-JFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDB1","description":"ICD-NKDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC145","description":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMA0","description":"ICD-GBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28H","description":"Clinically Complex _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Corf skilled nursing service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0128","description":"Corf skilled nursing service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (central nervous system)_ analysis of 30000 DNA methylation loci by methylation array_ utilizing DNA extracted from tumor tissue_ diagnostic algorithm reported as pro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0020M","description":"Oncology (central nervous system)_ analysis of 30000 DNA methylation loci by methylation array_ utilizing DNA extracted from tumor tissue_ diagnostic algorithm reported as pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal_ Osseointegrated Implant_ Skull; With Percutaneous Attachment To External Speech Processor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69726","description":"Removal_ Osseointegrated Implant_ Skull; With Percutaneous Attachment To External Speech Processor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYC0","description":"ICD-OIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQF1","description":"ICD-LDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWB1","description":"ICD-HBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAF1","description":"ICD-JFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chlmyd/gonrh tsts docd done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3511F","description":"Chlmyd/gonrh tsts docd done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOF0","description":"ICD-HBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: occipital headache in children","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2195","description":"Patients with clinical indications for imaging of the head: occipital headache in children","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93018","description":"Cardiovascular stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJD1","description":"ICD-BEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of large bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44025","description":"Incision of large bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKD1","description":"ICD-GDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ acute myelogenous leukemia_ DNA analysis_ 194 genes_ interrogation for sequence variants_ copy number variants or rearrangements","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0050U","description":"Targeted genomic sequence analysis panel_ acute myelogenous leukemia_ DNA analysis_ 194 genes_ interrogation for sequence variants_ copy number variants or rearrangements","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYA0","description":"ICD-DHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRD0","description":"ICD-HDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPE0","description":"ICD-KBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9738","description":"Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE206","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHC0","description":"ICD-OHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAD0","description":"ICD-NFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEB1","description":"ICD-MFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLA1","description":"ICD-BCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAA1","description":"ICD-ODAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTA0","description":"ICD-BCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGA0","description":"ICD-NLGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8X","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUD1","description":"ICD-NGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ nadofaragene firadenovec-vncg_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9029","description":"Injection_ nadofaragene firadenovec-vncg_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPF1","description":"ICD-KDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVE1","description":"ICD-CBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sewhfo cap design w/o jnt cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3975","description":"Sewhfo cap design w/o jnt cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBE1","description":"ICD-NFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYA0","description":"ICD-LIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEA0","description":"ICD-CEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove wrist joint cartilage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25107","description":"Remove wrist joint cartilage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXD0","description":"ICD-NKXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC11C","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Serum clotting time tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4771","description":"Serum clotting time tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYE1","description":"ICD-HGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA210","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPC0","description":"ICD-KCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cutting ramus open w/graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7943","description":"Cutting ramus open w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIF0","description":"ICD-JGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITF0","description":"ICD-FITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMB1","description":"ICD-FFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA5D","description":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2IC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IC21","description":"ICD-2IC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX3A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGD1","description":"ICD-GDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Musculoskeletal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20999","description":"Musculoskeletal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDA0","description":"ICD-CBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTD1","description":"ICD-CHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBD0","description":"ICD-ABBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ with endoluminal imaging of initial coronar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7516","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ with endoluminal imaging of initial coronar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Minocycline hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2265","description":"Minocycline hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUE1","description":"ICD-GIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE10D","description":"Special Care High _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0684U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684U","description":"CPT-0684U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQD1","description":"ICD-CDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMA1","description":"ICD-MBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"PelloGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4320","description":"PelloGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB141","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX3D","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age Or Older And Had At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of A","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2126","description":"Patients 66 Years Of Age Or Older And Had At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert multi-comp penis pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54405","description":"Insert multi-comp penis pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No prol intub req","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8570","description":"No prol intub req","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00560","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00560","description":"CPT-00560","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWD1","description":"ICD-LEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nursing fac care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99380","description":"Nursing fac care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Offset knee joint each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2390","description":"Offset knee joint each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFED0","description":"ICD-JFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMF1","description":"ICD-KCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLE0","description":"ICD-EFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEF0","description":"ICD-EDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMD0","description":"ICD-BGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp spenorenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35636","description":"Art byp spenorenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11450","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Odontics repr abutment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6095","description":"Odontics repr abutment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lso sag ctr rigi pos pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0643","description":"Lso sag ctr rigi pos pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPD0","description":"ICD-KAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQF0","description":"ICD-KFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Administration of respiratory syncytial virus_ monoclonal antibody_ seasonal dose by intramuscular injection_ with counseling by physician or other qualified health care profe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96380","description":"Administration of respiratory syncytial virus_ monoclonal antibody_ seasonal dose by intramuscular injection_ with counseling by physician or other qualified health care profe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNC0","description":"ICD-OJNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low pecarn ped head trauma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9593","description":"Low pecarn ped head trauma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHE0","description":"ICD-NIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cyclophosphamide 100 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9070","description":"Cyclophosphamide 100 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFF1","description":"ICD-GHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCB0","description":"ICD-KHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytomegalovirus dfa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87271","description":"Cytomegalovirus dfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HC21","description":"ICD-4HC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWA1","description":"ICD-PBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKB1","description":"ICD-KEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull/brain surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61735","description":"Incise skull/brain surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 6 genotyping (HPA-6w)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa_ antigen CD61] [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ po","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81110","description":"Human Platelet Antigen 6 genotyping (HPA-6w)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa_ antigen CD61] [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ po","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITE0","description":"ICD-GITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEE0","description":"ICD-KGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKF0","description":"ICD-OEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE230","description":"Reduced Physical Function _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEA0","description":"ICD-KEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMB0","description":"ICD-AHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spine fusion extra segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22632","description":"Spine fusion extra segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcath stent cca w/o eps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37216","description":"Transcath stent cca w/o eps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUE0","description":"ICD-NAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Serial salivary imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78231","description":"Serial salivary imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/maint cont hemo equip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4890","description":"Repair/maint cont hemo equip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDE0","description":"ICD-MHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay infectious agent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86317","description":"Immunoassay infectious agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXC0","description":"ICD-CEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neurofilament light chain (NfL)_ ultra-sensitive immunoassay_ serum or cerebrospinal fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0443U","description":"Neurofilament light chain (NfL)_ ultra-sensitive immunoassay_ serum or cerebrospinal fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test_ or patient has a reactive hcv antibody test and has a follow up hcv viral test that dete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1230","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test_ or patient has a reactive hcv antibody test and has a follow up hcv viral test that dete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inirs each vessel add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0205T","description":"Inirs each vessel add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYC1","description":"ICD-DEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIF0","description":"ICD-OEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE106","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPD0","description":"ICD-OFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41850","description":"Treatment of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50340","description":"Removal of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dexamethasone_ lacrimal opthalamic insert_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9048","description":"Dexamethasone_ lacrimal opthalamic insert_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1100T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1100T","description":"CPT-1100T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDF1","description":"ICD-MKDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lngleg cylndr ped f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4036","description":"Cast sup lngleg cylndr ped f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pemetrexed injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9305","description":"Pemetrexed injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Delay flap trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15600","description":"Delay flap trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL30","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEA1","description":"ICD-KIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBC0","description":"ICD-NIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ans parasymp & symp w/tilt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95924","description":"Ans parasymp & symp w/tilt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGB1","description":"ICD-FFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ hemodialysis_long-term","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1750","description":"Cath_ hemodialysis_long-term","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place rt device/marker pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55876","description":"Place rt device/marker pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACF0","description":"ICD-GACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILA1","description":"ICD-JILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous injection of calcium-based biodegradable osteoconductive material_ proximal femur_ including imaging guidance_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0814T","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material_ proximal femur_ including imaging guidance_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMA1","description":"ICD-GIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVD0","description":"ICD-KAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD213","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLB0","description":"ICD-OLLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"At least two orders for the same high-risk medication","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9637","description":"At least two orders for the same high-risk medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA155","description":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMB0","description":"ICD-JBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARA0","description":"ICD-KARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA3A","description":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUB0","description":"ICD-CCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation of heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33945","description":"Transplantation of heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX5C","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERC1","description":"ICD-PERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of beta-2 protein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82232","description":"Assay of beta-2 protein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"teledentistry synchronous real time encounter","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9995","description":"teledentistry synchronous real time encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression arm sleeve and glove combination_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6575","description":"Gradient compression arm sleeve and glove combination_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBF1","description":"ICD-GCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1075T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1075T","description":"CPT-1075T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit cath care noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5497","description":"Hit cath care noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Itch severity assessment score is reduced by 2 or more points from the initial (index) assessment score to the follow-up visit score","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1197","description":"Itch severity assessment score is reduced by 2 or more points from the initial (index) assessment score to the follow-up visit score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA12D","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx isodose intermed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77317","description":"Brachytx isodose intermed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGC0","description":"ICD-KCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0561U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","description":"CPT-0561U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bcg vaccine intravesical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90586","description":"Bcg vaccine intravesical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYA0","description":"ICD-HCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIB1","description":"ICD-IAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAME1","description":"ICD-CAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lodging costs (e.g. hotel ch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9994","description":"Lodging costs (e.g. hotel ch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Borrelia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86619","description":"Borrelia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDC1","description":"ICD-CIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSD1","description":"ICD-PDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9898","description":"Patient age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHA1","description":"ICD-FDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36561","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gtt-added samples","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82952","description":"Gtt-added samples","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Levamisole 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0177","description":"Levamisole 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Induced abortion 29-31 wks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2266","description":"Induced abortion 29-31 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65093","description":"Revise eye with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/cont_ lwr ext","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8912","description":"Mra w/cont_ lwr ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter tricuspid valve implantation/replacement (TTVI) with prosthetic valve_ percutaneous approach_ including right heart catheterization_ temporary pacemaker insertio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0646T","description":"Transcatheter tricuspid valve implantation/replacement (TTVI) with prosthetic valve_ percutaneous approach_ including right heart catheterization_ temporary pacemaker insertio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEE1","description":"ICD-MEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of spine 1 view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72020","description":"X-ray exam of spine 1 view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt not disch to home day#7","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8825","description":"Pt not disch to home day#7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat craniofacial fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21432","description":"Treat craniofacial fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast)_ mRNA_ microarray gene expression profiling of 70 content genes and 465 housekeeping genes_ utilizing fresh frozen or formalin-fixed paraffin-embedded tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81521","description":"Oncology (breast)_ mRNA_ microarray gene expression profiling of 70 content genes and 465 housekeeping genes_ utilizing fresh frozen or formalin-fixed paraffin-embedded tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMB0","description":"ICD-BAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUF0","description":"ICD-OHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFC0","description":"ICD-CBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Xray place prox ext thor ao","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75958","description":"Xray place prox ext thor ao","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intestine transplnt cadaver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44135","description":"Intestine transplnt cadaver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug delivery system <=50 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4306","description":"Drug delivery system <=50 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25635","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Deferoxamine mesylate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0895","description":"Deferoxamine mesylate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBB1","description":"ICD-KBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNB1","description":"ICD-NHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNB1","description":"ICD-JGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"In-line cartridge containing digestive enzyme(s) for enteral feeding_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9994","description":"In-line cartridge containing digestive enzyme(s) for enteral feeding_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Commissure splint","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5987","description":"Commissure splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Solid seat support base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2231","description":"Solid seat support base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXD1","description":"ICD-CCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen one/mult class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80304","description":"Drug screen one/mult class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAE0","description":"ICD-CFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doxepin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6034","description":"Doxepin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduction of facial bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21209","description":"Reduction of facial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28B","description":"Special Care High _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sys bp less 140","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8752","description":"Sys bp less 140","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFF1","description":"ICD-CDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOE0","description":"ICD-CAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPE1","description":"ICD-ODPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC230","description":"Clinically Complex _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ncntc r-t fluor wnd img ea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0599T","description":"Ncntc r-t fluor wnd img ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYC0","description":"ICD-CGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Filtered speech hearing test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92571","description":"Filtered speech hearing test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETE1","description":"ICD-KETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE10B","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61521","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vabra aspirator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4480","description":"Vabra aspirator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSF1","description":"ICD-KFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMB1","description":"ICD-EBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMC0","description":"ICD-NIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMF0","description":"ICD-IAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJF1","description":"ICD-GHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj ferric pyrophosphate cit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1443","description":"Inj ferric pyrophosphate cit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ full leg and foot_ padded_ for nighttime use_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6526","description":"Gradient compression garment_ full leg and foot_ padded_ for nighttime use_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLID1","description":"ICD-NLID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEE1","description":"ICD-MFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of infusion pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36260","description":"Insertion of infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acesso dl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4293","description":"Acesso dl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Healthcare Professional Online Assessment Service_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 11-20 Minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2062","description":"Qualified Nonphysician Healthcare Professional Online Assessment Service_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 11-20 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Solid caster tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2391","description":"Solid caster tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNA1","description":"ICD-BCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDE0","description":"ICD-KHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA5A","description":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBC0","description":"ICD-AEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWD1","description":"ICD-LAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ glove_ padded_ for nighttime use_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6520","description":"Gradient compression garment_ glove_ padded_ for nighttime use_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSA1","description":"ICD-GHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSD1","description":"ICD-HCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXC0","description":"ICD-KBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open iliac artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by abdominal or retroperitoneal inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34833","description":"Open iliac artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by abdominal or retroperitoneal inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCA0","description":"ICD-NFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHF1","description":"ICD-IHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIA0","description":"ICD-IIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ocular reconst transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65780","description":"Ocular reconst transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCC1","description":"ICD-FGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXE1","description":"ICD-NFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIE0","description":"ICD-KHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputate leg at thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27591","description":"Amputate leg at thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37282","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","description":"CPT-37282","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ef ped hydrolyzed/amino acid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4161","description":"Ef ped hydrolyzed/amino acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUA0","description":"ICD-FIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFC0","description":"ICD-BEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWB1","description":"ICD-DAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPF1","description":"ICD-JBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLA0","description":"ICD-MHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEB0","description":"ICD-MAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise wrist tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25118","description":"Excise wrist tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx sclc/nsclc limited","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9068","description":"Onc dx sclc/nsclc limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVF0","description":"ICD-JCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJB0","description":"ICD-BBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0581U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","description":"CPT-0581U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIA1","description":"ICD-FEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMD1","description":"ICD-EGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE215","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL5C","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Control throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42962","description":"Control throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISC1","description":"ICD-HISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQE0","description":"ICD-OKQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES30A","description":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove aorta constriction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33851","description":"Remove aorta constriction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDC1","description":"ICD-AGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEC0","description":"ICD-OIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXB0","description":"ICD-NFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTA1","description":"ICD-KGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plastic surgery neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15819","description":"Plastic surgery neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJC1","description":"ICD-OEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKE1","description":"ICD-OGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43107","description":"Removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGA0","description":"ICD-FBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90851","description":"Anesth removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWC1","description":"ICD-DCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLA0","description":"ICD-NGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIF1","description":"ICD-GAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Below knee sus/seal sleeve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5685","description":"Below knee sus/seal sleeve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALB1","description":"ICD-AALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N block inj hypogas plxs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64517","description":"N block inj hypogas plxs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gel cap app device for trach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8515","description":"Gel cap app device for trach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin fluid swg & stance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5728","description":"Knee-shin fluid swg & stance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIA1","description":"ICD-OIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACB1","description":"ICD-NACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCB1","description":"ICD-EGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLD1","description":"ICD-ICLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation with","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7558","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation with","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC20B","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEA1","description":"ICD-OEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GA31","description":"ICD-3GA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31635","description":"Bronchoscopy w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDD1","description":"ICD-FEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mdd severe w/psych","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3091F","description":"Mdd severe w/psych","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Penis study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54240","description":"Penis study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTE0","description":"ICD-MBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOD1","description":"ICD-CIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIB1","description":"ICD-AHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rigid ped w/c tilt-in-space","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1231","description":"Rigid ped w/c tilt-in-space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIE1","description":"ICD-OJIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDE0","description":"ICD-NKDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSD1","description":"ICD-OGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWE1","description":"ICD-LAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMF0","description":"ICD-JFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCND0","description":"ICD-CCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFA0","description":"ICD-CHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDB1","description":"ICD-MIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Manual standing system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2230","description":"Manual standing system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUD0","description":"ICD-BGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incis addl spine segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22216","description":"Incis addl spine segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELF0","description":"ICD-NELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCD1","description":"ICD-BGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE21C","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26455","description":"Incision of finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBC1","description":"ICD-EBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC11C","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28261","description":"Revision of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAC0","description":"ICD-KFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMF0","description":"ICD-GGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRB1","description":"ICD-HGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXC1","description":"ICD-GEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHA1","description":"ICD-GGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11446","description":"Exc face-mm b9+marg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ntrk3 (Neurotrophic Receptor Tyrosine Kinase 3) (Eg_ Solid Tumors) Translocation Analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81193","description":"Ntrk3 (Neurotrophic Receptor Tyrosine Kinase 3) (Eg_ Solid Tumors) Translocation Analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fuse liver ducts & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47765","description":"Fuse liver ducts & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFA1","description":"ICD-JBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEC0","description":"ICD-NJEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAA0","description":"ICD-EEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcvng ace/arb b-blockertx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4480F","description":"Pt rcvng ace/arb b-blockertx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXD1","description":"ICD-FEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBB0","description":"ICD-KHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA RESPIRATORY SYNCTIAL VIRUS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87420","description":"IAAD IA RESPIRATORY SYNCTIAL VIRUS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOE1","description":"ICD-DEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unclassified biologics","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3590","description":"Unclassified biologics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening buprenorphine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80348","description":"Drug screening buprenorphine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rerepair fem hernia blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49557","description":"Rerepair fem hernia blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKB0","description":"ICD-CFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECME1","description":"ICD-ECME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Preparation palate mold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42280","description":"Preparation palate mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67430","description":"Explore/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove part of neck vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22110","description":"Remove part of neck vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9306","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9306","description":"HCPCS-C9306","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst t/o & repair compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58292","description":"Vag hyst t/o & repair compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Instillation_ taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0911","description":"Instillation_ taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinolytic plasmin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85400","description":"Fibrinolytic plasmin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXB0","description":"ICD-OCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"External receiver_ cgm sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9278","description":"External receiver_ cgm sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDD0","description":"ICD-MCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Should sling/vest/abrestrain","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4566","description":"Should sling/vest/abrestrain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Human Health Factor 10 Amniotic Patch (HHF10-P)_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4224","description":"Human Health Factor 10 Amniotic Patch (HHF10-P)_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nephrology (chronic kidney disease)_ carboxymethyllysine_ methylglyoxal hydroimidazolone_ and carboxyethyl lysine by liquid chromatography with tandem mass spectrometry (LC-MS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0384U","description":"Nephrology (chronic kidney disease)_ carboxymethyllysine_ methylglyoxal hydroimidazolone_ and carboxyethyl lysine by liquid chromatography with tandem mass spectrometry (LC-MS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMD1","description":"ICD-FBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy w/rf delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0288T","description":"Anoscopy w/rf delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28103","description":"Remove/graft foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chore services per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5121","description":"Chore services per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX11","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5162","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","description":"HCPCS-Q5162","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDC1","description":"ICD-OBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRE1","description":"ICD-KCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pacemaker monitr digital/vis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0615","description":"Pacemaker monitr digital/vis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPB0","description":"ICD-JCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSF1","description":"ICD-CHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Initial or subsequent psychiatric collaborative care management_ each additional 30 minutes in a calendar month of behavioral health care manager activities_ in consultation w","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99494","description":"Initial or subsequent psychiatric collaborative care management_ each additional 30 minutes in a calendar month of behavioral health care manager activities_ in consultation w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDB1","description":"ICD-EGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transfer of embryo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58976","description":"Transfer of embryo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWD0","description":"ICD-OEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPD0","description":"ICD-NKPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy pyeloplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50544","description":"Laparoscopy pyeloplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HB11","description":"ICD-2HB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No filt remov w/in 3mos plcm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9544","description":"No filt remov w/in 3mos plcm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES214","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNF0","description":"ICD-JHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cid ext speech process repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8627","description":"Cid ext speech process repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFC0","description":"ICD-NKFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKF0","description":"ICD-OLKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRE1","description":"ICD-PDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unclassified drugs or biolog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9399","description":"Unclassified drugs or biolog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWB1","description":"ICD-DDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ coronary venous","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1900","description":"Lead_ coronary venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAE0","description":"ICD-IHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Situximab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9455","description":"Injection_ Situximab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE241","description":"Clinically Complex _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1315","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Symes met fr leath socket ar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5060","description":"Symes met fr leath socket ar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1246","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDD0","description":"ICD-EBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAE1","description":"ICD-GIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal tear gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68505","description":"Partial removal tear gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQE0","description":"ICD-CEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-97009","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","description":"CPT-97009","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr trunk addl 5cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13102","description":"Cmplx rpr trunk addl 5cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect neck tumor 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21558","description":"Resect neck tumor 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQF1","description":"ICD-LIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adenovirus ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87260","description":"Adenovirus ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; stable isotope dilution_ multiple analytes_ quantitative_ single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82544","description":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; stable isotope dilution_ multiple analytes_ quantitative_ single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOB0","description":"ICD-LDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAB1","description":"ICD-IFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA ASPERGILLUS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87305","description":"IAAD IA ASPERGILLUS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fit contac lens for managmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92072","description":"Fit contac lens for managmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIND1","description":"ICD-OIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA4B","description":"Default_ /PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rigid frame hyperex pre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0472","description":"Tlso rigid frame hyperex pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISE1","description":"ICD-GISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABC1","description":"ICD-OABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50660","description":"Removal of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim 6mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2505","description":"Injection_ pegfilgrastim 6mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELA0","description":"ICD-BELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRD1","description":"ICD-GFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSB1","description":"ICD-ODSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAC1","description":"ICD-BGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPA0","description":"ICD-FBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVA0","description":"ICD-KBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAF0","description":"ICD-AAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inner skull vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61702","description":"Inner skull vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWF0","description":"ICD-DAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFB0","description":"ICD-FEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pcp prophylaxis rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4279F","description":"Pcp prophylaxis rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYF1","description":"ICD-ODYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXA1","description":"ICD-JEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAA0","description":"ICD-JDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Retainer For Metal Fpd - Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6123","description":"Implant Supported Retainer For Metal Fpd - Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVF0","description":"ICD-NJVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth lens surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14251","description":"Anesth lens surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intercep dental tx transitn","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8060","description":"Intercep dental tx transitn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTB0","description":"ICD-OFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct hrt w/o dye w/ca test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75571","description":"Ct hrt w/o dye w/ca test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hep b core antibody total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86704","description":"Hep b core antibody total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Change gastric port open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43888","description":"Change gastric port open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEE0","description":"ICD-MIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection into brain canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61055","description":"Injection into brain canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILA0","description":"ICD-BILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA21C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28C","description":"Special Care High _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDB0","description":"ICD-CHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIE0","description":"ICD-JDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB25","description":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWC0","description":"ICD-LHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB2A","description":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth perineal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90477","description":"Anesth perineal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVA1","description":"ICD-JGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGB1","description":"ICD-NDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCME1","description":"ICD-BCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enzyme cell activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82657","description":"Enzyme cell activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTB0","description":"ICD-BCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJA0","description":"ICD-JCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEB1","description":"ICD-BBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brexucabtagene autoleucel_ up to 200 million autologous anti-cd19 car positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9073","description":"Brexucabtagene autoleucel_ up to 200 million autologous anti-cd19 car positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc opioid tx 1x during ther","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9578","description":"Doc opioid tx 1x during ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Albuterol comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7609","description":"Albuterol comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic & hip control thigh c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1680","description":"Pelvic & hip control thigh c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXC1","description":"ICD-JHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3FC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FC21","description":"ICD-3FC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Microbe suscept mycobacteri","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87190","description":"Microbe suscept mycobacteri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSA0","description":"ICD-LDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bx breast add lesion strtctc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19082","description":"Bx breast add lesion strtctc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection_ all nonsele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34704","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection_ all nonsele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEA1","description":"ICD-FHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINB0","description":"ICD-CINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUD0","description":"ICD-JDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cryopreservation sperm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89259","description":"Cryopreservation sperm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Administration of patient-focused health risk assessment instrument (eg_ health hazard appraisal) with scoring and documentation_ per standardized instrument","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96160","description":"Administration of patient-focused health risk assessment instrument (eg_ health hazard appraisal) with scoring and documentation_ per standardized instrument","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES126","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIE0","description":"ICD-JGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEF1","description":"ICD-FHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISE1","description":"ICD-LISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWC0","description":"ICD-HFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq tcat intratrl septl sht","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0613T","description":"Perq tcat intratrl septl sht","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUE1","description":"ICD-FAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYB0","description":"ICD-OKYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCF0","description":"ICD-NGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOD1","description":"ICD-CFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (pancreatic cancer)_ multiplex immunoassay of C5_ C4_ cystatin C_ factor B_ osteoprotegerin (OPG)_ gelsolin_ IGFBP3_ CA125 and multiplex electrochemiluminescent imm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0342U","description":"Oncology (pancreatic cancer)_ multiplex immunoassay of C5_ C4_ cystatin C_ factor B_ osteoprotegerin (OPG)_ gelsolin_ IGFBP3_ CA125 and multiplex electrochemiluminescent imm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hygienic item or device_ disposable or non-disposable_ any type_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9286","description":"Hygienic item or device_ disposable or non-disposable_ any type_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTE0","description":"ICD-AFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPA0","description":"ICD-GDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMA1","description":"ICD-FFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVF1","description":"ICD-GDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOA0","description":"ICD-GCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBD1","description":"ICD-FGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRA1","description":"ICD-LBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine lamina 1/2 lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63005","description":"Remove spine lamina 1/2 lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHB1","description":"ICD-GHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXE0","description":"ICD-FHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVA0","description":"ICD-BCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Slp stdy unatnd w/anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95801","description":"Slp stdy unatnd w/anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLF0","description":"ICD-OCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted px small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44799","description":"Unlisted px small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHD0","description":"ICD-OFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXF0","description":"ICD-FDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB53","description":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M0232","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0232","description":"HCPCS-M0232","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0539U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","description":"CPT-0539U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMA1","description":"ICD-BAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Frozen blood thaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86931","description":"Frozen blood thaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOD0","description":"ICD-DAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQB0","description":"ICD-HBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Belimumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0490","description":"Belimumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No low pecarn ped head traum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9597","description":"No low pecarn ped head traum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plasma_ cryoprecipitate reduced_ pathogen reduced_ each unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9025","description":"Plasma_ cryoprecipitate reduced_ pathogen reduced_ each unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGB0","description":"ICD-JBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No impr vis acuit w/in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9517","description":"No impr vis acuit w/in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainable pch w st wear barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4389","description":"Drainable pch w st wear barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEA0","description":"ICD-GFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spec stains not for microorg","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0477","description":"Spec stains not for microorg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAB0","description":"ICD-AFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEA1","description":"ICD-AGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interprt fees/laryngeal test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92617","description":"Interprt fees/laryngeal test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/3+ post-op nausea&vom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4556F","description":"Pt w/3+ post-op nausea&vom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFB1","description":"ICD-FCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOE0","description":"ICD-CBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJF1","description":"ICD-FAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGF1","description":"ICD-CDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHC0","description":"ICD-GFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXA1","description":"ICD-GEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin tissue procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17999","description":"Skin tissue procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMB1","description":"ICD-IEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTB0","description":"ICD-EHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tretinoin topical 5 g","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0117","description":"Tretinoin topical 5 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWF1","description":"ICD-DIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKF1","description":"ICD-OLKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTB1","description":"ICD-MDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC24A","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kafo pla sin up w/wo k/a cus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2034","description":"Kafo pla sin up w/wo k/a cus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Helicobacter pylori antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86677","description":"Helicobacter pylori antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDD0","description":"ICD-NJDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIE0","description":"ICD-GHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Single transfer toe-hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26553","description":"Single transfer toe-hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKC1","description":"ICD-CEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGA1","description":"ICD-BDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATD1","description":"ICD-JATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hhc slp ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0161","description":"Hhc slp ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destroy vag lesions simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57061","description":"Destroy vag lesions simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0940T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","description":"CPT-0940T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDC0","description":"ICD-MGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENB1","description":"ICD-KENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ hydroxocobalamin_ 10 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3425","description":"Injection_ hydroxocobalamin_ 10 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYB0","description":"ICD-GDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacemnt lithium ionbatter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7367","description":"Replacemnt lithium ionbatter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Scalp cooling_ mechanical; initial measurement and calibration of cap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0662T","description":"Scalp cooling_ mechanical; initial measurement and calibration of cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rem oct rta techl sprt min 8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0605T","description":"Rem oct rta techl sprt min 8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA156","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI chest w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71552","description":"MRI chest w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nerve teasing preparations","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88362","description":"Nerve teasing preparations","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELA0","description":"ICD-NELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBF1","description":"ICD-OLBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5155","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","description":"HCPCS-Q5155","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMB0","description":"ICD-CGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Total kt/v greater than or equal to 1. 7 per week (total clearance of urea [kt] / volume [v])","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8718","description":"Total kt/v greater than or equal to 1. 7 per week (total clearance of urea [kt] / volume [v])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx gastric unknown nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9104","description":"Onc dx gastric unknown nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLA0","description":"ICD-ADLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1093T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1093T","description":"CPT-1093T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIE0","description":"ICD-MBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Card output measure subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93562","description":"Card output measure subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0139","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","description":"HCPCS-J0139","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIED0","description":"ICD-FIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSF1","description":"ICD-LCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQE0","description":"ICD-LEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABF1","description":"ICD-GABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bk mold socket sach ft endo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5301","description":"Bk mold socket sach ft endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMF0","description":"ICD-BDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psytx pt&/family 45 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90834","description":"Psytx pt&/family 45 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory eeg monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95950","description":"Ambulatory eeg monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1064T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1064T","description":"CPT-1064T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Subs visit for episode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0526F","description":"Subs visit for episode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prefabricated porcelain/ceramic crown - permanent tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2928","description":"Prefabricated porcelain/ceramic crown - permanent tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHD1","description":"ICD-NEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB11A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (urothelial)_ mRNA expression profiling by real-time quantitative PCR of MDK_ HOXA13_ CDC2_ IGFBP5_ and CXCR2 in combination with droplet digital PCR (ddPCR) analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0420U","description":"Oncology (urothelial)_ mRNA expression profiling by real-time quantitative PCR of MDK_ HOXA13_ CDC2_ IGFBP5_ and CXCR2 in combination with droplet digital PCR (ddPCR) analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brain cavity shunt w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62201","description":"Brain cavity shunt w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAE0","description":"ICD-JBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAF1","description":"ICD-OJAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialysat sol fld vol > 999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4721","description":"Dialysat sol fld vol > 999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bupropion hcl sr 60 tablets","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0106","description":"Bupropion hcl sr 60 tablets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRB0","description":"ICD-HIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ omadacycline_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0121","description":"Injection_ omadacycline_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAD1","description":"ICD-EIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJC0","description":"ICD-OKJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy through stoma; with ablation of tumor(s)_ polyp(s)_ or other lesion(s) not amenable to removal by hot biopsy forceps_ bipolar cautery or snare technique","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6019","description":"Colonoscopy through stoma; with ablation of tumor(s)_ polyp(s)_ or other lesion(s) not amenable to removal by hot biopsy forceps_ bipolar cautery or snare technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hand tendon/muscle transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26494","description":"Hand tendon/muscle transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"R hrt art/grft angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93457","description":"R hrt art/grft angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1305","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring Of A Standardized Online Digital Cognitive Behavioral Therapy Program Ordered By A Physician Or Other Qualified Health Care Professional; Managem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0703T","description":"Remote Therapeutic Monitoring Of A Standardized Online Digital Cognitive Behavioral Therapy Program Ordered By A Physician Or Other Qualified Health Care Professional; Managem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOE0","description":"ICD-PHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy & duct catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52010","description":"Cystoscopy & duct catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJA0","description":"ICD-NLJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bl draw <3 yrs scalp vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36405","description":"Bl draw <3 yrs scalp vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYB0","description":"ICD-OFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4345","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","description":"HCPCS-Q4345","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWD0","description":"ICD-KIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTB1","description":"ICD-OGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA245","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFE1","description":"ICD-NBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKD0","description":"ICD-CDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEE0","description":"ICD-BDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOB0","description":"ICD-CHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPE0","description":"ICD-KEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assist oocyte fertilization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89281","description":"Assist oocyte fertilization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNC1","description":"ICD-BBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nursing fac care subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99308","description":"Nursing fac care subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX4D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0556","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","description":"HCPCS-G0556","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCF1","description":"ICD-MBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTE0","description":"ICD-IHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWD0","description":"ICD-KHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBF0","description":"ICD-JIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGB0","description":"ICD-KCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVD1","description":"ICD-OHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPF1","description":"ICD-BEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient not eligible due to active diagnosis of hypertension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9744","description":"Patient not eligible due to active diagnosis of hypertension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOF0","description":"ICD-CHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD23D","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX14","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLE1","description":"ICD-IBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWD1","description":"ICD-LDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKC0","description":"ICD-KGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAB1","description":"ICD-AIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUE0","description":"ICD-KGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB0A","description":"High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1109","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EB11","description":"ICD-2EB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX51","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDF0","description":"ICD-OBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQD0","description":"ICD-HGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA15A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQD0","description":"ICD-LEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert heart pm ventricular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33207","description":"Insert heart pm ventricular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26373","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYE1","description":"ICD-LBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28H","description":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Speech therapy_ in the home_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9128","description":"Speech therapy_ in the home_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUC1","description":"ICD-IGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC35","description":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMB1","description":"ICD-FIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCF1","description":"ICD-BCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAA0","description":"ICD-GDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOD1","description":"ICD-LAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVC1","description":"ICD-NAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar spine fusion combined","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22633","description":"Lumbar spine fusion combined","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDC1","description":"ICD-BHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLA1","description":"ICD-MBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine porphyrins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84120","description":"Assay of urine porphyrins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GB21","description":"ICD-3GB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQD1","description":"ICD-HGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0716T","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPC0","description":"ICD-FHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHD1","description":"ICD-KEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLE1","description":"ICD-BFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth vaginal endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95051","description":"Anesth vaginal endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEA0","description":"ICD-NDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Betamethasone acet&sod phosp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0702","description":"Betamethasone acet&sod phosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Creatine mb fraction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82553","description":"Creatine mb fraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/submuc inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45335","description":"Sigmoidoscopy w/submuc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGA0","description":"ICD-GEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefiderocol_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0699","description":"Injection_ cefiderocol_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Motor speech current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8999","description":"Motor speech current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTB0","description":"ICD-MLTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Limited (30 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ dom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0077","description":"Limited (30 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ dom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay tumor ca 15-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86300","description":"Immunoassay tumor ca 15-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mechanical allergen particle barrier/inhalation filter_ cream_ nasal_ topical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7023","description":"Mechanical allergen particle barrier/inhalation filter_ cream_ nasal_ topical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHA0","description":"ICD-OEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB120","description":"Clinically Complex _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant supported crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6065","description":"Implant supported crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC3B","description":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXA0","description":"ICD-CFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no sleep apnea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8840","description":"Doc reas no sleep apnea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx prostate t2no progres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9078","description":"Onc dx prostate t2no progres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLB0","description":"ICD-IBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMC0","description":"ICD-AIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient with transient or reversible cause of AF (e.g._ pneumonia_ hyperthyroidism_ pregnancy_ cardiac surgery)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9929","description":"Patient with transient or reversible cause of AF (e.g._ pneumonia_ hyperthyroidism_ pregnancy_ cardiac surgery)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mis sup/acc imp vad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0508","description":"Mis sup/acc imp vad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXB1","description":"ICD-CHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abdominal pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1270","description":"Abdominal pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mohs 1 stage h/n/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17311","description":"Mohs 1 stage h/n/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHA1","description":"ICD-OAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOD0","description":"ICD-ODOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of pulmonary artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33788","description":"Revision of pulmonary artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Uvl pnl 2 sq ft or less","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0691","description":"Uvl pnl 2 sq ft or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQE0","description":"ICD-OEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tte w or w/o contr_ cont ecg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8930","description":"Tte w or w/o contr_ cont ecg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBB0","description":"ICD-BIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of shoulders","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73050","description":"X-ray exam of shoulders","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX12","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Methylprednisolone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2930","description":"Methylprednisolone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETE0","description":"ICD-JETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iv hanger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0105","description":"Iv hanger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablate heart dysrhythm focus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33251","description":"Ablate heart dysrhythm focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXD1","description":"ICD-NIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gel pressure mattress pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0185","description":"Gel pressure mattress pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ non-small cell lung neoplasia_ DN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0136U","description":"Targeted genomic sequence analysis panel_ non-small cell lung neoplasia_ DN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA20C","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD211","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96567","description":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prgrmg eval cardiac modulj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0417T","description":"Prgrmg eval cardiac modulj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWC1","description":"ICD-KGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilation and curettage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58120","description":"Dilation and curettage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q0237","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0237","description":"HCPCS-Q0237","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYA1","description":"ICD-LFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUF1","description":"ICD-ADUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPE1","description":"ICD-NJPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHB1","description":"ICD-OBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinolytic plasminogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85420","description":"Fibrinolytic plasminogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01842","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01842","description":"CPT-01842","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD246","description":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUC0","description":"ICD-GEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLB1","description":"ICD-NFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX07","description":"Low Rehab plus Extensive _ ADL Index 2-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Body fluid cell count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89051","description":"Body fluid cell count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of femur epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27185","description":"Revision of femur epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54050","description":"Destruction penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dias bp less 90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8754","description":"Dias bp less 90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAME1","description":"ICD-IAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vasc embolize/occlude venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37241","description":"Vasc embolize/occlude venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLF1","description":"ICD-CGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4435","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","description":"HCPCS-Q4435","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc share dec prior proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9296","description":"Doc share dec prior proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Histotripsy (ie_ non-thermal ablation via acoustic energy delivery) of malignant renal tissue_ including imaging guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0888T","description":"Histotripsy (ie_ non-thermal ablation via acoustic energy delivery) of malignant renal tissue_ including imaging guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLE0","description":"ICD-OCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKF0","description":"ICD-NJKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGD0","description":"ICD-GCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJF0","description":"ICD-JDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFB1","description":"ICD-BDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00600","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00600","description":"CPT-00600","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRC1","description":"ICD-HBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCA0","description":"ICD-CHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26785","description":"Treat finger dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCA0","description":"ICD-BCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE12D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAA1","description":"ICD-CFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQB1","description":"ICD-CIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29882","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD206","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSF1","description":"ICD-HFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28I","description":"Clinically Complex _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydroxyzine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3410","description":"Hydroxyzine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLF1","description":"ICD-BGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESC0","description":"ICD-HESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0937T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","description":"CPT-0937T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0662","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","description":"HCPCS-G0662","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIC0","description":"ICD-IDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACB1","description":"ICD-GACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGA1","description":"ICD-JDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUE0","description":"ICD-CEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX60","description":"Low Rehab plus Extensive _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain open lung lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32200","description":"Drain open lung lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1110T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1110T","description":"CPT-1110T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVB1","description":"ICD-BFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJF0","description":"ICD-BHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBB0","description":"ICD-NKBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thiethylperazine maleate10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0174","description":"Thiethylperazine maleate10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36215","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBA1","description":"ICD-BDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMA0","description":"ICD-NBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEE1","description":"ICD-FEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIF1","description":"ICD-FDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIA0","description":"ICD-CGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repos nstim apnea sensing ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0433T","description":"Repos nstim apnea sensing ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBD0","description":"ICD-IEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPF1","description":"ICD-GCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair vessel graft defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35870","description":"Repair vessel graft defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chlamydia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86631","description":"Chlamydia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC12B","description":"Clinically Complex _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Triamcinolone acet inj nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3301","description":"Triamcinolone acet inj nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIE0","description":"ICD-EBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Construct thumb replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26550","description":"Construct thumb replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair septal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33853","description":"Repair septal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPC1","description":"ICD-CEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sgd spelling phys contact","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2508","description":"Sgd spelling phys contact","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDA0","description":"ICD-GFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYB1","description":"ICD-DHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMF0","description":"ICD-NCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTD0","description":"ICD-OLTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGB0","description":"ICD-JEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTA0","description":"ICD-CFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESF0","description":"ICD-CESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repl met band kafo-afo calf/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4090","description":"Repl met band kafo-afo calf/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ht pharm per hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9810","description":"Ht pharm per hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWB1","description":"ICD-KCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Batt pack/cart_ port conc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1356","description":"Batt pack/cart_ port conc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prev visit new age 5-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99383","description":"Prev visit new age 5-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL5D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLA1","description":"ICD-CCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release hand/finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26445","description":"Release hand/finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC131","description":"Special Care Low _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epidural lysis on single day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62264","description":"Epidural lysis on single day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFB1","description":"ICD-OHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colpopexy_ vaginal; minimally invasive extra-peritoneal approach (sacrospinous)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9778","description":"Colpopexy_ vaginal; minimally invasive extra-peritoneal approach (sacrospinous)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of esophagus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43100","description":"Excision of esophagus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOC0","description":"ICD-CAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28F","description":"Clinically Complex _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNB1","description":"ICD-NBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOE1","description":"ICD-GDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQA0","description":"ICD-PGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFF0","description":"ICD-KEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML53","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age Or Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adva","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2135","description":"Patients 66 Years Of Age Or Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1431","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","description":"HCPCS-M1431","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCA0","description":"ICD-GDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sio panel custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0624","description":"Sio panel custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPA1","description":"ICD-GFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4408","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","description":"HCPCS-Q4408","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2045","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","description":"HCPCS-A2045","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21077","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sedation (non-iv)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9248","description":"Sedation (non-iv)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0606U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","description":"CPT-0606U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC13B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disposable endoscope sheath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4270","description":"Disposable endoscope sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient had anaphylaxis due to the tetanus_ diphtheria or pertussis vaccine any time on or before the patient_s 13th birthday","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1161","description":"Patient had anaphylaxis due to the tetanus_ diphtheria or pertussis vaccine any time on or before the patient_s 13th birthday","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj paravert f jnt c/t 1 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64490","description":"Inj paravert f jnt c/t 1 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28G","description":"Clinically Complex _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDA0","description":"ICD-AIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring Treatment Management Services_ Physician Or Other Qualified Health Care Professional Time In A Calendar Month Requiring At Least One Interactive","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98980","description":"Remote Therapeutic Monitoring Treatment Management Services_ Physician Or Other Qualified Health Care Professional Time In A Calendar Month Requiring At Least One Interactive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Individual_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96159","description":"Health Behavior Intervention_ Individual_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSD0","description":"ICD-LFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disposable ext urethral dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4360","description":"Disposable ext urethral dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant auditory brain imp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2235","description":"Implant auditory brain imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA05","description":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medical nutrition group","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97804","description":"Medical nutrition group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prosthetic type socket molde","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2350","description":"Prosthetic type socket molde","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bridge payment: A one-time payment for the first Medicare Diabetes Prevention Program (MDPP) core session_ core maintenance session_ or ongoing maintenance session furnished b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9890","description":"Bridge payment: A one-time payment for the first Medicare Diabetes Prevention Program (MDPP) core session_ core maintenance session_ or ongoing maintenance session furnished b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sys bp > or = 140","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8753","description":"Sys bp > or = 140","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBD1","description":"ICD-ACBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIF1","description":"ICD-ECIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMA1","description":"ICD-KHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDME1","description":"ICD-FDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE22A","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDD0","description":"ICD-OJDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMB0","description":"ICD-ICMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOB1","description":"ICD-OAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27826","description":"Treat lower leg fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWB0","description":"ICD-GGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj dupuytren cord w/enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20527","description":"Inj dupuytren cord w/enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGF0","description":"ICD-KEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Encephaltis east eqne anbdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86652","description":"Encephaltis east eqne anbdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANF0","description":"ICD-OANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX03","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSA1","description":"ICD-GDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Calculus analysis qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82355","description":"Calculus analysis qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adjunctive continuous glucose monitor or receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2102","description":"Adjunctive continuous glucose monitor or receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBC1","description":"ICD-KGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ins mark thor for rt perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32553","description":"Ins mark thor for rt perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCA0","description":"ICD-EFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILD1","description":"ICD-AILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFID0","description":"ICD-IFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA15D","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDA0","description":"ICD-FGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVF0","description":"ICD-NFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHB0","description":"ICD-EHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSE0","description":"ICD-DFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0913T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","description":"CPT-0913T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETE1","description":"ICD-IETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKD1","description":"ICD-BFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUE1","description":"ICD-AHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTC0","description":"ICD-GDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAE1","description":"ICD-BBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB246","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC20","description":"Medium Rehab _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt no dchg home postop day 7","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9602","description":"Pt no dchg home postop day 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKF1","description":"ICD-FAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prostatic rf thermotx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53852","description":"Prostatic rf thermotx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICD0","description":"ICD-FICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autonomic nrv parasym inervj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95921","description":"Autonomic nrv parasym inervj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSB0","description":"ICD-CFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTE0","description":"ICD-GDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBME1","description":"ICD-BBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCE0","description":"ICD-AFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUA0","description":"ICD-MLUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQF1","description":"ICD-PEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pten gene dup/delet variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81323","description":"Pten gene dup/delet variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOC0","description":"ICD-GEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00454","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00454","description":"CPT-00454","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQD0","description":"ICD-PFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Histoplasmosis skin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86510","description":"Histoplasmosis skin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECD0","description":"ICD-NECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for level III_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0752T","description":"Digitization of glass microscope slides for level III_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUF1","description":"ICD-MLUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC14B","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASD0","description":"ICD-OASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLE1","description":"ICD-CHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAB1","description":"ICD-IEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Als iv drug therapy supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0394","description":"Als iv drug therapy supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JC11","description":"ICD-3JC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTE0","description":"ICD-MKTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUA1","description":"ICD-GBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cellesta_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4184","description":"Cellesta_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFC0","description":"ICD-NBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHF1","description":"ICD-CGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUB1","description":"ICD-OJUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAC1","description":"ICD-KCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIE1","description":"ICD-ICIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMF1","description":"ICD-JGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enterovirus probe&revrs trns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87498","description":"Enterovirus probe&revrs trns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of finger abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26010","description":"Drainage of finger abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAME1","description":"ICD-FAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient is currently on a statin therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9796","description":"Patient is currently on a statin therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIE0","description":"ICD-IAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunization admin by intramuscular injection of s (SARS-CoV-2) ([COVID-19]) vacc_ mRNA-LNP_ spike protein_ presev free_ 30mcg/0.3 mL dosage_ tris-sucrose formula; third dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0053A","description":"Immunization admin by intramuscular injection of s (SARS-CoV-2) ([COVID-19]) vacc_ mRNA-LNP_ spike protein_ presev free_ 30mcg/0.3 mL dosage_ tris-sucrose formula; third dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB144","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNE1","description":"ICD-NHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"AJCC stage at breast cancer diagnosis = I (Ia or Ib) and T-stage at breast cancer diagnosis does not equal = T1_ T1a_ T1b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9832","description":"AJCC stage at breast cancer diagnosis = I (Ia or Ib) and T-stage at breast cancer diagnosis does not equal = T1_ T1a_ T1b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI ct scan ord rvwd rqstd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3324F","description":"MRI ct scan ord rvwd rqstd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDE1","description":"ICD-MLDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of skin abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10060","description":"Drainage of skin abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove middle ear nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69676","description":"Remove middle ear nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHD0","description":"ICD-NHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Full mouth x-ray of teeth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70320","description":"Full mouth x-ray of teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vis inj at surg/1mos post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9628","description":"Vis inj at surg/1mos post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEC1","description":"ICD-FGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperatively and/or intraoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9958","description":"Patient did not receive combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperatively and/or intraoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ranibizumab_ via sustained release intravitreal implant (Susvimo)_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9093","description":"Injection_ ranibizumab_ via sustained release intravitreal implant (Susvimo)_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGC0","description":"ICD-CIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2AA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AA31","description":"ICD-2AA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX20","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIF1","description":"ICD-CAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HC31","description":"ICD-2HC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB256","description":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVB1","description":"ICD-GBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Variable concentration mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4620","description":"Variable concentration mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lithium ion battery charger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7368","description":"Lithium ion battery charger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"BRCA1 (BRCA1_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81165","description":"BRCA1 (BRCA1_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEC0","description":"ICD-JIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGB1","description":"ICD-CDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHE1","description":"ICD-OIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFME0","description":"ICD-AFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBD0","description":"ICD-MHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDE1","description":"ICD-OEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEA0","description":"ICD-GHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB154","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVD1","description":"ICD-FGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLA1","description":"ICD-BHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWB0","description":"ICD-LGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBD1","description":"ICD-GDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJC1","description":"ICD-KGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMD0","description":"ICD-KGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB42","description":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls repos perph cnula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33964","description":"Ecmo/ecls repos perph cnula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Not disch home by day #2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8838","description":"Not disch home by day #2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBE1","description":"ICD-OJBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBA1","description":"ICD-MCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUC1","description":"ICD-JHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD24C","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDD1","description":"ICD-MCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUB1","description":"ICD-KDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNC0","description":"ICD-KFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB114","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA20B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ntsty modul rad tx dlvr cplx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77386","description":"Ntsty modul rad tx dlvr cplx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAB0","description":"ICD-EAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61682","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVB1","description":"ICD-GEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"JK GNOTYP SLC14A1 EXON 9","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0192U","description":"JK GNOTYP SLC14A1 EXON 9","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHD0","description":"ICD-FFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ko elastic with joints","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1810","description":"Ko elastic with joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDB1","description":"ICD-KGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq stent/chest vert art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0075T","description":"Perq stent/chest vert art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDA0","description":"ICD-AEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ C-1 esterase inhibitor (human)_ (Haegarda)_ 10 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0599","description":"Injection_ C-1 esterase inhibitor (human)_ (Haegarda)_ 10 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJC1","description":"ICD-JCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXF1","description":"ICD-FEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lymphocytotoxicity assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86806","description":"Lymphocytotoxicity assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC02","description":"Very High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPD1","description":"ICD-FAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSB0","description":"ICD-ODSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of vein clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34401","description":"Removal of vein clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE244","description":"Special Care High _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of lumbar spine region infection at the time of the procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1039","description":"Patients with a diagnosis of lumbar spine region infection at the time of the procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mecp2 gene known variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81303","description":"Mecp2 gene known variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0205","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0205","description":"HCPCS-C0205","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHF0","description":"ICD-MIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGME1","description":"ICD-BGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48551","description":"Prep donor pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMD1","description":"ICD-ODMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Splint - intra-coronal; natural teeth or prosthetic crowns","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4322","description":"Splint - intra-coronal; natural teeth or prosthetic crowns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise/graft eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68335","description":"Revise/graft eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUB0","description":"ICD-MBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oocyte identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89254","description":"Oocyte identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELA1","description":"ICD-CELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJA1","description":"ICD-OIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (xembify)_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1558","description":"Injection_ immune globulin (xembify)_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Muscle-skin graft leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15738","description":"Muscle-skin graft leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Limited autopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88037","description":"Limited autopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise/graft eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68328","description":"Revise/graft eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No knee joint with artic ali","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5220","description":"No knee joint with artic ali","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score ls < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8660","description":"Fun stat score ls < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB24D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIB1","description":"ICD-NGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Postoperative biliary duct calculus removal_ percutaneous via t-tube tract_ basket_ or snare (eg_ burhenne technique)_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74327","description":"Postoperative biliary duct calculus removal_ percutaneous via t-tube tract_ basket_ or snare (eg_ burhenne technique)_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUC0","description":"ICD-AHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Etanercept injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1438","description":"Etanercept injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQF1","description":"ICD-KEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal aneuploidy trisom risk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81507","description":"Fetal aneuploidy trisom risk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBE1","description":"ICD-OKBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOA0","description":"ICD-GBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBB0","description":"ICD-NCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL42","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUB0","description":"ICD-OHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGB1","description":"ICD-GBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLC0","description":"ICD-OGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUB0","description":"ICD-JEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML60","description":"Medium Rehab plus Extensive_ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83655","description":"Assay of lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Voice current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9171","description":"Voice current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pain screened as moderate to severe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1000","description":"Pain screened as moderate to severe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSF1","description":"ICD-HHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA1A","description":"High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYE1","description":"ICD-DAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Isoetharine non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7649","description":"Isoetharine non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FC31","description":"ICD-1FC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBE0","description":"ICD-NKBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISC1","description":"ICD-GISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUD1","description":"ICD-AIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMF0","description":"ICD-JGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLF1","description":"ICD-JFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSF0","description":"ICD-PFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clotting assay whole blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85396","description":"Clotting assay whole blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of gastrostomy tube_ percutaneous_ with magnetic gastropexy_ under ultrasound guidance_ image documentation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0647T","description":"Insertion of gastrostomy tube_ percutaneous_ with magnetic gastropexy_ under ultrasound guidance_ image documentation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATB0","description":"ICD-EATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXE1","description":"ICD-GGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clin sign vol ovrld assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2002F","description":"Clin sign vol ovrld assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHA0","description":"ICD-AIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUB0","description":"ICD-CDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXA0","description":"ICD-FCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAD0","description":"ICD-BFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFA0","description":"ICD-KIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLB1","description":"ICD-BBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUB0","description":"ICD-AHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAE0","description":"ICD-CBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Consultation with family","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90887","description":"Consultation with family","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKD0","description":"ICD-OAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFC1","description":"ICD-GBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance cholangiopancreatography (QMRCP) including data preparation and transmission_ interpretation and report_ obtained without diagnostic magnetic r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0723T","description":"Quantitative magnetic resonance cholangiopancreatography (QMRCP) including data preparation and transmission_ interpretation and report_ obtained without diagnostic magnetic r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of neck of femur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27161","description":"Incision of neck of femur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trans-abdominal or trans-vaginal ultrasound not performed_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8808","description":"Trans-abdominal or trans-vaginal ultrasound not performed_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWB0","description":"ICD-GHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINC1","description":"ICD-KINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC11B","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRA0","description":"ICD-HCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD101","description":"Clinically Complex _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAA1","description":"ICD-BGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISA0","description":"ICD-LISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3375","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3375","description":"HCPCS-J3375","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGF0","description":"ICD-BAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATB0","description":"ICD-OATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMC0","description":"ICD-BCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXC1","description":"ICD-KHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUD0","description":"ICD-KCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGC1","description":"ICD-NIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPE0","description":"ICD-JGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC131","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dissect brain w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62161","description":"Dissect brain w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transplant related per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9975","description":"Transplant related per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNB1","description":"ICD-FDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWA0","description":"ICD-OIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dihydromorphinone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6046","description":"Dihydromorphinone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65205","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Grp b strep screening docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3294F","description":"Grp b strep screening docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Muscle transfer shoulder/arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23395","description":"Muscle transfer shoulder/arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pressure pneum appl full leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0671","description":"Pressure pneum appl full leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADC0","description":"ICD-BADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"von Willebrand factor (VWF)_ type 2N_ factor VIII and VWF binding evaluation_ enzyme-linked immunosorbent assays (ELISA)_ plasma (Versitiā„¢ VWD Type 2N Binding)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0284U","description":"von Willebrand factor (VWF)_ type 2N_ factor VIII and VWF binding evaluation_ enzyme-linked immunosorbent assays (ELISA)_ plasma (Versitiā„¢ VWD Type 2N Binding)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cogenex Amniotic Membrane_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4229","description":"Cogenex Amniotic Membrane_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMF0","description":"ICD-ECMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFD0","description":"ICD-NFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Photo patch test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95052","description":"Photo patch test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise spinal cord tract(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63170","description":"Incise spinal cord tract(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implantation_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69716","description":"Implantation_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylinder 4.25d/4.25-6d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2109","description":"Spherocylinder 4.25d/4.25-6d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPE1","description":"ICD-FCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB146","description":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA156","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBB0","description":"ICD-IDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOF0","description":"ICD-GCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC254","description":"Clinically Complex _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVE0","description":"ICD-NKVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEA0","description":"ICD-NIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQB1","description":"ICD-OKQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKB0","description":"ICD-FDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHF1","description":"ICD-OBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA22","description":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLB0","description":"ICD-EBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Silvr oxide batt glucose mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4236","description":"Silvr oxide batt glucose mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy with ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44401","description":"Colonoscopy with ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due t","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL60","description":"Very High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHB1","description":"ICD-ICHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUD1","description":"ICD-BIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB13C","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Platelets_ pheresis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9034","description":"Platelets_ pheresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWA0","description":"ICD-CBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Community Transition Svcs (Health Safety)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7336","description":"Community Transition Svcs (Health Safety)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSE0","description":"ICD-KGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA01","description":"Ultra High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert needle cath bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44015","description":"Insert needle cath bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFD1","description":"ICD-GBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"In-line cartridge containing digestive enzyme(s) for enteral feeding_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4105","description":"In-line cartridge containing digestive enzyme(s) for enteral feeding_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFB0","description":"ICD-JCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advanced I","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2117","description":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advanced I","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLF0","description":"ICD-FBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28H","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove pituit tumor w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62165","description":"Remove pituit tumor w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNE0","description":"ICD-NDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWC0","description":"ICD-LAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGA0","description":"ICD-FDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC211","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBD1","description":"ICD-JGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gel pressure mattress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0196","description":"Gel pressure mattress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMF0","description":"ICD-JEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKE0","description":"ICD-OEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUC1","description":"ICD-BIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Term device_ multi art digit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6715","description":"Term device_ multi art digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Throat muscle surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43030","description":"Throat muscle surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx colon metas noevid dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9088","description":"Onc dx colon metas noevid dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMA1","description":"ICD-JIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parathyrd planar w/spect&ct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78072","description":"Parathyrd planar w/spect&ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFC1","description":"ICD-KCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAB0","description":"ICD-ADAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQA1","description":"ICD-DIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMC1","description":"ICD-EGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAD0","description":"ICD-OLAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOC1","description":"ICD-OCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJC1","description":"ICD-GCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clamp neck artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61703","description":"Clamp neck artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLC0","description":"ICD-NJLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDC0","description":"ICD-ACDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRA1","description":"ICD-CBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYB1","description":"ICD-PGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSE1","description":"ICD-KCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Measure blood oxygen level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94762","description":"Measure blood oxygen level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative near-infrared fluorescence lymphatic mapping of lymp node(s) (sentinel or tumor draining) with administration of indocyanine green (ICG) (List separately in add","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9756","description":"Intraoperative near-infrared fluorescence lymphatic mapping of lymp node(s) (sentinel or tumor draining) with administration of indocyanine green (ICG) (List separately in add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Who nontorsion jnts pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3916","description":"Who nontorsion jnts pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13133","description":"Cmplx rpr f/c/c/m/n/ax/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Genetic testing for severe inherited conditions (eg_ cystic fibrosis_ Ashkenazi Jewish-associated disorders [eg_ Bloom syndrome_ Canavan disease_ Fanconi anemia type C_ mucoli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81443","description":"Genetic testing for severe inherited conditions (eg_ cystic fibrosis_ Ashkenazi Jewish-associated disorders [eg_ Bloom syndrome_ Canavan disease_ Fanconi anemia type C_ mucoli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKF1","description":"ICD-KFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPC1","description":"ICD-FAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSF0","description":"ICD-KHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lvef >/=40% systolic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3022F","description":"Lvef >/=40% systolic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVC0","description":"ICD-JGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52000","description":"Cystoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIE0","description":"ICD-MGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ethosuximide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80168","description":"Assay of ethosuximide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBF0","description":"ICD-EFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEC1","description":"ICD-KCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELD1","description":"ICD-AELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAC1","description":"ICD-CHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect back tum < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21935","description":"Resect back tum < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Indwelling catheter latex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4338","description":"Indwelling catheter latex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAA0","description":"ICD-CBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elec stim cancer treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0766","description":"Elec stim cancer treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC120","description":"Special Care Low _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33737","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25525","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISE1","description":"ICD-KISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLB1","description":"ICD-OHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGF1","description":"ICD-CEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUB0","description":"ICD-KAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAF0","description":"ICD-FIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAA1","description":"ICD-AIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of percutaneous transhepatic stent for internal and external biliary drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47511","description":"Introduction of percutaneous transhepatic stent for internal and external biliary drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVE1","description":"ICD-KBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscop stent placement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43212","description":"Esophagoscop stent placement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Normal saline solution infus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7040","description":"Normal saline solution infus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLB1","description":"ICD-FFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise/remove neuroreceiver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63688","description":"Revise/remove neuroreceiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sterile water/saline_ 10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4216","description":"Sterile water/saline_ 10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert pulse gen dual leads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33213","description":"Insert pulse gen dual leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPD1","description":"ICD-NBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTC0","description":"ICD-ACTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECF1","description":"ICD-BECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair spec sz spec ht a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1227","description":"Wheelchair spec sz spec ht a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eye exam new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92004","description":"Eye exam new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE206","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBD1","description":"ICD-KBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endometr ablate thermal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58353","description":"Endometr ablate thermal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion Of Drug-Eluting Implant_ Including Punctal Dilation When Performed_ Into Lacrimal Canaliculus_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68841","description":"Insertion Of Drug-Eluting Implant_ Including Punctal Dilation When Performed_ Into Lacrimal Canaliculus_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD114","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMD1","description":"ICD-FAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62220","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hysteroscopy resect septum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58560","description":"Hysteroscopy resect septum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOA0","description":"ICD-CAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAE1","description":"ICD-OCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDA0","description":"ICD-BEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQA1","description":"ICD-OEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18B","description":"Special Care Low _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of tongue lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41113","description":"Excision of tongue lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGC0","description":"ICD-GAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPE0","description":"ICD-CIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNE0","description":"ICD-OCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo proc hernia repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49659","description":"Laparo proc hernia repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCE1","description":"ICD-MFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJE0","description":"ICD-OEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD150","description":"Reduced Physical Function _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"AmnioTX_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4324","description":"AmnioTX_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHF0","description":"ICD-MDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYA0","description":"ICD-HEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBE0","description":"ICD-MLBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB06","description":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACA1","description":"ICD-OACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tissue exam by pathologist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88309","description":"Tissue exam by pathologist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Custom shape cvr hip disart","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5707","description":"Custom shape cvr hip disart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLA1","description":"ICD-OBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Feces culture aerobic bact","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87045","description":"Feces culture aerobic bact","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCC1","description":"ICD-GGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flexhd/allopatchhd/matrixhd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4128","description":"Flexhd/allopatchhd/matrixhd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHF0","description":"ICD-CDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHB1","description":"ICD-JFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMF0","description":"ICD-OGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTC1","description":"ICD-GGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rear whl complete solid tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0069","description":"Rear whl complete solid tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWD1","description":"ICD-PJWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQB1","description":"ICD-HAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27552","description":"Treat knee dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYA1","description":"ICD-OAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug outreach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0023","description":"Alcohol and/or drug outreach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAA0","description":"ICD-IEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIC1","description":"ICD-GFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCB1","description":"ICD-FBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician_ including a written report to the patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99451","description":"Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician_ including a written report to the patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention(s) (list separately in addition to code for primary procedure(s))","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31620","description":"Endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention(s) (list separately in addition to code for primary procedure(s))","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27508","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMD0","description":"ICD-NAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVE1","description":"ICD-KHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61320","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-linked intellectual dblt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81471","description":"X-linked intellectual dblt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Christian sci nurse visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9901","description":"Christian sci nurse visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEF1","description":"ICD-GGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTD1","description":"ICD-MHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRE1","description":"ICD-GDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prescrl fuse w/ instr l4/l5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0309T","description":"Prescrl fuse w/ instr l4/l5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Deep (Eg_ Subfascial) (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20700","description":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Deep (Eg_ Subfascial) (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pmkr_ dual_ non rate-resp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2619","description":"Pmkr_ dual_ non rate-resp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRB1","description":"ICD-CDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIID0","description":"ICD-FIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ht inj hormone diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9560","description":"Ht inj hormone diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open red simpl mandible fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7630","description":"Open red simpl mandible fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMF1","description":"ICD-KGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGND1","description":"ICD-NGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRD0","description":"ICD-LIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUC0","description":"ICD-IGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18D","description":"Special Care Low _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Emtricitabine 200mg and tenofovir disoproxil fumarate 300mg_ oral_ fda approved prescription_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0750","description":"Emtricitabine 200mg and tenofovir disoproxil fumarate 300mg_ oral_ fda approved prescription_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAF1","description":"ICD-IGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEC0","description":"ICD-IDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trach-esoph voice pros pt in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8507","description":"Trach-esoph voice pros pt in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with atherectomy_ includes angioplasty within the same vessel_ when performe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7534","description":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with atherectomy_ includes angioplasty within the same vessel_ when performe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFB0","description":"ICD-NKFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dna analysis deafness","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3844","description":"Dna analysis deafness","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMC0","description":"ICD-OEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0669U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0669U","description":"CPT-0669U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQA0","description":"ICD-HHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHF1","description":"ICD-NLHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQD0","description":"ICD-GBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIC0","description":"ICD-ICIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Osteochondral talus autogrft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28446","description":"Osteochondral talus autogrft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of bone lower jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21025","description":"Excision of bone lower jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Typhoid vaccine_ acetone-killed_ dried (akd)_ for subcutaneous or jetinjection use (u.s. military)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90693","description":"Typhoid vaccine_ acetone-killed_ dried (akd)_ for subcutaneous or jetinjection use (u.s. military)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEB1","description":"ICD-GEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ins bone device for rsa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0347T","description":"Ins bone device for rsa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDA1","description":"ICD-JHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"I131 max 100uci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9531","description":"I131 max 100uci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spacer with mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8101","description":"Spacer with mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPE1","description":"ICD-CHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJE1","description":"ICD-GHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ vancomycin hcl (mylan) not therapeutically equivalent to j3370_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3371","description":"Injection_ vancomycin hcl (mylan) not therapeutically equivalent to j3370_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reinnervate larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31590","description":"Reinnervate larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSB0","description":"ICD-DFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1608","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1608","description":"HCPCS-C1608","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54300","description":"Revision of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Afo plastic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1930","description":"Afo plastic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA24B","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBF0","description":"ICD-CEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPC1","description":"ICD-GBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJC0","description":"ICD-OLJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOA1","description":"ICD-KCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJE0","description":"ICD-CHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acetylcholinesterase assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82013","description":"Acetylcholinesterase assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUC0","description":"ICD-MCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTF0","description":"ICD-CHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth collar bone biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45451","description":"Anesth collar bone biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1044T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1044T","description":"CPT-1044T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHE1","description":"ICD-NGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cryopreservation ovary tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0058T","description":"Cryopreservation ovary tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKE0","description":"ICD-FHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise temple bone implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69718","description":"Revise temple bone implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHA1","description":"ICD-KFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95717","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit20.1-30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12046","description":"Intmd rpr n-hf/genit20.1-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1806","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1806","description":"CDT-D1806","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDF0","description":"ICD-EIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"3D printing of a 3D dental surfacet scan","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0396","description":"3D printing of a 3D dental surfacet scan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suprv interfac trnsport addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99486","description":"Suprv interfac trnsport addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQB1","description":"ICD-KHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28312","description":"Revision of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"O2/water vapor enrich w/o he","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1406","description":"O2/water vapor enrich w/o he","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD12D","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath_hemodialysis_short-term","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1752","description":"Cath_hemodialysis_short-term","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDB1","description":"ICD-KHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSE0","description":"ICD-GHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4382","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","description":"HCPCS-Q4382","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNF0","description":"ICD-BFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJD0","description":"ICD-OIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of pubic bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27282","description":"Fusion of pubic bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic defect closure within the entire gastrointestinal tract_ including upper endoscopy (including diagnostic_ if performed) or colonoscopy (including diagnostic_ if per","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9901","description":"Endoscopic defect closure within the entire gastrointestinal tract_ including upper endoscopy (including diagnostic_ if performed) or colonoscopy (including diagnostic_ if per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4431","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","description":"HCPCS-Q4431","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apply rem fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20660","description":"Apply rem fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKF0","description":"ICD-FAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES312","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0916T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","description":"CPT-0916T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apply intrcav radiat compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77763","description":"Apply intrcav radiat compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHE1","description":"ICD-MKHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX36","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown 3/4 cast noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2782","description":"Crown 3/4 cast noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter for hysterography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58340","description":"Catheter for hysterography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRE1","description":"ICD-CGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ calcium gluconate (wg critical care)_ per 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0613","description":"Injection_ calcium gluconate (wg critical care)_ per 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anticonv thxpy for 6 mos/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4230F","description":"Anticonv thxpy for 6 mos/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAC1","description":"ICD-BCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC15A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA25B","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove/revise male sling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53442","description":"Remove/revise male sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"In Hospice Or Using Hospice Services During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2153","description":"In Hospice Or Using Hospice Services During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDD1","description":"ICD-FDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise graft w/vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35881","description":"Revise graft w/vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANC0","description":"ICD-BANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Culture typing glc/hplc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87143","description":"Culture typing glc/hplc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBC1","description":"ICD-IEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBC0","description":"ICD-OLBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gonadotropin hormone panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80426","description":"Gonadotropin hormone panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJE0","description":"ICD-BDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOF1","description":"ICD-KEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGF0","description":"ICD-CGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Liver imaging (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78205","description":"Liver imaging (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGB0","description":"ICD-CAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"For diabetics only_ multiple density insert_ made by direct carving with CAM technology from a rectified CAD model created from","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0903","description":"For diabetics only_ multiple density insert_ made by direct carving with CAM technology from a rectified CAD model created from","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEID1","description":"ICD-EEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC21C","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRE0","description":"ICD-PIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEB0","description":"ICD-CHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of guide into renal pelvis and/or ureter with dilation to establish nephrostomy tract_ percutaneous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50395","description":"Introduction of guide into renal pelvis and/or ureter with dilation to establish nephrostomy tract_ percutaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELA0","description":"ICD-CELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Paramed intrcept nonvol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0208","description":"Paramed intrcept nonvol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA13D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCA1","description":"ICD-GBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATA0","description":"ICD-JATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXE1","description":"ICD-FGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg_ touch preparation_ squash preparation)_ each additional site (Lis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0844T","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg_ touch preparation_ squash preparation)_ each additional site (Lis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRA0","description":"ICD-OKRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCC1","description":"ICD-AHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBF1","description":"ICD-GGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHC0","description":"ICD-JFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Term dev mech hook vol open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6706","description":"Term dev mech hook vol open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHE1","description":"ICD-CEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHED0","description":"ICD-KHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB45","description":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ex h rate sz 30+ day ri only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0386T","description":"Ex h rate sz 30+ day ri only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIE1","description":"ICD-MAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD24D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal chrmoml aneuploidy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81420","description":"Fetal chrmoml aneuploidy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIC1","description":"ICD-OJIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB4C","description":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore wound neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20100","description":"Explore wound neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open/perq place stent ea add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37239","description":"Open/perq place stent ea add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOB1","description":"ICD-KIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNF1","description":"ICD-FCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ocular prosthesis interim","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5923","description":"Ocular prosthesis interim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEE1","description":"ICD-BDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42831","description":"Removal of adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orthodontic procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8999","description":"Orthodontic procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDE0","description":"ICD-BBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eye socket wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65290","description":"Repair of eye socket wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Socket insert below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5655","description":"Socket insert below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDD0","description":"ICD-MLDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Delayed breast prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19342","description":"Delayed breast prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Beta pres or already taking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9189","description":"Beta pres or already taking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHC1","description":"ICD-OJHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFA1","description":"ICD-GHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise thumb tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26490","description":"Revise thumb tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Strep a dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87651","description":"Strep a dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99282","description":"Emergency dept visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBB1","description":"ICD-CDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFC0","description":"ICD-GCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMF1","description":"ICD-FDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMD0","description":"ICD-BHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE215","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHF0","description":"ICD-NLHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath tbs c/v select","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88167","description":"Cytopath tbs c/v select","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUA1","description":"ICD-CDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE160","description":"Clinically Complex _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWE0","description":"ICD-HDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blooc clot factor v test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85220","description":"Blooc clot factor v test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5160","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","description":"HCPCS-Q5160","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPE0","description":"ICD-BAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Barium swallow test ordered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3142F","description":"Barium swallow test ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diphtheria antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86648","description":"Diphtheria antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHC0","description":"ICD-EGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEE1","description":"ICD-CCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIID0","description":"ICD-CIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Av fistula revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36833","description":"Av fistula revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18I","description":"Clinically Complex _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Etidronate disodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1436","description":"Etidronate disodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esano aca_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4275","description":"Esano aca_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj multihance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9577","description":"Inj multihance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam ribs bil 3 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71110","description":"X-ray exam ribs bil 3 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00192","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00192","description":"CPT-00192","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of magnesium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83735","description":"Assay of magnesium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of knee ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27405","description":"Repair of knee ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ micafungin sodium (par pharm) not thereapeutically equivalent to j2248_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2247","description":"Injection_ micafungin sodium (par pharm) not thereapeutically equivalent to j2248_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUF0","description":"ICD-NHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRD0","description":"ICD-GGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWE0","description":"ICD-PJWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of nose lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30000","description":"Drainage of nose lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXB0","description":"ICD-CDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37274","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","description":"CPT-37274","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHD0","description":"ICD-KHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUD0","description":"ICD-IDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBB0","description":"ICD-MFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVD1","description":"ICD-OCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kafo dbl solid stirrup w/o j","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2030","description":"Kafo dbl solid stirrup w/o j","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLB0","description":"ICD-MCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUC0","description":"ICD-KCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFE0","description":"ICD-BDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Optical endomicroscpy interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88375","description":"Optical endomicroscpy interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGME0","description":"ICD-KGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEF0","description":"ICD-IAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI and WAIS)_ with qualified health","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96102","description":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI and WAIS)_ with qualified health","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYB0","description":"ICD-KFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQD1","description":"ICD-DIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of progesterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84234","description":"Assay of progesterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trifoc prscrp lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0508","description":"Trifoc prscrp lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst w/enterocele repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58270","description":"Vag hyst w/enterocele repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVE0","description":"ICD-FAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAE1","description":"ICD-CAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDE0","description":"ICD-MFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4BA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BA11","description":"ICD-4BA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECC1","description":"ICD-AECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOA1","description":"ICD-HIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reusable enema bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4458","description":"Reusable enema bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ blinatumomab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9039","description":"Injection_ blinatumomab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWA0","description":"ICD-KGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXA1","description":"ICD-NFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special med equip_ noswaiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2029","description":"Special med equip_ noswaiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc forearm les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25075","description":"Exc forearm les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEE0","description":"ICD-CGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAD0","description":"ICD-MCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thumb fusion with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26820","description":"Thumb fusion with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENF0","description":"ICD-JENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28A","description":"Special Care High _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWB0","description":"ICD-PLWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antipsychotics nos 1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80342","description":"Antipsychotics nos 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYB0","description":"ICD-PEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUF1","description":"ICD-EBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incis spine 3 column lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22207","description":"Incis spine 3 column lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hg a1c level lt 7.0%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3044F","description":"Hg a1c level lt 7.0%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDC0","description":"ICD-KFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB2A","description":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcath emboliz microspher","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2095","description":"Transcath emboliz microspher","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIE1","description":"ICD-ADIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA22B","description":"Clinically Complex _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGD0","description":"ICD-CBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.6-1.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11311","description":"Shave skin lesion 0.6-1.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDE1","description":"ICD-CGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc idrl spine lesn lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63282","description":"Bx/exc idrl spine lesn lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp2 std seat elevate cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0831","description":"Pwc gp2 std seat elevate cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ald neck_ loop ind receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5283","description":"Ald neck_ loop ind receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEE0","description":"ICD-IEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITF0","description":"ICD-GITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGA0","description":"ICD-NGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unplnd ret to surg w in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9308","description":"Unplnd ret to surg w in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay porc 3/more sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2630","description":"Dental onlay porc 3/more sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ palonosetron HCl (Avyxa)_ not therapeutically equivalent to J2469_ 25 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2468","description":"Injection_ palonosetron HCl (Avyxa)_ not therapeutically equivalent to J2469_ 25 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dexamethasone panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80420","description":"Dexamethasone panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL4C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUF0","description":"ICD-KBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open tx nose fx w/skele fixj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21330","description":"Open tx nose fx w/skele fixj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES35D","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLD0","description":"ICD-CFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trnsprnl Impl Prm Adj Balln Cnt Dvc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9746","description":"Trnsprnl Impl Prm Adj Balln Cnt Dvc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSA0","description":"ICD-LHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES234","description":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home vent mgmt supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94005","description":"Home vent mgmt supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIF1","description":"ICD-KAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D6280","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D6280","description":"CDT-D6280","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHC1","description":"ICD-AAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB45","description":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBF0","description":"ICD-MEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDE1","description":"ICD-BFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB215","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYD1","description":"ICD-DFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43620","description":"Removal of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral counseling for diabetes prevention_ distance learning_ 60 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9887","description":"Behavioral counseling for diabetes prevention_ distance learning_ 60 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Missed appointment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9986","description":"Missed appointment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGE1","description":"ICD-NCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54220","description":"Treatment of penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVA1","description":"ICD-NEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOB0","description":"ICD-CAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artacent cord_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4216","description":"Artacent cord_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0676U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676U","description":"CPT-0676U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Harvest art for cabg add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35600","description":"Harvest art for cabg add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemo hormon antineopl sq/im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96402","description":"Chemo hormon antineopl sq/im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJB0","description":"ICD-JCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1183","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Child sitting services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1009","description":"Child sitting services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMD1","description":"ICD-EEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBD1","description":"ICD-KIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sterile_ gloves per pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4930","description":"Sterile_ gloves per pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIE0","description":"ICD-EDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJC0","description":"ICD-JEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flowcytometry/read 16 & >","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88189","description":"Flowcytometry/read 16 & >","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCA1","description":"ICD-IGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA2C","description":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQF0","description":"ICD-GCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXF0","description":"ICD-CHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ob us detailed addl fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76812","description":"Ob us detailed addl fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trichomonas vagin dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87660","description":"Trichomonas vagin dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEB1","description":"ICD-CEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQD1","description":"ICD-GDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4CB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CB11","description":"ICD-4CB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKC0","description":"ICD-FFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMC1","description":"ICD-CFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD156","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWA1","description":"ICD-LEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAB0","description":"ICD-AGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC260","description":"Clinically Complex _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6009","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYF0","description":"ICD-KHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECA1","description":"ICD-NECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIE0","description":"ICD-CGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNA1","description":"ICD-GDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDD1","description":"ICD-IEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Root surgery ea add root","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3426","description":"Root surgery ea add root","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOE0","description":"ICD-OHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAD1","description":"ICD-JDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMA0","description":"ICD-OIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL41","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUB0","description":"ICD-AEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Meals when receive services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1010","description":"Meals when receive services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plerixafor injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2562","description":"Plerixafor injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVC0","description":"ICD-NLVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHC1","description":"ICD-OIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine eltrd perq aray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63661","description":"Remove spine eltrd perq aray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Us exam infant hips static","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76886","description":"Us exam infant hips static","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLD1","description":"ICD-NKLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-routine bl draw 3/> yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36410","description":"Non-routine bl draw 3/> yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (genitourinary pathogens)_ antibiotic-resistance gene detection_ multiplex amplified probe technique_ urine_ reported as an antimicrobial stewardship risk s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0372U","description":"Infectious disease (genitourinary pathogens)_ antibiotic-resistance gene detection_ multiplex amplified probe technique_ urine_ reported as an antimicrobial stewardship risk s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24498","description":"Reinforce humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty_ central dialysis segment_ performed through dialysis circuit_ including all imaging and radiological supervision and interpretation required","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36907","description":"Transluminal balloon angioplasty_ central dialysis segment_ performed through dialysis circuit_ including all imaging and radiological supervision and interpretation required","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ evinacumab-dgnb_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9079","description":"Injection_ evinacumab-dgnb_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIE0","description":"ICD-MLIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAE1","description":"ICD-CEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No rsk fac or 1 mod risk te","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8970","description":"No rsk fac or 1 mod risk te","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel drg <= 16 in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6245","description":"Hydrogel drg <= 16 in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Analyze pacemaker system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93724","description":"Analyze pacemaker system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPC1","description":"ICD-BIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRA0","description":"ICD-HDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGME1","description":"ICD-FGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVE1","description":"ICD-FDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVA1","description":"ICD-BCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esoph fundoplasty lap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43327","description":"Esoph fundoplasty lap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eye exam with photos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92230","description":"Eye exam with photos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIA1","description":"ICD-JDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amniotic fluid scan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82143","description":"Amniotic fluid scan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of eyelid lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68040","description":"Treatment of eyelid lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBA1","description":"ICD-JFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML31","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSE1","description":"ICD-PKSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMA1","description":"ICD-KBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSA0","description":"ICD-OLSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAD0","description":"ICD-FEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6084","description":"Implant Supported Crown - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUF0","description":"ICD-JIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQB0","description":"ICD-HGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transthor diaphrag hern rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43335","description":"Transthor diaphrag hern rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWB1","description":"ICD-HGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKC1","description":"ICD-GHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVA0","description":"ICD-CBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCE1","description":"ICD-GGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEE1","description":"ICD-KDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA14D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFC1","description":"ICD-OJFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAF0","description":"ICD-ICAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEE1","description":"ICD-NDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLD0","description":"ICD-EBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Beremagene geperpavec-svdt for topical administration_ containing nominal 5 x 10^9 pfu/ml vector genomes_ per 0.1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3401","description":"Beremagene geperpavec-svdt for topical administration_ containing nominal 5 x 10^9 pfu/ml vector genomes_ per 0.1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBE0","description":"ICD-MEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esoph endoscopy dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43226","description":"Esoph endoscopy dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUF1","description":"ICD-OHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKF0","description":"ICD-GBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFE1","description":"ICD-NFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC24","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUF1","description":"ICD-JIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHF1","description":"ICD-NCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of neck wrinkles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15825","description":"Removal of neck wrinkles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHED1","description":"ICD-FHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esoph scope w/submucous inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43201","description":"Esoph scope w/submucous inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYA1","description":"ICD-GFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBA0","description":"ICD-KBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lens lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66830","description":"Removal of lens lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwr adpt pneum vad_ rep veh","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0504","description":"Pwr adpt pneum vad_ rep veh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDB1","description":"ICD-OFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD12B","description":"Special Care Low _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Change of bladder tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51705","description":"Change of bladder tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDD0","description":"ICD-NLDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3KC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KC11","description":"ICD-3KC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKA1","description":"ICD-NIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYF0","description":"ICD-HBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ileostomy/jejunostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44310","description":"Ileostomy/jejunostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cr51 chromate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9553","description":"Cr51 chromate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVD0","description":"ICD-OFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA150","description":"Reduced Physical Function _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC22C","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orth foot non-stndard size/w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3254","description":"Orth foot non-stndard size/w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0689U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689U","description":"CPT-0689U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy/needle bx each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31629","description":"Bronchoscopy/needle bx each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLB0","description":"ICD-OCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLB0","description":"ICD-CHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIC0","description":"ICD-BBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVB0","description":"ICD-NAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVA0","description":"ICD-OHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFC1","description":"ICD-CGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rebuild outer ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69310","description":"Rebuild outer ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCE0","description":"ICD-NHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bladder lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51530","description":"Removal of bladder lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Valvuloplasty tricuspid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33464","description":"Valvuloplasty tricuspid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBE0","description":"ICD-OIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMC0","description":"ICD-ABMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Icar ischm mntrng sys eltrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0303T","description":"Icar ischm mntrng sys eltrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC13A","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Penis study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54250","description":"Penis study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt scrnd hgh-risk sex behav","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4293F","description":"Pt scrnd hgh-risk sex behav","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWF1","description":"ICD-CHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBB1","description":"ICD-NDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Emtricitabine 200mg and tenofovir alafenamide 25mg_ oral_ fda approved prescription_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0751","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg_ oral_ fda approved prescription_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILE0","description":"ICD-BILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay secretory type ii pla2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0423T","description":"Assay secretory type ii pla2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOB0","description":"ICD-KGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Appl multlay comprs arm/hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29584","description":"Appl multlay comprs arm/hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMF1","description":"ICD-ICMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRC0","description":"ICD-PLRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQB0","description":"ICD-CFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYA0","description":"ICD-PHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMD0","description":"ICD-NHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGE1","description":"ICD-JAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enterectomy w/o taper cong","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44126","description":"Enterectomy w/o taper cong","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mdd severe w/o psych","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3090F","description":"Mdd severe w/o psych","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic Interventions That Focus On Cognitive Function (Eg_ Attention_ Memory_ Reasoning_ Executive Function_ Problem Solving_ And/Or Pragmatic Functioning) And Compensato","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97130","description":"Therapeutic Interventions That Focus On Cognitive Function (Eg_ Attention_ Memory_ Reasoning_ Executive Function_ Problem Solving_ And/Or Pragmatic Functioning) And Compensato","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1489","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","description":"HCPCS-M1489","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICF0","description":"ICD-OICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB240","description":"Special Care High _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXD0","description":"ICD-FFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFME1","description":"ICD-EFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlso flex trunk/thor pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0450","description":"Tlso flex trunk/thor pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXC1","description":"ICD-BDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74430","description":"Contrast x-ray bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraocular fomivirsen na","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1452","description":"Intraocular fomivirsen na","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATF1","description":"ICD-FATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIF0","description":"ICD-GFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJA0","description":"ICD-BHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apply r&l pulm art bands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33620","description":"Apply r&l pulm art bands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Debride nail 6 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11721","description":"Debride nail 6 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of parastomal hernia_ any approach (ie_ open_ laparoscopic_ robotic)_ initial or recurrent_ including implantation of mesh or other prosthesis_ when performed; reducibl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49621","description":"Repair of parastomal hernia_ any approach (ie_ open_ laparoscopic_ robotic)_ initial or recurrent_ including implantation of mesh or other prosthesis_ when performed; reducibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDF0","description":"ICD-GGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFF0","description":"ICD-FFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLA0","description":"ICD-KGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQD0","description":"ICD-LGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAF1","description":"ICD-FIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Colorectal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1086","description":"Radiation Therapy For Colorectal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRB1","description":"ICD-CGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ emicizumab-kxwh_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9995","description":"Injection_ emicizumab-kxwh_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAE0","description":"ICD-EGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTA0","description":"ICD-IGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELA1","description":"ICD-NELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHE1","description":"ICD-IBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1601","description":"HCPCS-A1601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOA1","description":"ICD-PCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHF1","description":"ICD-OCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heart infarct image (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78469","description":"Heart infarct image (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHC0","description":"ICD-NHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lvef greater than 35%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3056F","description":"Lvef greater than 35%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXF1","description":"ICD-NEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYB1","description":"ICD-CEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFD1","description":"ICD-OKFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCC1","description":"ICD-AFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE110","description":"Special Care High _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVD1","description":"ICD-CIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUA0","description":"ICD-GBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64565","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine chloride","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82436","description":"Assay of urine chloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIC1","description":"ICD-AIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68360","description":"Revise eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATE0","description":"ICD-BATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pulp cap direct","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3110","description":"Pulp cap direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVE0","description":"ICD-OJVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stereotactic body radiation therapy_ treatment delivery_ per fraction to 1 or more lesions_ including image guidance and real-time positron emissions-based delivery adjustment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9795","description":"Stereotactic body radiation therapy_ treatment delivery_ per fraction to 1 or more lesions_ including image guidance and real-time positron emissions-based delivery adjustment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCF1","description":"ICD-FGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0858T","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWB0","description":"ICD-CBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61321","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSA0","description":"ICD-GCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Topical app of fluoride","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1208","description":"Topical app of fluoride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEF0","description":"ICD-MIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBA1","description":"ICD-JDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXE1","description":"ICD-OAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92986","description":"Revision of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFB1","description":"ICD-CGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic control thoracic ba","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2660","description":"Thoracic control thoracic ba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARF0","description":"ICD-GARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB55","description":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIF1","description":"ICD-IGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fem/popl revas w/ather","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37225","description":"Fem/popl revas w/ather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIF1","description":"ICD-JGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair lumbar hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49540","description":"Repair lumbar hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTF0","description":"ICD-GBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIF1","description":"ICD-AAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC144","description":"Special Care High _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFID1","description":"ICD-JFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCC0","description":"ICD-CDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy and biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45380","description":"Colonoscopy and biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIC0","description":"ICD-OGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL3D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLD1","description":"ICD-ADLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of nickel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83885","description":"Assay of nickel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERA0","description":"ICD-CERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXD1","description":"ICD-CAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB210","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not providing tobacco cessation intervention if identified as a tobacco user (e.g._ limited life expectancy_ other medical reason)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9909","description":"Documentation of medical reason(s) for not providing tobacco cessation intervention if identified as a tobacco user (e.g._ limited life expectancy_ other medical reason)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50561","description":"Kidney endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75658","description":"Artery x-rays arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVF0","description":"ICD-BGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Impact tooth remov comp bony","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7240","description":"Impact tooth remov comp bony","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41822","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUC1","description":"ICD-JBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIC1","description":"ICD-MFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAE1","description":"ICD-GFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDC0","description":"ICD-KIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of skull arteries","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61711","description":"Fusion of skull arteries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise penis/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54328","description":"Revise penis/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA2B","description":"Low Rehab_ ADL Index 0-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj paravert f jnt c/t 2 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64491","description":"Inj paravert f jnt c/t 2 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18F","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQE1","description":"ICD-DIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX0B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHC1","description":"ICD-BHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYA0","description":"ICD-KFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Etonogestrel implant system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7307","description":"Etonogestrel implant system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Microprcsr cu elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0481","description":"Microprcsr cu elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKA0","description":"ICD-CCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACF1","description":"ICD-MACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTF1","description":"ICD-ADTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQD0","description":"ICD-DGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJC1","description":"ICD-KEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBE0","description":"ICD-KIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHE0","description":"ICD-AEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYC0","description":"ICD-DBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEF1","description":"ICD-CHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDF0","description":"ICD-GHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"External transmitter_ cgm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9277","description":"External transmitter_ cgm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADD1","description":"ICD-FADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin exo fluid swing ph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5724","description":"Knee-shin exo fluid swing ph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt infosys alarm 4 nxt mammo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"7025F","description":"Pt infosys alarm 4 nxt mammo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHF0","description":"ICD-MCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJC0","description":"ICD-KCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSF0","description":"ICD-DFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJF1","description":"ICD-OCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKE0","description":"ICD-CIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPC1","description":"ICD-KIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eye exam with photos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92250","description":"Eye exam with photos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCA1","description":"ICD-OBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTF1","description":"ICD-NLTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIB1","description":"ICD-KDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUB0","description":"ICD-FBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES11C","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDD0","description":"ICD-CIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx chron care addl 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99489","description":"Cmplx chron care addl 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIC0","description":"ICD-NCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEB1","description":"ICD-CCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLA0","description":"ICD-CDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC2A","description":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spec site no lung","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9420","description":"Spec site no lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLF0","description":"ICD-IBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYD0","description":"ICD-HFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"A/d halfway house_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2034","description":"A/d halfway house_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cptr ophth dx img post segmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92134","description":"Cptr ophth dx img post segmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal aneuploidy (trisomy 13_ 18_ and 21)_ DNA sequence analysis of selected regions using maternal plasma_ algorithm reported as a risk score for each trisomy_ includes sex r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0327U","description":"Fetal aneuploidy (trisomy 13_ 18_ and 21)_ DNA sequence analysis of selected regions using maternal plasma_ algorithm reported as a risk score for each trisomy_ includes sex r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES13A","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVA0","description":"ICD-BHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam thorac spine 3vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72072","description":"X-ray exam thorac spine 3vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVB0","description":"ICD-FDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX26","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATF0","description":"ICD-OATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s)_ all","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34707","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s)_ all","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Debride infected skin add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11001","description":"Debride infected skin add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLE1","description":"ICD-MHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompress forearm 1 space","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25020","description":"Decompress forearm 1 space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAC0","description":"ICD-NEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB14A","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shigella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86771","description":"Shigella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUE0","description":"ICD-FBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"PrecisionBloodā„¢_ San Diego Blood Bank","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0246U","description":"PrecisionBloodā„¢_ San Diego Blood Bank","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp3 std sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0856","description":"Pwc gp3 std sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPF1","description":"ICD-KHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLF1","description":"ICD-GHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMB0","description":"ICD-OHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWD0","description":"ICD-PKWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mult mech switches","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2322","description":"Mult mech switches","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLD0","description":"ICD-NDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUC1","description":"ICD-FGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Complete sl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4270","description":"Complete sl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHF0","description":"ICD-CCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGC0","description":"ICD-BHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCE0","description":"ICD-EDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGD0","description":"ICD-FBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSA0","description":"ICD-KBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWC0","description":"ICD-PEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Butorphanol tartrate_ nasal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0012","description":"Butorphanol tartrate_ nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ dexamethasone acetate_ per 1mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1095","description":"Injection_ dexamethasone acetate_ per 1mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair spec sz spec ht b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1228","description":"Wheelchair spec sz spec ht b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEME0","description":"ICD-NEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecg monit/reprt up to 48 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93226","description":"Ecg monit/reprt up to 48 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj testosterone cypionate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1071","description":"Inj testosterone cypionate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVF1","description":"ICD-KEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6073","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB240","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1504","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1504","description":"CDT-D1504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Growth hormone antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86277","description":"Growth hormone antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOE1","description":"ICD-LIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDF0","description":"ICD-NCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA53","description":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAE0","description":"ICD-OBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJC0","description":"ICD-GHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAF0","description":"ICD-CGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCB0","description":"ICD-GCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oral device/appliance used to reduce upper airway collapsibility_ without fixed mechanical hinge_ custom fabricated_ includes fitting and adjustment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1027","description":"Oral device/appliance used to reduce upper airway collapsibility_ without fixed mechanical hinge_ custom fabricated_ includes fitting and adjustment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No start/rec antvir tx hep c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9499","description":"No start/rec antvir tx hep c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair no. 2 footplates","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0970","description":"Wheelchair no. 2 footplates","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAA0","description":"ICD-ADAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFB1","description":"ICD-JFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIA1","description":"ICD-IBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWC1","description":"ICD-DAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0914T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","description":"CPT-0914T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAF0","description":"ICD-NHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBA0","description":"ICD-CFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation tx management x5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77427","description":"Radiation tx management x5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of rectal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45005","description":"Drainage of rectal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp3 hd sing pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0859","description":"Pwc gp3 hd sing pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAE1","description":"ICD-MAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIC1","description":"ICD-JGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBB0","description":"ICD-OCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQD1","description":"ICD-DAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGA0","description":"ICD-OHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ambulance response/treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0998","description":"Ambulance response/treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wireless Skin Sensor Thermal Anisotropy Measurement(S) And Assessment Of Flow In Cerebrospinal Fluid Shunt_ Including Ultrasound Guidance_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0639T","description":"Wireless Skin Sensor Thermal Anisotropy Measurement(S) And Assessment Of Flow In Cerebrospinal Fluid Shunt_ Including Ultrasound Guidance_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGA0","description":"ICD-FHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYA0","description":"ICD-GAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit12.6-20","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12045","description":"Intmd rpr n-hf/genit12.6-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFD1","description":"ICD-OAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVF1","description":"ICD-KFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES231","description":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54115","description":"Treatment of penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBE0","description":"ICD-OJBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breast tomosynthesis bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77063","description":"Breast tomosynthesis bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Phentolaine mesylate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2760","description":"Phentolaine mesylate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct both jaws","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0383","description":"Cone beam ct both jaws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental prophylaxis adult","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1110","description":"Dental prophylaxis adult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHF0","description":"ICD-MBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETB1","description":"ICD-JETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0406","description":"HCPCS-A0406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPA1","description":"ICD-FGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRA1","description":"ICD-ODRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALA1","description":"ICD-FALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYF1","description":"ICD-LIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of foot bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28288","description":"Partial removal of foot bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36217","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES120","description":"Extensive Services _ ADL Index 2-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB30","description":"Ultra High Rehab _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOB1","description":"ICD-GHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mod sed diff phys/qhp 5/>yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99149","description":"Mod sed diff phys/qhp 5/>yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAC1","description":"ICD-FHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHF0","description":"ICD-EDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extracorp shock wv tx ms nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0019T","description":"Extracorp shock wv tx ms nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contracept iud","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4989","description":"Contracept iud","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Md certification hha patient","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0180","description":"Md certification hha patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat big toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28505","description":"Treat big toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87627","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","description":"CPT-87627","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Attempted vbac delivery only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59620","description":"Attempted vbac delivery only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remov/replc ur sphinctr comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53448","description":"Remov/replc ur sphinctr comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mecasermin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2170","description":"Mecasermin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art pancreas inv disp sensor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1035","description":"Art pancreas inv disp sensor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace aortic valve w/byp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33368","description":"Replace aortic valve w/byp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAD1","description":"ICD-KBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1552","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","description":"HCPCS-J1552","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inject spine w/cath crv/thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62318","description":"Inject spine w/cath crv/thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laser tx skin >500 sq cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96922","description":"Laser tx skin >500 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35211","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCF0","description":"ICD-KCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artacent wound_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4169","description":"Artacent wound_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hip arthr0 w/synovectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29863","description":"Hip arthr0 w/synovectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgery of great vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33916","description":"Surgery of great vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEB1","description":"ICD-AHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEB1","description":"ICD-IIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Memoderm/derma/tranz/integup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4126","description":"Memoderm/derma/tranz/integup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunofluor antb addl stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88350","description":"Immunofluor antb addl stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement_ aortic valve; by translocation of autologous pulmonary valve and transventricular aortic annulus enlargement of the left ventricular outflow tract with valved con","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33440","description":"Replacement_ aortic valve; by translocation of autologous pulmonary valve and transventricular aortic annulus enlargement of the left ventricular outflow tract with valved con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNB1","description":"ICD-KHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace aortic valve open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33365","description":"Replace aortic valve open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0303","description":"HCPCS-B0303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGD0","description":"ICD-FFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMD1","description":"ICD-ACMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXF1","description":"ICD-BHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYB1","description":"ICD-LBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of knuckle with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26852","description":"Fusion of knuckle with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLD1","description":"ICD-CGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSC1","description":"ICD-CBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBB1","description":"ICD-BCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFA0","description":"ICD-CBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAB0","description":"ICD-NCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ThyGeNEXTĀ® Thyroid Oncogene Panel_ Interpace Diagnostics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0245U","description":"ThyGeNEXTĀ® Thyroid Oncogene Panel_ Interpace Diagnostics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Portable liquid 02","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0434","description":"Portable liquid 02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUC1","description":"ICD-MDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKE1","description":"ICD-CGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coch implant trans coil repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8617","description":"Coch implant trans coil repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEE1","description":"ICD-NAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBB0","description":"ICD-AIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Whole body photography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96904","description":"Whole body photography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLA1","description":"ICD-IHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA52","description":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc extend prosth init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34825","description":"Endovasc extend prosth init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sup fee antiem_antica_immuno","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0511","description":"Sup fee antiem_antica_immuno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Combination sit to stand sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0637","description":"Combination sit to stand sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive adjuvant treatment course including both chemotherapy and her2-targeted therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2208","description":"Patient did not receive adjuvant treatment course including both chemotherapy and her2-targeted therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADB1","description":"ICD-MADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAB0","description":"ICD-CHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASF1","description":"ICD-LASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Romidepsin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9315","description":"Romidepsin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWF0","description":"ICD-LEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSD1","description":"ICD-DDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dark adaptation eye exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92284","description":"Dark adaptation eye exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43020","description":"Incision of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB145","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKC0","description":"ICD-NAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1139","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parasymp&symp hrt rate test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95943","description":"Parasymp&symp hrt rate test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOE1","description":"ICD-PCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHF0","description":"ICD-OHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inject suprvlv aortography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93567","description":"Inject suprvlv aortography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUD1","description":"ICD-FAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suspension of uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58410","description":"Suspension of uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACF0","description":"ICD-FACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIF1","description":"ICD-IBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHA1","description":"ICD-KGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQB1","description":"ICD-OIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33966","description":"Ecmo/ecls rmvl prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of finger tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26471","description":"Fusion of finger tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYD0","description":"ICD-LEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8E","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B2003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2003","description":"HCPCS-B2003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablation of malignant prostate tissue by magnetic field induction_ including all intraprocedural_ transperineal needle/catheter placement for nanoparticle installation and int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0739T","description":"Ablation of malignant prostate tissue by magnetic field induction_ including all intraprocedural_ transperineal needle/catheter placement for nanoparticle installation and int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELD1","description":"ICD-JELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBF0","description":"ICD-IBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Io rad tx deliver by elctrns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77425","description":"Io rad tx deliver by elctrns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCD0","description":"ICD-NKCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nesiritide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2325","description":"Nesiritide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26992","description":"Drainage of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOE1","description":"ICD-OFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"O shoe convert to sof counte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3590","description":"O shoe convert to sof counte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Minoxidil_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0139","description":"Minoxidil_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB4A","description":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation physics consult","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77370","description":"Radiation physics consult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILB1","description":"ICD-JILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gadoxetate disodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9581","description":"Gadoxetate disodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Phq-9 >9 during 12m time","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9511","description":"Phq-9 >9 during 12m time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYA0","description":"ICD-OKYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC2C","description":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Add ue prost b/e acrylic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7403","description":"Add ue prost b/e acrylic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surg reduct osseoustuberosit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7485","description":"Surg reduct osseoustuberosit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLC0","description":"ICD-OFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJE0","description":"ICD-KHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert picvad cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36571","description":"Insert picvad cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLF1","description":"ICD-OKLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert pacing lead & connect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33224","description":"Insert pacing lead & connect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE160","description":"Reduced Physical Function _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB06","description":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel drg >16<=48 w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6243","description":"Hydrogel drg >16<=48 w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUF0","description":"ICD-EGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adult size brief/diaper lg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4523","description":"Adult size brief/diaper lg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0780T","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA0C","description":"Default_ /SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ald fm/dm system binaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5282","description":"Ald fm/dm system binaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX1B","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOB1","description":"ICD-GFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of renin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84244","description":"Assay of renin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQB1","description":"ICD-OCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUD0","description":"ICD-KFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transducer protect/fld bar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1575","description":"Transducer protect/fld bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01634","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01634","description":"CPT-01634","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACC1","description":"ICD-AACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXF0","description":"ICD-OFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGF1","description":"ICD-NEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXE1","description":"ICD-FBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES24A","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 10-12 under the MDPP Expanded Model (EM).","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9877","description":"Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 10-12 under the MDPP Expanded Model (EM).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB115","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75651","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA226","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Activity therapy_ per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2032","description":"Activity therapy_ per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Arthrodesis sacroiliac joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27279","description":"Arthrodesis sacroiliac joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open red comp malar/zygma fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7750","description":"Open red comp malar/zygma fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOC0","description":"ICD-HHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heavyduty/wide commode chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0168","description":"Heavyduty/wide commode chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAD0","description":"ICD-KIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMB0","description":"ICD-FHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAB0","description":"ICD-NBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-S4024","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","description":"HCPCS-S4024","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB210","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEID0","description":"ICD-EEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD224","description":"Clinically Complex _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWD1","description":"ICD-OAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6609","description":"Gradient compression bandaging supply_ not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28735","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFC0","description":"ICD-NDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJE1","description":"ICD-JFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUF0","description":"ICD-BDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Deionizer h2o puri system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1615","description":"Deionizer h2o puri system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITC1","description":"ICD-BITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Porcine implant_ permacol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9364","description":"Porcine implant_ permacol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDB0","description":"ICD-KFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise knuckle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26530","description":"Revise knuckle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocolloid drg filler dry","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6241","description":"Hydrocolloid drg filler dry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWC1","description":"ICD-HBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00846","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00846","description":"CPT-00846","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antidepressant tricyclic 1/2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80335","description":"Antidepressant tricyclic 1/2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insulin pump initiation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9145","description":"Insulin pump initiation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQC0","description":"ICD-OEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No cont ppi or h2ra rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4186F","description":"No cont ppi or h2ra rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA26","description":"Default_ /14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01820","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01820","description":"CPT-01820","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC240","description":"Clinically Complex _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydroxyzine pamoate 25mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0177","description":"Hydroxyzine pamoate 25mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBID1","description":"ICD-NBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunohisto antb 1st stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88342","description":"Immunohisto antb 1st stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAC0","description":"ICD-KEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOB1","description":"ICD-CAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEB0","description":"ICD-FEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTC1","description":"ICD-GHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXE0","description":"ICD-OAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRB1","description":"ICD-PKRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPA1","description":"ICD-FDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMB0","description":"ICD-MIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJA1","description":"ICD-BDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Io ga n-stim subsq w/reprog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95982","description":"Io ga n-stim subsq w/reprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rout foot care per visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0390","description":"Rout foot care per visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCC1","description":"ICD-FCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score hip >= 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8651","description":"Fun stat score hip >= 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLA1","description":"ICD-MGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Body pos current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8981","description":"Body pos current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trastuzumab not administered within 12 months of diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9837","description":"Trastuzumab not administered within 12 months of diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML22","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electron elbow adolescent sw","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7185","description":"Electron elbow adolescent sw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBF0","description":"ICD-OJBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27350","description":"Removal of kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQD1","description":"ICD-LFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTC0","description":"ICD-MHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBA0","description":"ICD-FBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEB1","description":"ICD-GIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEF1","description":"ICD-AHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg 0.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11600","description":"Exc tr-ext mal+marg 0.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRA0","description":"ICD-DFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73120","description":"X-ray exam of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Control nose/throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42970","description":"Control nose/throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL40","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopy of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50953","description":"Endoscopy of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUC1","description":"ICD-JCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLD1","description":"ICD-EFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42950","description":"Reconstruction of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADE1","description":"ICD-MADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESC0","description":"ICD-DESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLD0","description":"ICD-MGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1401","description":"HCPCS-A1401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB20","description":"Very High Rehab _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder passive restor comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6310","description":"Shoulder passive restor comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB155","description":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDC1","description":"ICD-ADDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16071","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16071","description":"CPT-16071","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"The Number Of Adult Patient-Months In The Denominator Who Were On Maintenance Hemodialysis Using A Catheter Continuously For Three Months Or Longer Under The Care Of The Same","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1026","description":"The Number Of Adult Patient-Months In The Denominator Who Were On Maintenance Hemodialysis Using A Catheter Continuously For Three Months Or Longer Under The Care Of The Same","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSA1","description":"ICD-DHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alpha-fetoprotein serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82105","description":"Alpha-fetoprotein serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18B","description":"Special Care Low _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lacosamide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9254","description":"Injection_ lacosamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin pro/pos wc cus wd>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2608","description":"Skin pro/pos wc cus wd>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEB0","description":"ICD-MCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Personal Emergency Response System (Installation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1894","description":"Personal Emergency Response System (Installation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLE0","description":"ICD-IGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRB1","description":"ICD-HIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFB0","description":"ICD-JAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ewho w/joint(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3764","description":"Ewho w/joint(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIC1","description":"ICD-NAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYA0","description":"ICD-DEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA07","description":"Default_ /Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ with iliac and/or femoral artery angiograph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7517","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ with iliac and/or femoral artery angiograph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQF1","description":"ICD-HCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVA1","description":"ICD-NDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery_ procedure or test with analysis_ review and report_ leadle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0390T","description":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery_ procedure or test with analysis_ review and report_ leadle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who are breastfeeding","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9779","description":"Patients who are breastfeeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medical home_ initial plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0280","description":"Medical home_ initial plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Craniofacial approach skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61582","description":"Craniofacial approach skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Paliperidone palmitate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2426","description":"Paliperidone palmitate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vagotomy & pylorus repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43640","description":"Vagotomy & pylorus repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLE0","description":"ICD-GDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDB1","description":"ICD-KBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transplant femur ridge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27140","description":"Transplant femur ridge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJA0","description":"ICD-NDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPA1","description":"ICD-BEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJE0","description":"ICD-CDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prep bk ptb laminated socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5540","description":"Prep bk ptb laminated socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEB0","description":"ICD-AFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNA0","description":"ICD-GHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE21C","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCB0","description":"ICD-ADCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHF0","description":"ICD-CGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Right Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone; Abnormal Native Connecti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93594","description":"Right Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone; Abnormal Native Connecti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCA1","description":"ICD-OJCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tib/per revasc w/tla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37228","description":"Tib/per revasc w/tla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUF0","description":"ICD-OKUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Safety equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0700","description":"Safety equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMB1","description":"ICD-MLMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPB0","description":"ICD-NBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSF0","description":"ICD-CFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enverse_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4258","description":"Enverse_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYB1","description":"ICD-LGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of eyelid abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67700","description":"Drainage of eyelid abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRD0","description":"ICD-OLRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGE0","description":"ICD-NFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVC1","description":"ICD-KDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBF0","description":"ICD-IHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGF0","description":"ICD-CCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWA0","description":"ICD-LBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLE1","description":"ICD-GGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt not consid poss risk fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3573F","description":"Pt not consid poss risk fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA151","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMF0","description":"ICD-EDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Igh vari regional mutation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81263","description":"Igh vari regional mutation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dermabrasion segmental face","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15781","description":"Dermabrasion segmental face","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB12D","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylinder over 12.00d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2114","description":"Spherocylinder over 12.00d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interro eval npgs sleep apne","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0434T","description":"Interro eval npgs sleep apne","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDF0","description":"ICD-JCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRE0","description":"ICD-OGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLF0","description":"ICD-AGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Athletic training evaluation_ high complexity_ requiring these components: A medical history and physical activity profile_ with 3 or more comorbidities that affect physical a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97171","description":"Athletic training evaluation_ high complexity_ requiring these components: A medical history and physical activity profile_ with 3 or more comorbidities that affect physical a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCB0","description":"ICD-MHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nephrology (chronic kidney disease)_ apolipoprotein A4 (ApoA4)_ CD5 antigen-like (CD5L)_ and insulin-like growth factor binding protein 3 (IGFBP3) by enzyme-linked immunoassay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0385U","description":"Nephrology (chronic kidney disease)_ apolipoprotein A4 (ApoA4)_ CD5 antigen-like (CD5L)_ and insulin-like growth factor binding protein 3 (IGFBP3) by enzyme-linked immunoassay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRF1","description":"ICD-PKRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFF1","description":"ICD-CEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1152","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lso sc r pos/lat pnl pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0633","description":"Lso sc r pos/lat pnl pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRF1","description":"ICD-HDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ko rigid w/o joints pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1836","description":"Ko rigid w/o joints pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Imaging Of Retina For Detection Or Monitoring Of Disease; Point-Of-Care Automated Analysis And Report_ Unilateral Or Bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92229","description":"Imaging Of Retina For Detection Or Monitoring Of Disease; Point-Of-Care Automated Analysis And Report_ Unilateral Or Bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Body fluid specific gravity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84315","description":"Body fluid specific gravity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJB1","description":"ICD-BEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGD1","description":"ICD-NEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAB1","description":"ICD-GFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No conformal radn thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4182F","description":"No conformal radn thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8A","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc med reas no follow imag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9549","description":"Doc med reas no follow imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRD1","description":"ICD-DFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of heart lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93505","description":"Biopsy of heart lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXF0","description":"ICD-NIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVA1","description":"ICD-OIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Cystoscopy/Transurethral Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0615","description":"Hospital Special Treatment Room Support Component (Hstrsc) Cystoscopy/Transurethral Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ht musc image planar mult","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78454","description":"Ht musc image planar mult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLF1","description":"ICD-IHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0903","description":"HCPCS-B0903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No improve visual funct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0915","description":"No improve visual funct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVC1","description":"ICD-NBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIC1","description":"ICD-GDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPE1","description":"ICD-NAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLA0","description":"ICD-CBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASB1","description":"ICD-CASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB22A","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVD0","description":"ICD-BDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOE0","description":"ICD-PCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical; with guided transhepatic cholangiography with biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47561","description":"Laparoscopy_ surgical; with guided transhepatic cholangiography with biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AC11","description":"ICD-3AC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAB1","description":"ICD-MHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dementia measures group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8902","description":"Dementia measures group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Safety counseling dementia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6101F","description":"Safety counseling dementia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISD1","description":"ICD-CISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPD1","description":"ICD-OJPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRD1","description":"ICD-KHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Portable 02 contents_ liquid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0444","description":"Portable 02 contents_ liquid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LB21","description":"ICD-2LB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKD1","description":"ICD-NCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore inner ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69806","description":"Explore inner ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bmi calc_ pt no f/u plan elg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8938","description":"Bmi calc_ pt no f/u plan elg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDE0","description":"ICD-KEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGC1","description":"ICD-OGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQE0","description":"ICD-GCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thyroid met imaging/studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78016","description":"Thyroid met imaging/studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with the power source and control electronics unit_ controlled by phon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0493","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with the power source and control electronics unit_ controlled by phon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0221","description":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy dilate w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31631","description":"Bronchoscopy dilate w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTA0","description":"ICD-EBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5167","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5167","description":"HCPCS-Q5167","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAE1","description":"ICD-BHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlso 2 piece rigid shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0491","description":"Tlso 2 piece rigid shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJC0","description":"ICD-CFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Limb muscle testing manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95831","description":"Limb muscle testing manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal abdomen lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38564","description":"Removal abdomen lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAD0","description":"ICD-OHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft iliofemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35565","description":"Art byp grft iliofemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPA1","description":"ICD-KBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25272","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXB1","description":"ICD-NKXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIB1","description":"ICD-EGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEC0","description":"ICD-FIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure for cholangiography through an existing catheter(eg_ percutaneous transhepatic or t-tube)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47505","description":"Injection procedure for cholangiography through an existing catheter(eg_ percutaneous transhepatic or t-tube)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDE1","description":"ICD-ICDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMF1","description":"ICD-ODMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ionm remote/>1 pt or per hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95941","description":"Ionm remote/>1 pt or per hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat craniofacial fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21436","description":"Treat craniofacial fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBE1","description":"ICD-IFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWC0","description":"ICD-DIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enteral infusion pump w/ ala","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9002","description":"Enteral infusion pump w/ ala","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIE0","description":"ICD-NKIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc tb scrng-rslts interpd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3510F","description":"Doc tb scrng-rslts interpd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant nerve end","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64787","description":"Implant nerve end","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct maxillofacial w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70487","description":"Ct maxillofacial w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD124","description":"Special Care Low _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC40","description":"Very High Rehab _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEB0","description":"ICD-OCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUD0","description":"ICD-GGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAA0","description":"ICD-CHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB154","description":"Clinically Complex _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIE1","description":"ICD-GFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dispensing fee_ monaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5241","description":"Dispensing fee_ monaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15936","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRB0","description":"ICD-GHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75051","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Methadone; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2067","description":"Medication Assisted Treatment_ Methadone; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA STREPTOCOCCUS GROUP A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87430","description":"IAAD IA STREPTOCOCCUS GROUP A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Multi-axial ankle/ft prosth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5979","description":"Multi-axial ankle/ft prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCE1","description":"ICD-ACCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap gastr bypass incl smll i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43645","description":"Lap gastr bypass incl smll i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYD1","description":"ICD-OIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"3d photographic image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0351","description":"3d photographic image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of 5-hiaa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83497","description":"Assay of 5-hiaa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWE1","description":"ICD-PFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ped crit care transport addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99467","description":"Ped crit care transport addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemo iv push addl drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96411","description":"Chemo iv push addl drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth pharyngeal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17451","description":"Anesth pharyngeal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBB1","description":"ICD-AFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18X","description":"Special Care High _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJC1","description":"ICD-NHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJD0","description":"ICD-CIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect forearm/wrist tum<3cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25077","description":"Resect forearm/wrist tum<3cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDA1","description":"ICD-CHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEC0","description":"ICD-EFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0870","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0870","description":"HCPCS-J0870","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Frozen cell preparation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88241","description":"Frozen cell preparation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"SARSCOV2 VAC 50NCG/0.25ML IM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91306","description":"SARSCOV2 VAC 50NCG/0.25ML IM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFA0","description":"ICD-BAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCF1","description":"ICD-MCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eye surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67299","description":"Eye surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDB0","description":"ICD-MDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTA0","description":"ICD-GHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKD0","description":"ICD-OIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMB0","description":"ICD-BGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBB1","description":"ICD-EDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMA0","description":"ICD-IBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVC1","description":"ICD-KFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQE0","description":"ICD-DCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam entire spi 6/> vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72084","description":"X-ray exam entire spi 6/> vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISB1","description":"ICD-OISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCE1","description":"ICD-CBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat midfoot fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28450","description":"Treat midfoot fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVD0","description":"ICD-OKVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRE0","description":"ICD-HDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of tear duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70170","description":"X-ray exam of tear duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVD0","description":"ICD-KGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWA1","description":"ICD-CAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFE1","description":"ICD-JGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENB0","description":"ICD-NENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinician documented that patient was not an eligible candidate for evaluation of footwear as patient is bilateral lower extremity amputee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2180","description":"Clinician documented that patient was not an eligible candidate for evaluation of footwear as patient is bilateral lower extremity amputee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"NEURO MUSC DYS DMD SEQ ALYS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0218U","description":"NEURO MUSC DYS DMD SEQ ALYS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rhophylac injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2791","description":"Rhophylac injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMB0","description":"ICD-AGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB21A","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy w/us needle bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43232","description":"Esophagoscopy w/us needle bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPF1","description":"ICD-NKPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace/irrigate catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62194","description":"Replace/irrigate catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMB1","description":"ICD-BEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBA1","description":"ICD-BCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt cat and thck on report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9294","description":"Pt cat and thck on report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIC1","description":"ICD-ECIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection pantroprazole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0164","description":"Injection pantroprazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Woundplus membrane or e-graft_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4277","description":"Woundplus membrane or e-graft_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKF1","description":"ICD-BDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foam drg > 48 sq in w/border","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6214","description":"Foam drg > 48 sq in w/border","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB15A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKB0","description":"ICD-OAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ef ped specmetabolic inherit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4162","description":"Ef ped specmetabolic inherit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXC1","description":"ICD-FFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ankle bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28130","description":"Removal of ankle bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Derm autograft f/n/hf/g add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15136","description":"Derm autograft f/n/hf/g add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKD1","description":"ICD-FIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1KA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KA31","description":"ICD-1KA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8B","description":"High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB50","description":"High Rehab _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orbitocranial approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61592","description":"Orbitocranial approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Harvest allogeneic stem cell","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38205","description":"Harvest allogeneic stem cell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARD0","description":"ICD-DARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALE0","description":"ICD-BALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBC0","description":"ICD-ADBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1247","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB10","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHB0","description":"ICD-FGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKF1","description":"ICD-NAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3CC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CC21","description":"ICD-3CC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD21B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDC0","description":"ICD-JFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDB0","description":"ICD-OGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBA0","description":"ICD-OKBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ped term dev_ hand_ vol clos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6714","description":"Ped term dev_ hand_ vol clos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPA1","description":"ICD-NJPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilate ic vasospasm add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61642","description":"Dilate ic vasospasm add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISC0","description":"ICD-OISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLF0","description":"ICD-OHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1202","description":"HCPCS-A1202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anti-mullerian hormone (AMH)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82166","description":"Anti-mullerian hormone (AMH)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVC1","description":"ICD-CEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARF1","description":"ICD-HARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUB0","description":"ICD-NIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEB0","description":"ICD-GGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28D","description":"Special Care Low _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAID1","description":"ICD-FAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYE0","description":"ICD-LIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICE1","description":"ICD-KICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1DB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DB11","description":"ICD-1DB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUB0","description":"ICD-FCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27256","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHF0","description":"ICD-MLHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extracorp shockwv tx hi enrg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0101T","description":"Extracorp shockwv tx hi enrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBD1","description":"ICD-MHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHC0","description":"ICD-NEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth bladder stone surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87051","description":"Anesth bladder stone surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIE1","description":"ICD-NGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilated macular exam was not performed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9977","description":"Dilated macular exam was not performed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCA0","description":"ICD-JCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Srs spinal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63620","description":"Srs spinal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of retinal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67218","description":"Treatment of retinal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cervical laminoplsty 2/> seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63050","description":"Cervical laminoplsty 2/> seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0502T","description":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPA0","description":"ICD-KFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVA1","description":"ICD-FDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB217","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA217","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC25B","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTE1","description":"ICD-KDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUC1","description":"ICD-CHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVF1","description":"ICD-JEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Genome sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81426","description":"Genome sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPB0","description":"ICD-OHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIA0","description":"ICD-JIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of tricuspid valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33468","description":"Revision of tricuspid valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJB1","description":"ICD-FIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVA0","description":"ICD-KAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Influenza dna amp prob 1+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87501","description":"Influenza dna amp prob 1+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKB0","description":"ICD-NCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYF0","description":"ICD-LFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMF0","description":"ICD-KGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23500","description":"Treat clavicle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAF1","description":"ICD-JDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUA0","description":"ICD-EBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Culture type pulse field gel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87152","description":"Culture type pulse field gel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sps forearm device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1818","description":"Sps forearm device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDF1","description":"ICD-CEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWE1","description":"ICD-OBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skull base/brainstem surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61576","description":"Skull base/brainstem surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTD1","description":"ICD-NLTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOC1","description":"ICD-LIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression arm sleeve_ custom_ heavy weight_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6577","description":"Gradient compression arm sleeve_ custom_ heavy weight_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ald fm/dm aud input receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5285","description":"Ald fm/dm aud input receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHF1","description":"ICD-MLHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLB1","description":"ICD-FDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHD1","description":"ICD-JEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBE0","description":"ICD-MFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRD1","description":"ICD-KCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTA1","description":"ICD-CDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHB0","description":"ICD-BFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC211","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Soft interface above knee se","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2830","description":"Soft interface above knee se","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQA1","description":"ICD-OLQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt/caregiver counsel safety","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6090F","description":"Pt/caregiver counsel safety","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of aldolase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82085","description":"Assay of aldolase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBF0","description":"ICD-FCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21510","description":"Drainage of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALF1","description":"ICD-NALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXF1","description":"ICD-KHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLED1","description":"ICD-MLED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSB0","description":"ICD-PGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABB0","description":"ICD-OABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXC1","description":"ICD-NJXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8H","description":"High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDD1","description":"ICD-OFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary cardiomyopathy (eg_ hypertrophic cardiomyopathy_ dilated cardiomyopathy_ arrhythmogenic right ventricular cardiomyopathy)_ genomic sequence analysis panel_ must inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81439","description":"Hereditary cardiomyopathy (eg_ hypertrophic cardiomyopathy_ dilated cardiomyopathy_ arrhythmogenic right ventricular cardiomyopathy)_ genomic sequence analysis panel_ must inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAB1","description":"ICD-BGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX16","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRA0","description":"ICD-PIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mastectomy form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8020","description":"Mastectomy form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAE1","description":"ICD-JHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMB0","description":"ICD-FBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of circulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37145","description":"Revision of circulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1125","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEA1","description":"ICD-IDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Major Abdominal Blood Vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77059","description":"Major Abdominal Blood Vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hla x-math non-cytotoxic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86825","description":"Hla x-math non-cytotoxic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFD0","description":"ICD-GCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKA1","description":"ICD-FAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHD0","description":"ICD-OJHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQD1","description":"ICD-OFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPA0","description":"ICD-OGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28I","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht arm ped plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4011","description":"Cast sup sht arm ped plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1036T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1036T","description":"CPT-1036T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPC1","description":"ICD-GDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove intra-aortic balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33974","description":"Remove intra-aortic balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXE0","description":"ICD-GFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUC1","description":"ICD-FFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Im b1 mrw cel ther xcl hrvst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0264T","description":"Im b1 mrw cel ther xcl hrvst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Image cath fluid peri/retro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49406","description":"Image cath fluid peri/retro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIE0","description":"ICD-NHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLA0","description":"ICD-OBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"F2 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81240","description":"F2 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrst x-ray uppr gi tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74249","description":"Contrst x-ray uppr gi tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWB1","description":"ICD-HHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61600","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9026","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","description":"HCPCS-J9026","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOB0","description":"ICD-KCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Egd remove foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43247","description":"Egd remove foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44150","description":"Removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJE0","description":"ICD-JFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKF1","description":"ICD-BEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp4 hd mult pow s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0886","description":"Pwc gp4 hd mult pow s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARF1","description":"ICD-DARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRD1","description":"ICD-OJRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No doc opioid tx 1x at ther","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9579","description":"No doc opioid tx 1x at ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATA0","description":"ICD-OATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDC0","description":"ICD-GBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB10D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC230","description":"Special Care Low _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUE0","description":"ICD-KBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOE1","description":"ICD-LEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVA1","description":"ICD-CIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC5D","description":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nikaidoh proc w/ostia implt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33783","description":"Nikaidoh proc w/ostia implt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETD1","description":"ICD-IETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA3B","description":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE21A","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Functional status not performed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9918","description":"Functional status not performed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML34","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYA0","description":"ICD-GIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heat lamp without stand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0200","description":"Heat lamp without stand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPE1","description":"ICD-FAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICE1","description":"ICD-MICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOB1","description":"ICD-OEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB07","description":"Medium Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ex hd hosp bed > 600 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0302","description":"Ex hd hosp bed > 600 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCB1","description":"ICD-JCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXA0","description":"ICD-BDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDF1","description":"ICD-BIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Facility/Er/Emergency Room","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"450U5","description":"Facility/Er/Emergency Room","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBC0","description":"ICD-MKBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trapeze bar attached to bed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0910","description":"Trapeze bar attached to bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heavy duty wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0006","description":"Heavy duty wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCE1","description":"ICD-ADCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85018","description":"Hemoglobin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTF0","description":"ICD-FCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXD1","description":"ICD-NBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOA1","description":"ICD-CGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJC0","description":"ICD-FGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90635","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","description":"CPT-90635","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUF1","description":"ICD-MHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Complex body section x-rays","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76102","description":"Complex body section x-rays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQD1","description":"ICD-OIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXE0","description":"ICD-NDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat penis lesion graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54111","description":"Treat penis lesion graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alveoplasty w/ extraction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7310","description":"Alveoplasty w/ extraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No photodoc cecal ldmk exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9614","description":"No photodoc cecal ldmk exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit antibiotic q3h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9497","description":"Hit antibiotic q3h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neurorraphy w/vein autograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64911","description":"Neurorraphy w/vein autograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0012","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct abdomen w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74150","description":"Ct abdomen w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease_ chronic hepatitis C virus (HCV) infection_ six biochemical assays (ALT_ A2-macroglobulin_ apolipoprotein A-1_ total bilirubin_ GGT_ and haptoglobin) utiliz","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0001M","description":"Infectious disease_ chronic hepatitis C virus (HCV) infection_ six biochemical assays (ALT_ A2-macroglobulin_ apolipoprotein A-1_ total bilirubin_ GGT_ and haptoglobin) utiliz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block_ with frozen section(s)_ single specimen (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0841T","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block_ with frozen section(s)_ single specimen (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOE0","description":"ICD-KGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLB1","description":"ICD-OCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOA1","description":"ICD-OKOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYE1","description":"ICD-CCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXC1","description":"ICD-OJXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWA1","description":"ICD-GCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELB0","description":"ICD-BELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMF0","description":"ICD-MFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIB0","description":"ICD-MJIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD115","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0401","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0401","description":"CDT-D0401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWC1","description":"ICD-LFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandage roll_ inelastic short stretch_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6599","description":"Gradient compression bandage roll_ inelastic short stretch_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1015T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","description":"CPT-1015T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA01","description":"High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1385","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","description":"HCPCS-M1385","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace vad intra w/bp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33983","description":"Replace vad intra w/bp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lso sc r ant/pos pnl pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0650","description":"Lso sc r ant/pos pnl pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLA0","description":"ICD-IDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDD0","description":"ICD-NHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove aneurysm sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61613","description":"Remove aneurysm sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug training","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0021","description":"Alcohol and/or drug training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCC1","description":"ICD-KGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1285","description":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDB1","description":"ICD-BGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAB1","description":"ICD-MGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repos nstim apnea stimj ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0432T","description":"Repos nstim apnea stimj ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray bile duct endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74328","description":"X-ray bile duct endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29825","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRB1","description":"ICD-GGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAF0","description":"ICD-OLAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hyqvia 100mg immuneglobulin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1575","description":"Hyqvia 100mg immuneglobulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1AA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AA11","description":"ICD-1AA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pierce skull implant device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61210","description":"Pierce skull implant device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUF1","description":"ICD-GDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIC1","description":"ICD-MKIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUB0","description":"ICD-MAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acetylcysteine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0132","description":"Acetylcysteine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8F","description":"Low Rehab_ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tx dental pain minor proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9110","description":"Tx dental pain minor proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOC1","description":"ICD-PBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWF1","description":"ICD-PFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCA0","description":"ICD-AHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEE0","description":"ICD-NLEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICA1","description":"ICD-MICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDF0","description":"ICD-MEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHB1","description":"ICD-BGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQB0","description":"ICD-HCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWC1","description":"ICD-OIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES21B","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLF0","description":"ICD-IHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEE0","description":"ICD-JAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABE1","description":"ICD-EABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOD1","description":"ICD-DDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spec childcare waiver 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2027","description":"Spec childcare waiver 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral con def inter plt","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5958","description":"Intraoral con def inter plt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6033","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","description":"HCPCS-L6033","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAD0","description":"ICD-OFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWC1","description":"ICD-KFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUF1","description":"ICD-GGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHE0","description":"ICD-AAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJF0","description":"ICD-BGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDND0","description":"ICD-KDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert tun ip cath perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49418","description":"Insert tun ip cath perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy oocyte polar body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89291","description":"Biopsy oocyte polar body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIF0","description":"ICD-MKIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder prosthesis removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23335","description":"Shoulder prosthesis removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXF0","description":"ICD-FHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suction lipectomy head&neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15876","description":"Suction lipectomy head&neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMA1","description":"ICD-GBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dem severity class severe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1493F","description":"Dem severity class severe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18A","description":"Clinically Complex _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No implantable/insertable device used with device-intensive procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1890","description":"No implantable/insertable device used with device-intensive procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prefab steel crown primary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2934","description":"Prefab steel crown primary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; Unmonitored","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95714","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; Unmonitored","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDA0","description":"ICD-KHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIA0","description":"ICD-CAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJE0","description":"ICD-NAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKE1","description":"ICD-NDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home hospice case 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0271","description":"Home hospice case 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect scapula tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23210","description":"Resect scapula tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRB1","description":"ICD-DHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMF1","description":"ICD-FAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGD0","description":"ICD-KIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-sterile gauze<=16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6216","description":"Non-sterile gauze<=16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral supply kit premix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4220","description":"Parenteral supply kit premix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUD0","description":"ICD-IBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneum full leg splnt pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4370","description":"Pneum full leg splnt pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMC1","description":"ICD-MEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Toc dur aneth to icu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9657","description":"Toc dur aneth to icu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPD1","description":"ICD-CIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18X","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Initial hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99223","description":"Initial hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHF1","description":"ICD-AGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anatomic guide 3D-printed and designed from image data set(s); each additional anatomic guide (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0562T","description":"Anatomic guide 3D-printed and designed from image data set(s); each additional anatomic guide (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOA1","description":"ICD-DEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISD0","description":"ICD-CISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHF1","description":"ICD-NJHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8G","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGD0","description":"ICD-GEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGB0","description":"ICD-JIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFC0","description":"ICD-FHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGB1","description":"ICD-OFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTA1","description":"ICD-KBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA3B","description":"Low Rehab_ ADL Index 0-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUA1","description":"ICD-KEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient with diagnosis of osteoporosis on date of encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1153","description":"Patient with diagnosis of osteoporosis on date of encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHF0","description":"ICD-EBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLC0","description":"ICD-BFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repl cushions for jaw motion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1701","description":"Repl cushions for jaw motion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esrd srv 2-3 vsts p mo 12-19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90958","description":"Esrd srv 2-3 vsts p mo 12-19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHE0","description":"ICD-BIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJA1","description":"ICD-OCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEF0","description":"ICD-JHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECED1","description":"ICD-ECED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHB1","description":"ICD-FFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4340","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","description":"HCPCS-Q4340","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNB1","description":"ICD-GCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQD0","description":"ICD-PBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of metatarsals","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28322","description":"Repair of metatarsals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HC21","description":"ICD-2HC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKA0","description":"ICD-JFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dihydrocodeinone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6045","description":"Dihydrocodeinone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Janssen Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC Ad26 5x1010 VP/.5mL IM DOSE BOOSTER)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1712","description":"Janssen Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC Ad26 5x1010 VP/.5mL IM DOSE BOOSTER)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELA0","description":"ICD-FELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMA1","description":"ICD-KEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28116","description":"Revision of foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemo iv push sngl drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96409","description":"Chemo iv push sngl drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tob non-user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9459","description":"Tob non-user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRE0","description":"ICD-HGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSC1","description":"ICD-CFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJF0","description":"ICD-FFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSF0","description":"ICD-PCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28B","description":"Special Care High _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDD1","description":"ICD-JHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardioassist external","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92971","description":"Cardioassist external","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLE1","description":"ICD-NGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug screenin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0003","description":"Alcohol and/or drug screenin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduce bowel obstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44050","description":"Reduce bowel obstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB13C","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHD1","description":"ICD-CAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLD1","description":"ICD-IBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPB1","description":"ICD-CFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARB0","description":"ICD-LARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/decompression","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45393","description":"Colonoscopy w/decompression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Part hand no fingers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6020","description":"Part hand no fingers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8G","description":"Very High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc new diag 1st/addl mdd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3093F","description":"Doc new diag 1st/addl mdd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUC0","description":"ICD-CCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEB0","description":"ICD-MEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of tear gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68510","description":"Biopsy of tear gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCD0","description":"ICD-CHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL12","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDF0","description":"ICD-GDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLE1","description":"ICD-NLLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of urethra injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53505","description":"Repair of urethra injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQA1","description":"ICD-GFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Subepithelial tissue graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4273","description":"Subepithelial tissue graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMF1","description":"ICD-BGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKC1","description":"ICD-FDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDD0","description":"ICD-MGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICC1","description":"ICD-JICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nursing care in home rn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9123","description":"Nursing care in home rn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL34","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINE0","description":"ICD-BINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADA0","description":"ICD-CADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reason for not administering adjuvant treatment course including both chemotherapy and her2-targeted therapy (e.g. poor performance status (ecog 3-4; karnofsky =50)_ cardiac c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2207","description":"Reason for not administering adjuvant treatment course including both chemotherapy and her2-targeted therapy (e.g. poor performance status (ecog 3-4; karnofsky =50)_ cardiac c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27230","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30410","description":"Reconstruction of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIB0","description":"ICD-NKIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0935T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","description":"CPT-0935T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No pt category on report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9293","description":"No pt category on report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20611","description":"Drain/inj joint/bursa w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMA1","description":"ICD-JCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90695","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","description":"CPT-90695","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPE0","description":"ICD-KGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epifix_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4186","description":"Epifix_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBD1","description":"ICD-MJBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5164","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5164","description":"HCPCS-Q5164","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of intervertebral biomechanical device(s) (eg_ synthetic cage_ mesh) with integral anterior instrumentation for device anchoring (eg_ screws_ flanges)_ when performe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22854","description":"Insertion of intervertebral biomechanical device(s) (eg_ synthetic cage_ mesh) with integral anterior instrumentation for device anchoring (eg_ screws_ flanges)_ when performe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGE0","description":"ICD-FHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dent therapeutic drug inject","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9610","description":"Dent therapeutic drug inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJC1","description":"ICD-NEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHID1","description":"ICD-IHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNB0","description":"ICD-OKNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair lead pace-defib dual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33220","description":"Repair lead pace-defib dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Integra drt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4105","description":"Integra drt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEID0","description":"ICD-JEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTA1","description":"ICD-FBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHA1","description":"ICD-EHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx nose fx w/ stablj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21320","description":"Closed tx nose fx w/ stablj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat midfoot fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28456","description":"Treat midfoot fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCA0","description":"ICD-MKCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD14D","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXD1","description":"ICD-GHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWD0","description":"ICD-LAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFF0","description":"ICD-JFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCC0","description":"ICD-JFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC111","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRD1","description":"ICD-DIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTB1","description":"ICD-JFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB234","description":"Special Care Low _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Metaproterenol non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7669","description":"Metaproterenol non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hocm>= 400mg/ml iodine_ 1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9964","description":"Hocm>= 400mg/ml iodine_ 1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUE1","description":"ICD-ODUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXE0","description":"ICD-FIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHA0","description":"ICD-NEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENF1","description":"ICD-KENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove anal fist complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46280","description":"Remove anal fist complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lung cx bx rpt no doc class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9421","description":"Lung cx bx rpt no doc class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Overdenture complete max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5863","description":"Overdenture complete max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA244","description":"Clinically Complex _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBB1","description":"ICD-KFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQE0","description":"ICD-GBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJF0","description":"ICD-CFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIE0","description":"ICD-CFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTF0","description":"ICD-AGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB11B","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal) screening_ biochemical enzyme-linked immunosorbent assay (ELISA) of 3 plasma or serum proteins (teratocarcinoma derived growth factor-1 [TDGF-1_ Cripto-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0163U","description":"Oncology (colorectal) screening_ biochemical enzyme-linked immunosorbent assay (ELISA) of 3 plasma or serum proteins (teratocarcinoma derived growth factor-1 [TDGF-1_ Cripto-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair bowel-bladder fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44660","description":"Repair bowel-bladder fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Finger tendon transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26497","description":"Finger tendon transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAED0","description":"ICD-OAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); known familial variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81362","description":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); known familial variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No qual card diag prior12mon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1461F","description":"No qual card diag prior12mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHC0","description":"ICD-EBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trach supply noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8189","description":"Trach supply noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Health risk assessment test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99420","description":"Health risk assessment test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Peng benzathine/procaine inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0558","description":"Peng benzathine/procaine inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESF0","description":"ICD-KESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIE0","description":"ICD-BIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCC1","description":"ICD-NJCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL14","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"So acro/clav can web pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3670","description":"So acro/clav can web pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Test for chlorohydrocarbons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82441","description":"Test for chlorohydrocarbons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tyrosinemia type I monitoring by patient-collected blood card sample_ quantitative measurement of tyrosine_ phenylalanine_ methionine_ succinylacetone_ nitisinone_ liquid chro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0383U","description":"Tyrosinemia type I monitoring by patient-collected blood card sample_ quantitative measurement of tyrosine_ phenylalanine_ methionine_ succinylacetone_ nitisinone_ liquid chro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Talk pt/crgvr re areds prev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4177F","description":"Talk pt/crgvr re areds prev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99153","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOE0","description":"ICD-DEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBB1","description":"ICD-IEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECF0","description":"ICD-FECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of urethra injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53515","description":"Repair of urethra injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr trunk 1.1-2.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13100","description":"Cmplx rpr trunk 1.1-2.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surg lower abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84051","description":"Anesth surg lower abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tkr composite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9233","description":"Tkr composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Office consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99242","description":"Office consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKA1","description":"ICD-FIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGD1","description":"ICD-GEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of hand bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25820","description":"Fusion of hand bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening tapentadol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80372","description":"Drug screening tapentadol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hocm 300-349mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9962","description":"Hocm 300-349mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFA0","description":"ICD-OIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBC1","description":"ICD-IDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUC1","description":"ICD-ABUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8A","description":"Low Rehab_ ADL Index 0-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove knee joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27335","description":"Remove knee joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELA1","description":"ICD-MELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKC0","description":"ICD-CDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIB1","description":"ICD-FAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGC0","description":"ICD-CHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYC1","description":"ICD-HIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUE1","description":"ICD-AFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove brain cavity fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61020","description":"Remove brain cavity fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKA1","description":"ICD-NDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lens material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66852","description":"Removal of lens material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADE0","description":"ICD-EADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXC1","description":"ICD-FCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUB0","description":"ICD-FHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVE0","description":"ICD-JEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Meningococcal recombinant protein and outer membrane vesicle vaccine_ serogroup B (MenB-4C)_ 2 dose schedule_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90620","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine_ serogroup B (MenB-4C)_ 2 dose schedule_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALF0","description":"ICD-FALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Er+ or pr+ breast cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3315F","description":"Er+ or pr+ breast cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Advanced life support mileag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0390","description":"Advanced life support mileag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/mediast exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32662","description":"Thoracoscopy w/mediast exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCD1","description":"ICD-GCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair umbilical lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49605","description":"Repair umbilical lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTB0","description":"ICD-IFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUD1","description":"ICD-NKUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALA0","description":"ICD-OALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKB0","description":"ICD-JBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone imaging whole body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78306","description":"Bone imaging whole body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth tubal ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85151","description":"Anesth tubal ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of non-biodegradable drug delivery implants_ 4 or more (services for subdermal rod implant)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0516","description":"Insertion of non-biodegradable drug delivery implants_ 4 or more (services for subdermal rod implant)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDD0","description":"ICD-ADDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0560U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","description":"CPT-0560U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Re-eval post-op visit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0171","description":"Re-eval post-op visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8B","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHB1","description":"ICD-OJHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBD1","description":"ICD-JEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECD1","description":"ICD-BECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGID0","description":"ICD-JGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"removal of fixed orthodontic appliances for reasons other than completion of treatm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8695","description":"removal of fixed orthodontic appliances for reasons other than completion of treatm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXC0","description":"ICD-GHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMF0","description":"ICD-CDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Zaire ebolavirus vaccine_ live_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90758","description":"Zaire ebolavirus vaccine_ live_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy w/bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45305","description":"Proctosigmoidoscopy w/bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCF1","description":"ICD-KCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBB0","description":"ICD-EDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLE1","description":"ICD-GHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTE1","description":"ICD-IGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie_ external genitalia_ perineum_ abdominal wall) due to soft tissue infection or trauma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15778","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie_ external genitalia_ perineum_ abdominal wall) due to soft tissue infection or trauma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1604","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1604","description":"HCPCS-A1604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMA0","description":"ICD-ICMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA134","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRC0","description":"ICD-KDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUD0","description":"ICD-OGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPC0","description":"ICD-JEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOB1","description":"ICD-DAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBB0","description":"ICD-NHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28G","description":"Special Care High _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDD0","description":"ICD-EGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35206","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAB0","description":"ICD-CDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ siltuximab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2860","description":"Injection_ siltuximab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXF0","description":"ICD-FIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAE1","description":"ICD-KGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iop down >15% of pre-svc lvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3284F","description":"Iop down >15% of pre-svc lvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscp rig trnso rem fb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43194","description":"Esophagoscp rig trnso rem fb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prq revasc byp graft addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92938","description":"Prq revasc byp graft addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGA0","description":"ICD-NHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPA1","description":"ICD-JAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQA1","description":"ICD-GGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood gases o2 sat only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82810","description":"Blood gases o2 sat only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOA0","description":"ICD-DCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interferon alfa-2b inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9214","description":"Interferon alfa-2b inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a normal neurological examination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9535","description":"Patients with a normal neurological examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Strep a dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87652","description":"Strep a dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age Or Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Pe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2134","description":"Patients 66 Years Of Age Or Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVB1","description":"ICD-OFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDB1","description":"ICD-KCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOF1","description":"ICD-GFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct soft tissue neck w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70490","description":"Ct soft tissue neck w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place cath carotid/inom art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36223","description":"Place cath carotid/inom art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pegaptanib sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2503","description":"Pegaptanib sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Emergency anesthesia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99140","description":"Emergency anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLD0","description":"ICD-KBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUD1","description":"ICD-NCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Toc tool incl elem not used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9658","description":"Toc tool incl elem not used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNA0","description":"ICD-CDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (cerebral folate deficiency)_ serum_ detection of anti-human folate receptor IgG-binding antibody and blocking autoantibodies by enzyme-linked immunoassay (ELISA)_ q","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0399U","description":"Neurology (cerebral folate deficiency)_ serum_ detection of anti-human folate receptor IgG-binding antibody and blocking autoantibodies by enzyme-linked immunoassay (ELISA)_ q","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSF0","description":"ICD-KFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHB0","description":"ICD-CBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITD1","description":"ICD-CITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin peel therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17360","description":"Skin peel therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCB1","description":"ICD-BCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKC1","description":"ICD-OKKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"I&d abscess p-spine l/s/ls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22015","description":"I&d abscess p-spine l/s/ls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphc trifo 7.25-12/2.25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2312","description":"Lens sphc trifo 7.25-12/2.25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABE1","description":"ICD-KABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Health And Well-Being Coaching Face-To-Face; Individual_ Follow-Up Session_ At Least 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0592T","description":"Health And Well-Being Coaching Face-To-Face; Individual_ Follow-Up Session_ At Least 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDF1","description":"ICD-NEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28740","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNF1","description":"ICD-BFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18A","description":"Special Care High _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECF1","description":"ICD-AECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sbrt management","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77435","description":"Sbrt management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCA0","description":"ICD-KBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat shoulder dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23660","description":"Treat shoulder dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQA0","description":"ICD-DCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLF1","description":"ICD-EDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Standing frame sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0638","description":"Standing frame sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heart flow reserve measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93572","description":"Heart flow reserve measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Whlchr att- conv 1 arm drive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0958","description":"Whlchr att- conv 1 arm drive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWE0","description":"ICD-GHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMC1","description":"ICD-GDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBB0","description":"ICD-ICBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Complement total (ch50)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86162","description":"Complement total (ch50)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Lymphoma Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1096","description":"Radiation Therapy For Lymphoma Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBC1","description":"ICD-JBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHF0","description":"ICD-MFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home visit new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99344","description":"Home visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Scratch resistant coating","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2760","description":"Scratch resistant coating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWB0","description":"ICD-PGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive chemotherapy in the last 14 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9848","description":"Patient did not receive chemotherapy in the last 14 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter insertion or replacement of permanent leadless pacemaker_ ventricular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0387T","description":"Transcatheter insertion or replacement of permanent leadless pacemaker_ ventricular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inlay porcelain/ceramic 1 su","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2610","description":"Inlay porcelain/ceramic 1 su","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not performing functional status (e.g._ patient is severely impaired and caregiver knowledge is limited_ other medical reason)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9917","description":"Documentation of medical reason(s) for not performing functional status (e.g._ patient is severely impaired and caregiver knowledge is limited_ other medical reason)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt reas no pneumococcal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8866","description":"Doc pt reas no pneumococcal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospital outpt clinic visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0463","description":"Hospital outpt clinic visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemi-wheelchair detachable a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1086","description":"Hemi-wheelchair detachable a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tdap or td or 1tet/dipth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9416","description":"Tdap or td or 1tet/dipth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bupren/nal up to 3mg bupreno","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0572","description":"Bupren/nal up to 3mg bupreno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGE0","description":"ICD-BBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy flex remove fb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43215","description":"Esophagoscopy flex remove fb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crutch underarm pair no wood","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0114","description":"Crutch underarm pair no wood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDB1","description":"ICD-JIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRE0","description":"ICD-GHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct orbit/ear/fossa w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70481","description":"Ct orbit/ear/fossa w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYC0","description":"ICD-PFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUC1","description":"ICD-JFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKA0","description":"ICD-OJKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Occupational therapy evaluation_ high complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes review of medical and/or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97167","description":"Occupational therapy evaluation_ high complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes review of medical and/or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNA1","description":"ICD-CBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFD1","description":"ICD-CCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAA0","description":"ICD-BAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEF1","description":"ICD-JHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUE0","description":"ICD-MKUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEB1","description":"ICD-EBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLA1","description":"ICD-AGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAE1","description":"ICD-ACAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC1C","description":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onlay porc/crmc >=3 surfaces","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6609","description":"Onlay porc/crmc >=3 surfaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQA0","description":"ICD-KAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJE1","description":"ICD-FAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GC11","description":"ICD-3GC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFE0","description":"ICD-GHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9817","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9817","description":"HCPCS-C9817","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M0231","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0231","description":"HCPCS-M0231","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIA0","description":"ICD-AEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00145","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00145","description":"CPT-00145","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYF0","description":"ICD-OKYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIE0","description":"ICD-FDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFC1","description":"ICD-JIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1038T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1038T","description":"CPT-1038T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"BCR/ABL1 (t(9;22)) (eg_ chronic myelogenous leukemia) translocation analysis_ major breakpoint_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0040U","description":"BCR/ABL1 (t(9;22)) (eg_ chronic myelogenous leukemia) translocation analysis_ major breakpoint_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy w/bx & op scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31536","description":"Laryngoscopy w/bx & op scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCF1","description":"ICD-MJCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7176","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7176","description":"HCPCS-J7176","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home visit day life activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99509","description":"Home visit day life activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iloprost non-comp unit dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4074","description":"Iloprost non-comp unit dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eps Gast Cardia Plic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9724","description":"Eps Gast Cardia Plic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB14B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laiv4 vaccine intranasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90672","description":"Laiv4 vaccine intranasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ther/proph/diag inj ia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96373","description":"Ther/proph/diag inj ia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E2403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2403","description":"HCPCS-E2403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Change of percutaneous biliary drainage catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47525","description":"Change of percutaneous biliary drainage catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSA1","description":"ICD-LHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4296","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","description":"HCPCS-A4296","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ factor VIII (antihemophilic factor_ recombinant) (Afstyla)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9140","description":"Injection_ factor VIII (antihemophilic factor_ recombinant) (Afstyla)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHD1","description":"ICD-MIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVD1","description":"ICD-BBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAF0","description":"ICD-FAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"SARSCOV2 VACCINE BIVALENT 25 MCG/0.25 ML IM USE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91314","description":"SARSCOV2 VACCINE BIVALENT 25 MCG/0.25 ML IM USE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Complete ft_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4271","description":"Complete ft_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of tongue fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41010","description":"Incision of tongue fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of skull tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61564","description":"Excision of skull tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Imaging study ordered (bkp)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3330F","description":"Imaging study ordered (bkp)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abciximab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0130","description":"Abciximab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64466","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","description":"CPT-64466","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Combo pegintf/rib rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4153F","description":"Combo pegintf/rib rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMA1","description":"ICD-NAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVD0","description":"ICD-KEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIF1","description":"ICD-NCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Create eardrum opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69433","description":"Create eardrum opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8X","description":"High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIF0","description":"ICD-ACIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUB0","description":"ICD-NDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL4D","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disease modif pharmacothxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4540F","description":"Disease modif pharmacothxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWA0","description":"ICD-PGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX46","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQE1","description":"ICD-GEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDE1","description":"ICD-KHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHF0","description":"ICD-IAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLE0","description":"ICD-OJLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Not ref for oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8858","description":"Not ref for oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJC0","description":"ICD-BFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATA1","description":"ICD-FATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWB1","description":"ICD-GFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASF0","description":"ICD-GASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct bronchus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31775","description":"Reconstruct bronchus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy_ high resolution (hra) (with magnification and chemical agent enhancement); diagnostic_ including collection of specimen(s) by brushing or washing when performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6027","description":"Anoscopy_ high resolution (hra) (with magnification and chemical agent enhancement); diagnostic_ including collection of specimen(s) by brushing or washing when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJF1","description":"ICD-KFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTF0","description":"ICD-JBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX01","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFE1","description":"ICD-CEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoabdominal graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33877","description":"Thoracoabdominal graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chest wall manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94667","description":"Chest wall manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGB1","description":"ICD-BBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auto test panel pricing code_ 20 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP20","description":"Auto test panel pricing code_ 20 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXF0","description":"ICD-GEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Peanut allergen specific IgE and quantitative assessment of 64 epitopes using enzyme-linked immunosorbent assay (ELISA)_ blood_ individual epitope results and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0165U","description":"Peanut allergen specific IgE and quantitative assessment of 64 epitopes using enzyme-linked immunosorbent assay (ELISA)_ blood_ individual epitope results and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anemia plan of care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0516F","description":"Anemia plan of care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXD1","description":"ICD-GCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpt doc class histo type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9422","description":"Rpt doc class histo type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFF0","description":"ICD-FIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Edetate calcium disodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0600","description":"Edetate calcium disodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx nhl relapse/refractor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9137","description":"Onc dx nhl relapse/refractor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE15D","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroretinography (ERG)_ with interpretation and report; multifocal (mfERG)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92274","description":"Electroretinography (ERG)_ with interpretation and report; multifocal (mfERG)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBC1","description":"ICD-ODBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (prior disease)_ cerebrospinal fluid_ detection of prion protein by quaking-induced conf conversion_ qualitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0035U","description":"Neurology (prior disease)_ cerebrospinal fluid_ detection of prion protein by quaking-induced conf conversion_ qualitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB255","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat sternum fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21820","description":"Treat sternum fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGF1","description":"ICD-FEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26735","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28G","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIE0","description":"ICD-AEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-15017","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","description":"CPT-15017","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHA1","description":"ICD-NBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC14C","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIC0","description":"ICD-MHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLB1","description":"ICD-KHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMA0","description":"ICD-AFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSF1","description":"ICD-DHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extension drainage tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4331","description":"Extension drainage tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HPYLORI","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87339","description":"IAAD IA HPYLORI","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIA0","description":"ICD-IBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDF1","description":"ICD-ICDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brexucabtagene autoleucel_ up to 200 million autologous anti-cd19 car positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2053","description":"Brexucabtagene autoleucel_ up to 200 million autologous anti-cd19 car positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTD0","description":"ICD-BHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trach care kit for new trach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4625","description":"Trach care kit for new trach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Functional status measurement with score was obtained utilizing the Oxford Knee Score (OKS) patient reported outcome tool withi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1045","description":"Functional status measurement with score was obtained utilizing the Oxford Knee Score (OKS) patient reported outcome tool withi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EB21","description":"ICD-2EB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inherited bone marrow failure syndromes (IBMFS) (eg_ Fanconi anemia_ dyskeratosis congenita_ Diamond-Blackfan anemia_ Shwachman-Diamond syndrome_ GATA2 deficiency syndrome_ co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81441","description":"Inherited bone marrow failure syndromes (IBMFS) (eg_ Fanconi anemia_ dyskeratosis congenita_ Diamond-Blackfan anemia_ Shwachman-Diamond syndrome_ GATA2 deficiency syndrome_ co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUC0","description":"ICD-MDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"W/ch access det adj armrest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0973","description":"W/ch access det adj armrest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWB1","description":"ICD-LAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELF1","description":"ICD-AELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBC0","description":"ICD-MJBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOF0","description":"ICD-OLOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompress spinal cord lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63056","description":"Decompress spinal cord lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYD1","description":"ICD-GGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of calcitonin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82308","description":"Assay of calcitonin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy orchiopexy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54692","description":"Laparoscopy orchiopexy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00840","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00840","description":"CPT-00840","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITE0","description":"ICD-CITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc (colorectal)_ quant assess of three urine metabolites by liq chromatography w tandem mass spectro (LC-MS/MS) using multireaction monitoring acquisition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0002U","description":"Onc (colorectal)_ quant assess of three urine metabolites by liq chromatography w tandem mass spectro (LC-MS/MS) using multireaction monitoring acquisition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc neck tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21554","description":"Exc neck tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Us exam pelvic limited","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76857","description":"Us exam pelvic limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKD1","description":"ICD-OAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC14B","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAF1","description":"ICD-FAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0014","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Planar back for ped size wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2291","description":"Planar back for ped size wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYE1","description":"ICD-KDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPD1","description":"ICD-OIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insulin reuse pen 3 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5561","description":"Insulin reuse pen 3 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPC0","description":"ICD-OHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUA1","description":"ICD-CFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAD1","description":"ICD-EEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trans care mgmt 14 day disch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99495","description":"Trans care mgmt 14 day disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCB0","description":"ICD-NBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bilirubin total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82247","description":"Bilirubin total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATE1","description":"ICD-BATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA2C","description":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unipuncture control system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1580","description":"Unipuncture control system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB2B","description":"Ultra High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKC1","description":"ICD-JDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQD1","description":"ICD-LIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKD1","description":"ICD-NAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35361","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICC1","description":"ICD-KICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLE0","description":"ICD-ODLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Truss addition to std pad wa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8320","description":"Truss addition to std pad wa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Syst bp lt 130 mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3074F","description":"Syst bp lt 130 mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Desoxycorticosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82633","description":"Desoxycorticosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFF0","description":"ICD-KFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breath test analysis c-14","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78268","description":"Breath test analysis c-14","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Porcelain/ceramic retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6548","description":"Porcelain/ceramic retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Internal root repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3333","description":"Internal root repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCF1","description":"ICD-CGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAF1","description":"ICD-JIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXA1","description":"ICD-FIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Posaconazole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80187","description":"Posaconazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABC0","description":"ICD-MABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE12A","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heparin infusion pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1520","description":"Heparin infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAC0","description":"ICD-BEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFD1","description":"ICD-OCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXD1","description":"ICD-FFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy thigh soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27323","description":"Biopsy thigh soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt doc w burn prior to d/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8908","description":"Pt doc w burn prior to d/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWB1","description":"ICD-DBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4FC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FC21","description":"ICD-4FC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSE1","description":"ICD-CCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA25A","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLA0","description":"ICD-IGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of stomach lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43611","description":"Excision of stomach lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alpha-1-antitrypsin pheno","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82104","description":"Alpha-1-antitrypsin pheno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTC1","description":"ICD-OGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYC1","description":"ICD-PFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTA1","description":"ICD-MCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC5B","description":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL1C","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect face/scalp tum 2 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21016","description":"Resect face/scalp tum 2 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4383","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","description":"HCPCS-Q4383","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anatomic model 3D-printed from image data set(s); each additional individually prepared and processed component of an anatomic structure (List separately in addition to code f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0560T","description":"Anatomic model 3D-printed from image data set(s); each additional individually prepared and processed component of an anatomic structure (List separately in addition to code f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBB0","description":"ICD-CHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODME1","description":"ICD-ODME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUC1","description":"ICD-KCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Atropine comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7636","description":"Atropine comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWB0","description":"ICD-PCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE135","description":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8I","description":"Medium Rehab _ ADL Index 0-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"O2 saturation >88%/pao>55 hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3037F","description":"O2 saturation >88%/pao>55 hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hib-hepb vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90748","description":"Hib-hepb vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFC0","description":"ICD-CFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACD1","description":"ICD-OACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQE0","description":"ICD-PGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/cont_ chest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8909","description":"Mra w/cont_ chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHB0","description":"ICD-BCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLB1","description":"ICD-IBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLC0","description":"ICD-FGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental case management - addressing appointment compliance barriers","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9991","description":"Dental case management - addressing appointment compliance barriers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEF0","description":"ICD-KIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1741","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1741","description":"HCPCS-C1741","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAE0","description":"ICD-NGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVE1","description":"ICD-JEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33410","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYC0","description":"ICD-CAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRD1","description":"ICD-PJRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA210","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB11C","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHED0","description":"ICD-IHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPE1","description":"ICD-GDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSC0","description":"ICD-CGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMD1","description":"ICD-OKMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVD1","description":"ICD-GDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB13","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Retainer Crown 3/4 - Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6784","description":"Retainer Crown 3/4 - Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTB1","description":"ICD-OCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKD0","description":"ICD-KFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANF1","description":"ICD-GANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHID0","description":"ICD-MHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC22C","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No elig tpa init w/in 3 hrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8601","description":"No elig tpa init w/in 3 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of hip casts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29325","description":"Application of hip casts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destroy vulva lesion/s compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56515","description":"Destroy vulva lesion/s compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCF1","description":"ICD-JBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61684","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNE1","description":"ICD-OHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ins cath abd/l-ext art 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36245","description":"Ins cath abd/l-ext art 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","description":"HCPCS-M1405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESA1","description":"ICD-DESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anti-reflective coating","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2750","description":"Anti-reflective coating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIB0","description":"ICD-FEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSB1","description":"ICD-GHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGID0","description":"ICD-BGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treated water per gallon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4714","description":"Treated water per gallon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD126","description":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDB1","description":"ICD-OCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAA1","description":"ICD-MAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vitamin b-12","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82607","description":"Vitamin b-12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo new ureter/bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50948","description":"Laparo new ureter/bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostomy mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7525","description":"Tracheostomy mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2029","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","description":"HCPCS-A2029","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDD0","description":"ICD-KCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEB0","description":"ICD-BGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28430","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFB0","description":"ICD-JIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGF1","description":"ICD-GFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDF1","description":"ICD-OEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92945","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","description":"CPT-92945","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAD0","description":"ICD-CBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTA1","description":"ICD-BBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDF0","description":"ICD-CDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWD0","description":"ICD-OCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHE1","description":"ICD-EGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXD1","description":"ICD-BDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23420","description":"Repair of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Latex suspension sleeve each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6632","description":"Latex suspension sleeve each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFC1","description":"ICD-BDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWC1","description":"ICD-HDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHA1","description":"ICD-KAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRE1","description":"ICD-OFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHB1","description":"ICD-OFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVA0","description":"ICD-GEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDF1","description":"ICD-MCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bcg vaccine percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90585","description":"Bcg vaccine percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMF1","description":"ICD-CFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLC0","description":"ICD-OHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rxt breast appl place/remov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9726","description":"Rxt breast appl place/remov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of shoulder cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29055","description":"Application of shoulder cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIC0","description":"ICD-CEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPD0","description":"ICD-JDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Scrn hcv infec not recd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9386","description":"Scrn hcv infec not recd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unskilled respitecare /diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5151","description":"Unskilled respitecare /diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Med trng & support per 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0034","description":"Med trng & support per 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental tomographic survey","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0322","description":"Dental tomographic survey","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECB1","description":"ICD-FECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTD1","description":"ICD-EHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMC1","description":"ICD-MKMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHA0","description":"ICD-KGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who utilize hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9768","description":"Patients who utilize hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUA0","description":"ICD-AFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1947","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1947","description":"HCPCS-J1947","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr ing hernia init reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49500","description":"Rpr ing hernia init reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETA1","description":"ICD-OETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise inner eye adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65865","description":"Incise inner eye adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Platelet pheres leukoreduced","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9035","description":"Platelet pheres leukoreduced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6030","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","description":"HCPCS-L6030","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEA0","description":"ICD-FEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Egd endo mucosal resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43254","description":"Egd endo mucosal resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilated macular exam performed_ including documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage and the level of macular degenerat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9974","description":"Dilated macular exam performed_ including documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage and the level of macular degenerat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA01","description":"Very High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35351","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Semen analysis w/huhner","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89300","description":"Semen analysis w/huhner","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE13A","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-52597","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","description":"CPT-52597","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57100","description":"Biopsy of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWC0","description":"ICD-HEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ 120 or more drugs and substances_ definitive tandem mass spectrometry with chromatography_ urine_ qualitative report of presence (including quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0006U","description":"Prescription drug monitoring_ 120 or more drugs and substances_ definitive tandem mass spectrometry with chromatography_ urine_ qualitative report of presence (including quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGE1","description":"ICD-GAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"History of mole changes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1050F","description":"History of mole changes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tear gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68500","description":"Removal of tear gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFB0","description":"ICD-OFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00100","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00100","description":"CPT-00100","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGC1","description":"ICD-KBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"American amnion ac_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4306","description":"American amnion ac_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLE0","description":"ICD-BDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYB1","description":"ICD-KBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKC1","description":"ICD-JFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJA1","description":"ICD-BFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCC0","description":"ICD-CHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUE0","description":"ICD-CBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBE0","description":"ICD-CDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Completion pneumonectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32488","description":"Completion pneumonectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC10C","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVF0","description":"ICD-OLVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home visit cath maintain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99507","description":"Home visit cath maintain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES336","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQF0","description":"ICD-LBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQA0","description":"ICD-PHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHC1","description":"ICD-MLHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEC0","description":"ICD-ICEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGF0","description":"ICD-BFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8I","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNC0","description":"ICD-CGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Upper limb orthosis nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3999","description":"Upper limb orthosis nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOA1","description":"ICD-KAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mirvetuximab soravtansine-gynx_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9146","description":"Injection_ mirvetuximab soravtansine-gynx_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Device(S) Supply With Scheduled (Eg_ Daily)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98976","description":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Device(S) Supply With Scheduled (Eg_ Daily)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove & graft wrist lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25135","description":"Remove & graft wrist lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWE0","description":"ICD-GDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glucagon hydrochloride/1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1610","description":"Glucagon hydrochloride/1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXC0","description":"ICD-KHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8D","description":"Medium Rehab _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC155","description":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUA0","description":"ICD-GDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGE1","description":"ICD-CDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown lengthen hard tissue","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4249","description":"Crown lengthen hard tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA2A","description":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of csf protein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83873","description":"Assay of csf protein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDD0","description":"ICD-KHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUC1","description":"ICD-AGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGND0","description":"ICD-FGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prochlorperazine maleate 5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0164","description":"Prochlorperazine maleate 5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBE1","description":"ICD-IGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMC0","description":"ICD-NAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove prostate regrowth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52630","description":"Remove prostate regrowth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Bone Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1077","description":"Radiation Therapy For Bone Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull/sutures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61556","description":"Incise skull/sutures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plmt biliary drainage cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47534","description":"Plmt biliary drainage cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMA0","description":"ICD-MKMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nos flu vacc_ 3 yrs & >_ im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2039","description":"Nos flu vacc_ 3 yrs & >_ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEF0","description":"ICD-OCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPD0","description":"ICD-CGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYB0","description":"ICD-LCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEE1","description":"ICD-FIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hightop w/ supp/pronator jun","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3207","description":"Hightop w/ supp/pronator jun","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc abd tum over 10 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49205","description":"Exc abd tum over 10 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove uterus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59100","description":"Remove uterus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD204","description":"Special Care High _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHD0","description":"ICD-CHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ceftazidime and avibactam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0714","description":"Ceftazidime and avibactam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADF0","description":"ICD-EADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQD0","description":"ICD-HBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31511","description":"Remove foreign body larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Solid propulsion tire each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2220","description":"Solid propulsion tire each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exchange drainage catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49423","description":"Exchange drainage catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echocardiography contrast","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9700","description":"Echocardiography contrast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGME0","description":"ICD-BGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICB0","description":"ICD-FICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBE0","description":"ICD-JEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJA0","description":"ICD-OAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA20B","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAA0","description":"ICD-IGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24145","description":"Partial removal of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim-bmez_ biosimilar_ (ziextenzo)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5120","description":"Injection_ pegfilgrastim-bmez_ biosimilar_ (ziextenzo)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegcetacoplan_ intravitreal_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2781","description":"Injection_ pegcetacoplan_ intravitreal_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an RHC or FQHC","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0071","description":"Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an RHC or FQHC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bk waist belt webbing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5688","description":"Bk waist belt webbing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXB0","description":"ICD-OIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYD1","description":"ICD-OFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMF1","description":"ICD-EIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of rectal marker","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46030","description":"Removal of rectal marker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRB1","description":"ICD-HBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiographic procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76499","description":"Radiographic procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical exposure prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55860","description":"Surgical exposure prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skn sub grft t/a/l child add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15274","description":"Skn sub grft t/a/l child add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERE1","description":"ICD-HERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise/drain eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68020","description":"Incise/drain eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mold sckt ext knee shin sach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5150","description":"Mold sckt ext knee shin sach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARC0","description":"ICD-GARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00604","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00604","description":"CPT-00604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRD0","description":"ICD-GDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Visual evoked potential_ testing for glaucoma_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0464T","description":"Visual evoked potential_ testing for glaucoma_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8E","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIB1","description":"ICD-OHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCC1","description":"ICD-FBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA42","description":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB23D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMC1","description":"ICD-GGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAE1","description":"ICD-OGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHD0","description":"ICD-IFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCA0","description":"ICD-MGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWF0","description":"ICD-KFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tpa initi w/in 3 hrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8600","description":"Tpa initi w/in 3 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBB1","description":"ICD-GEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADF0","description":"ICD-KADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUF0","description":"ICD-IFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hand restorat thumb/1 finger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6900","description":"Hand restorat thumb/1 finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQE1","description":"ICD-KBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extracorporeal shock wave for integumentary wound healing_ high energy_ including topical application and dressing care; each additional wound (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0513T","description":"Extracorporeal shock wave for integumentary wound healing_ high energy_ including topical application and dressing care; each additional wound (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPC1","description":"ICD-BCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95147","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59151","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA23B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct abd & pelvis w/o contrast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74176","description":"Ct abd & pelvis w/o contrast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4030","description":"Pulmonology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Personalized target development for accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation derived from a structural and resting-state fu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0889T","description":"Personalized target development for accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation derived from a structural and resting-state fu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSA0","description":"ICD-OHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"In hospice or using hospice services during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1167","description":"In hospice or using hospice services during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDF1","description":"ICD-FDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rigid plastic pre one","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0490","description":"Tlso rigid plastic pre one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair hand joint with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26541","description":"Repair hand joint with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTA0","description":"ICD-MDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTC0","description":"ICD-NCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insj ocular telescope prosth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0308T","description":"Insj ocular telescope prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQD1","description":"ICD-KFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMD1","description":"ICD-IEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trans elec jt stim dev sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0762","description":"Trans elec jt stim dev sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTD0","description":"ICD-NHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXB0","description":"ICD-BDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDE0","description":"ICD-NJDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEB1","description":"ICD-NGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYA1","description":"ICD-KBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFA1","description":"ICD-FCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8E","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKA1","description":"ICD-JHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVE1","description":"ICD-GBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70380","description":"X-ray exam of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHB1","description":"ICD-AGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEA1","description":"ICD-IHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMC1","description":"ICD-NEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD144","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9610","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9610","description":"HCPCS-C9610","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOD0","description":"ICD-GGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bcg live intravesical vac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9031","description":"Bcg live intravesical vac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWD1","description":"ICD-GAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHA0","description":"ICD-MDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES251","description":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJF1","description":"ICD-CFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nikaidoh proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33782","description":"Nikaidoh proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAID1","description":"ICD-CAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC14C","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBD1","description":"ICD-AGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAB1","description":"ICD-GHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES117","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBE0","description":"ICD-IIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ ITE/ITE","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5211","description":"Hearing aid_ contralateral routing system_ binaural_ ITE/ITE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAA0","description":"ICD-KCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMD0","description":"ICD-EFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIC1","description":"ICD-KGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tafasitamab-cxix_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9070","description":"Injection_ tafasitamab-cxix_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic seq analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81445","description":"Targeted genomic seq analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gallium ga-68_ dotatoc_ diagnostic_ 0.01 mci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9067","description":"Gallium ga-68_ dotatoc_ diagnostic_ 0.01 mci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGE0","description":"ICD-JCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHE0","description":"ICD-NFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Daprodustat_ oral_ 1 mg_ (for ESRD on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0889","description":"Daprodustat_ oral_ 1 mg_ (for ESRD on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCID1","description":"ICD-GCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALF0","description":"ICD-GALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWE1","description":"ICD-HDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Guide nerv destr needle emg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95874","description":"Guide nerv destr needle emg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7174","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","description":"HCPCS-J7174","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDID1","description":"ICD-MDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart septum defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33681","description":"Repair heart septum defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAF1","description":"ICD-EBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Borrelia burgdorferi_ antibody detection of 12 recombinant protein groups_ by immunoblot_ IgG","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0042U","description":"Borrelia burgdorferi_ antibody detection of 12 recombinant protein groups_ by immunoblot_ IgG","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGB1","description":"ICD-FEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVC1","description":"ICD-JGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRF0","description":"ICD-OIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEA1","description":"ICD-MBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWC1","description":"ICD-GDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHB1","description":"ICD-BFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHC0","description":"ICD-AEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQB0","description":"ICD-OFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablate inf turbinate submuc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30802","description":"Ablate inf turbinate submuc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETD0","description":"ICD-EETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOF0","description":"ICD-CEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA3C","description":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation caregiver is trained and certified in dementia care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2185","description":"Documentation caregiver is trained and certified in dementia care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Screening tests dm done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3754F","description":"Screening tests dm done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Protector heel or elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0191","description":"Protector heel or elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAE0","description":"ICD-ADAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hc pro phone call 11-20 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98967","description":"Hc pro phone call 11-20 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0554","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","description":"HCPCS-G0554","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCF1","description":"ICD-BGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERF0","description":"ICD-KERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA114","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Varicella zoster ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87290","description":"Varicella zoster ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt pres antibiotic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8710","description":"Pt pres antibiotic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITB1","description":"ICD-GITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Beta blckr admin w/in 24 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4115F","description":"Beta blckr admin w/in 24 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of breath ethanol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82075","description":"Assay of breath ethanol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMB1","description":"ICD-BDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABME1","description":"ICD-ABME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18A","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTA0","description":"ICD-NCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01652","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01652","description":"CPT-01652","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE215","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat elbow dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24600","description":"Treat elbow dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYD0","description":"ICD-CBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1013","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFE0","description":"ICD-OAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace thrc unit hrt syst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0052T","description":"Replace thrc unit hrt syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOC1","description":"ICD-PKOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRE1","description":"ICD-DFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOB0","description":"ICD-OEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter intraoperative blood vessel microinfusion(s) (e.g._ intraluminal_ vascular wall and/or perivascular) ther","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9759","description":"Transcatheter intraoperative blood vessel microinfusion(s) (e.g._ intraluminal_ vascular wall and/or perivascular) ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1LB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LB11","description":"ICD-1LB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion >2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11303","description":"Shave skin lesion >2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDID0","description":"ICD-BDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Etoposide oral 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8560","description":"Etoposide oral 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopy ligate perf veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37500","description":"Endoscopy ligate perf veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX10","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGD0","description":"ICD-BFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHC1","description":"ICD-BGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINA1","description":"ICD-NINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nervous system surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64999","description":"Nervous system surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOC0","description":"ICD-GGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFD0","description":"ICD-FCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert body dcmprn lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63090","description":"Remove vert body dcmprn lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFD0","description":"ICD-NJFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3EC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EC21","description":"ICD-3EC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIA1","description":"ICD-CCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJB0","description":"ICD-NLJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUD0","description":"ICD-NDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEE1","description":"ICD-EIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1039T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1039T","description":"CPT-1039T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI abdomen w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74181","description":"MRI abdomen w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYB1","description":"ICD-LCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reaching/grabbing device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9281","description":"Reaching/grabbing device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Streptokinase antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86590","description":"Streptokinase antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHD0","description":"ICD-CFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wrist/elbow bowden cable mol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6580","description":"Wrist/elbow bowden cable mol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFF1","description":"ICD-BCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33427","description":"Repair of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ureter endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50957","description":"Ureter endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2CB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CB11","description":"ICD-2CB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUA1","description":"ICD-ODUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHD0","description":"ICD-IIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter insertion or replacement of permanent leadless pacemaker_ right ventricular_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ ventriculography_ fe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33274","description":"Transcatheter insertion or replacement of permanent leadless pacemaker_ right ventricular_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ ventriculography_ fe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEE0","description":"ICD-EEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFE1","description":"ICD-BEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKE0","description":"ICD-JEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADF0","description":"ICD-GADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKC0","description":"ICD-NGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Calc bmi norm parameters","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8420","description":"Calc bmi norm parameters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Liver imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78201","description":"Liver imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD13B","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAC1","description":"ICD-BIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXE0","description":"ICD-GHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXC1","description":"ICD-GDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAC0","description":"ICD-MDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUD1","description":"ICD-GEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystouretero & or pyeloscope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52351","description":"Cystouretero & or pyeloscope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29000","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Islet cell antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86341","description":"Islet cell antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (cutaneous squamous cell carcinoma)_ mRNA gene expression profiling by RT-PCR of 40 genes (34 content and 6 housekeeping)_ utilizing formalin-fixed paraffin-embedded","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0315U","description":"Oncology (cutaneous squamous cell carcinoma)_ mRNA gene expression profiling by RT-PCR of 40 genes (34 content and 6 housekeeping)_ utilizing formalin-fixed paraffin-embedded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise anal ext tag/papilla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46220","description":"Excise anal ext tag/papilla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc nhlstg 1-2 no relap no","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9134","description":"Onc nhlstg 1-2 no relap no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Co57/58","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9546","description":"Co57/58","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUE1","description":"ICD-NKUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE216","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQE1","description":"ICD-PBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPC0","description":"ICD-CGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWB0","description":"ICD-GFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28C","description":"Special Care Low _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMB1","description":"ICD-FBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAB1","description":"ICD-ADAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56632","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18X","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITB1","description":"ICD-OITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB24B","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOC0","description":"ICD-OBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYB1","description":"ICD-GGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLA0","description":"ICD-BDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDC1","description":"ICD-MIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heart failure assessed (includes assessment of all the following components) (CAD): Blood pressure measured (2000F) Level of activity assessed (1003F) Clinical symptoms of vol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0105U","description":"Heart failure assessed (includes assessment of all the following components) (CAD): Blood pressure measured (2000F) Level of activity assessed (1003F) Clinical symptoms of vol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of hip tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27097","description":"Revision of hip tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFE1","description":"ICD-BBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHA0","description":"ICD-IDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTD1","description":"ICD-KFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28X","description":"Special Care High _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILF0","description":"ICD-MILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQD0","description":"ICD-KCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANE1","description":"ICD-JANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLB0","description":"ICD-FBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRE0","description":"ICD-ODRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTA0","description":"ICD-NGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc abd les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22902","description":"Exc abd les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Power bone marrow bx needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1830","description":"Power bone marrow bx needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD22D","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES326","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEE1","description":"ICD-OEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFC1","description":"ICD-NBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES30B","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISB1","description":"ICD-PISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFD1","description":"ICD-OGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Metoclopramide hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2765","description":"Metoclopramide hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert mesh/pelvic flr addon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57267","description":"Insert mesh/pelvic flr addon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDD0","description":"ICD-AHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATF1","description":"ICD-NATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLF1","description":"ICD-ABLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of permanently implantable aortic counterpulsation ventricular assist system; mechano-electrical skin interface","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0457T","description":"Removal of permanently implantable aortic counterpulsation ventricular assist system; mechano-electrical skin interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD10D","description":"Special Care High _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXF1","description":"ICD-FIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWE1","description":"ICD-DHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWD1","description":"ICD-HFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELA1","description":"ICD-EELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQC0","description":"ICD-PJQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Custom grad sleeve med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8422","description":"Custom grad sleeve med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJD0","description":"ICD-GGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mod sed diff phys/qhp add on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99150","description":"Mod sed diff phys/qhp add on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCC0","description":"ICD-OJCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHE0","description":"ICD-AGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23155","description":"Removal of humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGB0","description":"ICD-OJGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9743","description":"Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX56","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj trimetrexate glucoronate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3305","description":"Inj trimetrexate glucoronate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reposition l ventric lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33226","description":"Reposition l ventric lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDD0","description":"ICD-JEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0942T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","description":"CPT-0942T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reguard_ for topical use only_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4255","description":"Reguard_ for topical use only_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINF0","description":"ICD-OINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTF0","description":"ICD-GCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFID0","description":"ICD-GFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRD0","description":"ICD-OCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92642","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","description":"CPT-92642","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFF1","description":"ICD-OAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDA0","description":"ICD-NDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MLH1 (mutL homolog 1) (eg_ hereditary non-polyposis colorectal cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0158U","description":"MLH1 (mutL homolog 1) (eg_ hereditary non-polyposis colorectal cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMB0","description":"ICD-NJMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJA1","description":"ICD-GIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Retainer For Metal Fpd - Noble Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6122","description":"Implant Supported Retainer For Metal Fpd - Noble Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYC1","description":"ICD-LGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEA0","description":"ICD-OBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive hand surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26250","description":"Extensive hand surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lymphocyte culture mixed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86821","description":"Lymphocyte culture mixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pmp22 gene known fam variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81326","description":"Pmp22 gene known fam variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast)_ mRNA_ gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81518","description":"Oncology (breast)_ mRNA_ gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIED1","description":"ICD-JIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQB0","description":"ICD-LBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Swallow current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8996","description":"Swallow current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Next gen aco model<10min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9868","description":"Next gen aco model<10min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C7568","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7568","description":"HCPCS-C7568","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dentures mandibl part metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5214","description":"Dentures mandibl part metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMB1","description":"ICD-BGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWC1","description":"ICD-OLWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Visc & infraren abd 2 prosth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34846","description":"Visc & infraren abd 2 prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIB1","description":"ICD-OFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup long leg plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4029","description":"Cast sup long leg plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUC1","description":"ICD-CGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERB1","description":"ICD-OERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKF0","description":"ICD-CFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2JC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JC31","description":"ICD-2JC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq sacral augmt unilat inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0200T","description":"Perq sacral augmt unilat inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDA0","description":"ICD-JHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; transthoracic exposure (eg_ thoracotomy_ transapical)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0484T","description":"Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; transthoracic exposure (eg_ thoracotomy_ transapical)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0321","description":"Home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHB1","description":"ICD-CBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92631","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","description":"CPT-92631","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMD1","description":"ICD-FGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHB0","description":"ICD-AHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOF1","description":"ICD-HFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ below knee_ 40 mmhg or greater_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6554","description":"Gradient compression stocking_ below knee_ 40 mmhg or greater_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQF1","description":"ICD-OJQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1813","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","description":"HCPCS-E1813","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITC1","description":"ICD-GITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear rx oral admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79005","description":"Nuclear rx oral admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBC0","description":"ICD-ABBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hmes or trach valve housing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7505","description":"Hmes or trach valve housing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA56","description":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt rsk death w/in 1yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1150F","description":"Doc pt rsk death w/in 1yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHD0","description":"ICD-EBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUD1","description":"ICD-KEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLB1","description":"ICD-CDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Botulism ig iv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90288","description":"Botulism ig iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDE1","description":"ICD-GHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ granisetron extended release_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9486","description":"Injection_ granisetron extended release_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35305","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKC1","description":"ICD-NIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITE1","description":"ICD-OITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB05","description":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ortho shoe add leather insol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3500","description":"Ortho shoe add leather insol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTE0","description":"ICD-BGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0901","description":"HCPCS-J0901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFE0","description":"ICD-GBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLD0","description":"ICD-ODLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gabapentin non-blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80355","description":"Gabapentin non-blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug scrn quan mycophenolate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80180","description":"Drug scrn quan mycophenolate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOB1","description":"ICD-LBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; pulse generator only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33280","description":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; pulse generator only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPF0","description":"ICD-GCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIA0","description":"ICD-CHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Supplemental electrical test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92547","description":"Supplemental electrical test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mepolizumab_ 1 mg (Nucala)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9473","description":"Injection_ mepolizumab_ 1 mg (Nucala)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ oritavancin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2407","description":"Injection_ oritavancin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1601","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1601","description":"CDT-D1601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHB1","description":"ICD-KFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAF1","description":"ICD-KBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC2D","description":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcath occlusion non-cns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61626","description":"Transcath occlusion non-cns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL36","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stereoisomer analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80374","description":"Stereoisomer analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD12A","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAC0","description":"ICD-JBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative computed tomography (CT) tissue characterization_ including interpretation and report_ obtained with concurrent CT examination of any structure contained in the c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0722T","description":"Quantitative computed tomography (CT) tissue characterization_ including interpretation and report_ obtained with concurrent CT examination of any structure contained in the c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA12","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1402","description":"HCPCS-C1402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Correct skin color ea 20.0cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11922","description":"Correct skin color ea 20.0cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAB1","description":"ICD-MFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWF0","description":"ICD-PHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vitrectomy_ mechanical_ pars plana approach_ with subretinal injection of pharmacologic/biologic agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9770","description":"Vitrectomy_ mechanical_ pars plana approach_ with subretinal injection of pharmacologic/biologic agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27828","description":"Treat lower leg fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALD1","description":"ICD-MALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thrombomodulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85337","description":"Thrombomodulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Complete occlusal adjustment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9952","description":"Complete occlusal adjustment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLB1","description":"ICD-JDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Muscle-skin graft trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15734","description":"Muscle-skin graft trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHD0","description":"ICD-NEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPF1","description":"ICD-NDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC21","description":"Very High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBC1","description":"ICD-IGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHA0","description":"ICD-GIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEID1","description":"ICD-GEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resin-based composite - four or more surfaces (anterior)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2335","description":"Resin-based composite - four or more surfaces (anterior)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ subsequent treatment_ including noninvasive electroneurographic localizat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0769T","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ subsequent treatment_ including noninvasive electroneurographic localizat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ivig non-lyophilized_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1599","description":"Ivig non-lyophilized_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOD0","description":"ICD-DFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFE1","description":"ICD-BCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 21 Or More Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99423","description":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 21 Or More Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXA0","description":"ICD-GAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHD0","description":"ICD-FAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise spinal cord ligaments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63180","description":"Revise spinal cord ligaments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVA0","description":"ICD-GFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHD1","description":"ICD-KFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insulin for insulin pump use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1817","description":"Insulin for insulin pump use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Albumin; urine (eg_ microalbumin)_ semiquantitative (eg_ reagent strip assay)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82044","description":"Albumin; urine (eg_ microalbumin)_ semiquantitative (eg_ reagent strip assay)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g._ general_ intravenous sedation (monitored anesthesia ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0330","description":"Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g._ general_ intravenous sedation (monitored anesthesia ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYE1","description":"ICD-KFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCF1","description":"ICD-KDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUF1","description":"ICD-BAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Protein c concentrate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2724","description":"Protein c concentrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCID0","description":"ICD-BCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of cranial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64716","description":"Revision of cranial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLB0","description":"ICD-EGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ mRNA expression profiling of HOXC6 and DLX1_ reverse transcription polymerase chain reaction (RT-PCR)_ first-void urine following digital rectal examinati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0339U","description":"Oncology (prostate)_ mRNA expression profiling of HOXC6 and DLX1_ reverse transcription polymerase chain reaction (RT-PCR)_ first-void urine following digital rectal examinati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair solid seat insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0992","description":"Wheelchair solid seat insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALD1","description":"ICD-CALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ romidepsin_ nonlyophilized_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9318","description":"Injection_ romidepsin_ nonlyophilized_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWF0","description":"ICD-HDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJD0","description":"ICD-FFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFB1","description":"ICD-NDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHC0","description":"ICD-FEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger deformity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26590","description":"Repair finger deformity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEND0","description":"ICD-OEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSB1","description":"ICD-HBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKF1","description":"ICD-BCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Othe therapist at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9478","description":"Othe therapist at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D6049","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D6049","description":"CDT-D6049","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj ctr cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33956","description":"Ecmo/ecls insj ctr cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive jaw surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21045","description":"Extensive jaw surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mesh (implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1781","description":"Mesh (implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRD0","description":"ICD-PKRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Idarubicin hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9211","description":"Idarubicin hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES23D","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Io map of sent lymph node","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38900","description":"Io map of sent lymph node","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIA0","description":"ICD-NLIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision graft thorax","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35905","description":"Excision graft thorax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB10D","description":"Special Care High _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOC1","description":"ICD-OLOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"U1nonsealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2364","description":"U1nonsealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYC1","description":"ICD-HBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFA0","description":"ICD-GBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYD0","description":"ICD-DIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBE1","description":"ICD-IIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGC1","description":"ICD-KIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 8 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP08","description":"Auto.test pane pricing code_ 8 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWE1","description":"ICD-OCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC35","description":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRE0","description":"ICD-GIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Salivary surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42699","description":"Salivary surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26418","description":"Repair finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special casting material","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4590","description":"Special casting material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFD1","description":"ICD-OBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHA1","description":"ICD-GHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-pvc intravenous administ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1016","description":"Non-pvc intravenous administ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bk pn xm on init visit date","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2040F","description":"Bk pn xm on init visit date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pemivibart_ for the pre-exposure prophylaxis only_ for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known SARS-CoV-2 e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0224","description":"Injection_ pemivibart_ for the pre-exposure prophylaxis only_ for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known SARS-CoV-2 e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"At least two orders for the same high-risk medications not ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9638","description":"At least two orders for the same high-risk medications not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKA0","description":"ICD-CIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDD0","description":"ICD-AIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYE0","description":"ICD-CAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAA0","description":"ICD-CAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJF0","description":"ICD-OFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of achilles tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27606","description":"Incision of achilles tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFA0","description":"ICD-NCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGC0","description":"ICD-BCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEC1","description":"ICD-NGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove nail plate add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11732","description":"Remove nail plate add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"1st course antitnf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8868","description":"1st course antitnf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSD0","description":"ICD-KBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1701","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1701","description":"HCPCS-B1701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADD0","description":"ICD-MADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKA1","description":"ICD-OBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBF0","description":"ICD-CGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Soft liner for complete or partial removable denture - indirect","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5765","description":"Soft liner for complete or partial removable denture - indirect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJF0","description":"ICD-KGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Platelets leukoreduced irrad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9033","description":"Platelets leukoreduced irrad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHC1","description":"ICD-FIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITF1","description":"ICD-IITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYC0","description":"ICD-CFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat hand joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26070","description":"Explore/treat hand joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSB1","description":"ICD-LHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Temporal artery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37609","description":"Temporal artery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUD0","description":"ICD-GDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGB1","description":"ICD-GGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQA0","description":"ICD-GFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41006","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXC0","description":"ICD-CFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fancc gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81242","description":"Fancc gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr ing hernia baby reduc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49495","description":"Rpr ing hernia baby reduc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSF1","description":"ICD-CFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIF0","description":"ICD-CEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00546","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00546","description":"CPT-00546","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant maintenance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6080","description":"Implant maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQA0","description":"ICD-LAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAB0","description":"ICD-OFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCF0","description":"ICD-OCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLC1","description":"ICD-NDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHC1","description":"ICD-AFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unskilled respite care /15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5150","description":"Unskilled respite care /15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNF0","description":"ICD-BHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYA0","description":"ICD-PGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC23","description":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB25A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol (ethanol); any specimen except breath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6040","description":"Alcohol (ethanol); any specimen except breath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPD1","description":"ICD-BCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIA1","description":"ICD-CBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Who w/o joints cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3906","description":"Who w/o joints cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Term dev mech hand vol open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6708","description":"Term dev mech hand vol open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB201","description":"Special Care High _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSE0","description":"ICD-OKSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB14A","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIA1","description":"ICD-ADIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKA0","description":"ICD-OEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDA0","description":"ICD-OHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQF0","description":"ICD-LEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental coronoidectomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7991","description":"Dental coronoidectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (oropharyngeal)_ detection of minimal residual disease by next-generation sequencing (NGS) based quantitative evaluation of 8 DNA targets_ cell-free HPV 16 and 18 DNA","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0470U","description":"Oncology (oropharyngeal)_ detection of minimal residual disease by next-generation sequencing (NGS) based quantitative evaluation of 8 DNA targets_ cell-free HPV 16 and 18 DNA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBD0","description":"ICD-KEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFD1","description":"ICD-KCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWF0","description":"ICD-KBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC214","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSB1","description":"ICD-DCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy_ flexible_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0885T","description":"Colonoscopy_ flexible_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44376","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEA0","description":"ICD-AIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRE0","description":"ICD-DGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKF1","description":"ICD-CGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28C","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-elec oscillatory pep dvc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0484","description":"Non-elec oscillatory pep dvc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILA1","description":"ICD-IILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrast bath therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97034","description":"Contrast bath therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXF0","description":"ICD-KGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompress eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61330","description":"Decompress eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iron binding test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83550","description":"Iron binding test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mod or severe osa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8846","description":"Mod or severe osa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHC1","description":"ICD-CFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neg pres wound ther drsg set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6550","description":"Neg pres wound ther drsg set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clin depres scrn no f/u doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8511","description":"Clin depres scrn no f/u doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENC0","description":"ICD-BENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKF1","description":"ICD-KCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient admitted for performance of elective carotid intervention","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9689","description":"Patient admitted for performance of elective carotid intervention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTC1","description":"ICD-CCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEB0","description":"ICD-MLEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bk molded distal cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5668","description":"Bk molded distal cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release of midfoot joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28260","description":"Release of midfoot joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylindr 7.25d/.25-2.25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2111","description":"Spherocylindr 7.25d/.25-2.25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNA1","description":"ICD-NBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUC0","description":"ICD-EBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No elig ref for oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8857","description":"No elig ref for oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGED0","description":"ICD-AGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cesarean delivery only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59514","description":"Cesarean delivery only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of biceps tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24340","description":"Repair of biceps tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKF1","description":"ICD-FDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPB1","description":"ICD-GCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychoed svc_ per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2027","description":"Psychoed svc_ per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cyclophosphamide (ingenus)_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9073","description":"Injection_ cyclophosphamide (ingenus)_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXA1","description":"ICD-KFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fqhc visit_ mh estab pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0470","description":"Fqhc visit_ mh estab pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N block inj suprascapular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64418","description":"N block inj suprascapular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pow mobil dev no dmepdac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0899","description":"Pow mobil dev no dmepdac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemo ia push tecnique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96420","description":"Chemo ia push tecnique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVE0","description":"ICD-ODVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocolld drg >16<=48 w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6238","description":"Hydrocolld drg >16<=48 w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spirom fev/fvc <70% w/copd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3025F","description":"Spirom fev/fvc <70% w/copd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth kidney stone destruct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87251","description":"Anesth kidney stone destruct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1 Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66991","description":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1 Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXD0","description":"ICD-CCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBF1","description":"ICD-IIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHD1","description":"ICD-AGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9981","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA0B","description":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUF0","description":"ICD-CGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAB0","description":"ICD-NAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Overdenture partial mandib","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5866","description":"Overdenture partial mandib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGME1","description":"ICD-GGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC213","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPB0","description":"ICD-CCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSA0","description":"ICD-PJSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA21A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYD0","description":"ICD-PAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYD0","description":"ICD-HEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clotting funct activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85397","description":"Clotting funct activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFE1","description":"ICD-GIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUD0","description":"ICD-ICUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient achieves refraction +-1 d for the eye that underwent cataract surgery_ measured at the one month follow up visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9391","description":"Patient achieves refraction +-1 d for the eye that underwent cataract surgery_ measured at the one month follow up visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWB1","description":"ICD-OBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychological or neuropsychological test administration and scoring by technician_ two or more tests_ any method; each additional 30 minutes (List separately in addition to co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96139","description":"Psychological or neuropsychological test administration and scoring by technician_ two or more tests_ any method; each additional 30 minutes (List separately in addition to co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dentures rebase part mandbl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5721","description":"Dentures rebase part mandbl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTC0","description":"ICD-CFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cntct lens pmma color vision","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2503","description":"Cntct lens pmma color vision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services utilized by patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9694","description":"Hospice services utilized by patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHE1","description":"ICD-BDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPF1","description":"ICD-JGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUC0","description":"ICD-GDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco counseling","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1320","description":"Tobacco counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGB0","description":"ICD-ODGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth vaginal procedures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94051","description":"Anesth vaginal procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC250","description":"Clinically Complex _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chlordiazepoxide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1990","description":"Chlordiazepoxide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disposable cycler set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4671","description":"Disposable cycler set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHA0","description":"ICD-MAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQE0","description":"ICD-KGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLD1","description":"ICD-MLLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYF1","description":"ICD-CCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair fibula nonunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27726","description":"Repair fibula nonunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neutron beam tx simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77422","description":"Neutron beam tx simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVE1","description":"ICD-FBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPE0","description":"ICD-OKPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC0A","description":"High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Telethx isodose plan cplx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77307","description":"Telethx isodose plan cplx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIB1","description":"ICD-EBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sleep study unatt&resp efft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95806","description":"Sleep study unatt&resp efft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXE0","description":"ICD-FGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHB0","description":"ICD-FDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt talk eval hlthwkr re mdd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2060F","description":"Pt talk eval hlthwkr re mdd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXD0","description":"ICD-JCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJA1","description":"ICD-FFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEF1","description":"ICD-NCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC41","description":"High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVC0","description":"ICD-OHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection eye drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67028","description":"Injection eye drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDB1","description":"ICD-ECDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dressing change not for burn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15852","description":"Dressing change not for burn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0806","description":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMB0","description":"ICD-GEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYF1","description":"ICD-KBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOD0","description":"ICD-CFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB245","description":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of pharynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42890","description":"Partial removal of pharynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB254","description":"Special Care High _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repr elbw med ligmnt w/tissu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24345","description":"Repr elbw med ligmnt w/tissu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical; with destruction by cryoablation_ posterior nasal nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31243","description":"Nasal/sinus endoscopy_ surgical; with destruction by cryoablation_ posterior nasal nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Family stabilization 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9482","description":"Family stabilization 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8I","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGME0","description":"ICD-CGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology colorectal scr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81528","description":"Oncology colorectal scr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMB1","description":"ICD-EEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLD0","description":"ICD-AHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Helicoll_ per square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4164","description":"Helicoll_ per square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOE1","description":"ICD-PBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01140","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01140","description":"CPT-01140","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noninvas resp support talk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4550F","description":"Noninvas resp support talk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDC1","description":"ICD-KHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB136","description":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAA1","description":"ICD-JFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBE1","description":"ICD-MLBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHF0","description":"ICD-BBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMC1","description":"ICD-MAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair elevating leg res","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0990","description":"Wheelchair elevating leg res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCA1","description":"ICD-ODCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQA0","description":"ICD-DDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wnd prep f/n/hf/g addl cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15005","description":"Wnd prep f/n/hf/g addl cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBE1","description":"ICD-KCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive thyroid surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60254","description":"Extensive thyroid surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00902","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00902","description":"CPT-00902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5161","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","description":"HCPCS-Q5161","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise hand/finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26390","description":"Revise hand/finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy rigid balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43195","description":"Esophagoscopy rigid balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No pt care icu/vent in 24hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4169F","description":"No pt care icu/vent in 24hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABME0","description":"ICD-ABME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVB1","description":"ICD-JCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDC1","description":"ICD-OKDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"NEURO ALZHEIMER CELL AGGREGJ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0206U","description":"NEURO ALZHEIMER CELL AGGREGJ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQF0","description":"ICD-KAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQA1","description":"ICD-CGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin barrier solid 4x4 equiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4372","description":"Skin barrier solid 4x4 equiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAC0","description":"ICD-KHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA3A","description":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKB1","description":"ICD-FEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration/repair of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45563","description":"Exploration/repair of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBF0","description":"ICD-BHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJF1","description":"ICD-KEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEC1","description":"ICD-OJEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGID0","description":"ICD-KGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOE1","description":"ICD-PKOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMA0","description":"ICD-JGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay porcelin 3 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2643","description":"Dental onlay porcelin 3 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0531U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","description":"CPT-0531U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01960","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01960","description":"CPT-01960","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKD0","description":"ICD-BCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHC1","description":"ICD-BEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exchange lens prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66986","description":"Exchange lens prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gingival irrigation per quad","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4921","description":"Gingival irrigation per quad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTA1","description":"ICD-FGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic laryngoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31505","description":"Diagnostic laryngoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSA0","description":"ICD-CCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWF0","description":"ICD-DEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNE1","description":"ICD-KFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB25","description":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical preparation and cannulation of marginal (extended) cadaver donor lung(s) to ex vivo organ perfusion system_ including decannulation_ separation from the perfusion sys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0494T","description":"Surgical preparation and cannulation of marginal (extended) cadaver donor lung(s) to ex vivo organ perfusion system_ including decannulation_ separation from the perfusion sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1493","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","description":"HCPCS-M1493","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIA0","description":"ICD-JBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXC1","description":"ICD-OBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental house call","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9410","description":"Dental house call","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLF0","description":"ICD-ICLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Periodontal scaling 1-3teeth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4342","description":"Periodontal scaling 1-3teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQE1","description":"ICD-KIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Circumcision w/regionl block","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54150","description":"Circumcision w/regionl block","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXB1","description":"ICD-FEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1496","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","description":"HCPCS-M1496","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of knuckle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26516","description":"Fusion of knuckle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28202","description":"Repair/graft of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove stent via transureth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50386","description":"Remove stent via transureth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAD0","description":"ICD-JCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rbc osmotic fragility","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85557","description":"Rbc osmotic fragility","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perc cryo ablate renal tum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50593","description":"Perc cryo ablate renal tum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elbow orthosis (EO)_ with adjustable position locking joint(s)_ prefabricated_ item that has been trimmed_ bent_ molded_ assembled_ or otherwise customized to fit a specific p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3760","description":"Elbow orthosis (EO)_ with adjustable position locking joint(s)_ prefabricated_ item that has been trimmed_ bent_ molded_ assembled_ or otherwise customized to fit a specific p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSC1","description":"ICD-PDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug delivery system >=50 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4305","description":"Drug delivery system >=50 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOD1","description":"ICD-HIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"DNA analysis_ fecal_ for colorectal cancer screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3890","description":"DNA analysis_ fecal_ for colorectal cancer screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Syphilis test non-trep qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86592","description":"Syphilis test non-trep qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD116","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87183","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","description":"CPT-87183","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rituximab and hyaluronidase_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9467","description":"Injection_ rituximab and hyaluronidase_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUD1","description":"ICD-CAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC245","description":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB150","description":"Clinically Complex _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystourethroscopy_ with ureteroscopy and/or pyeloscopy_ with lithotripsy (ureteral catheterization is included) and vacuum aspiration of the kidney_ collecting system and uret","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9761","description":"Cystourethroscopy_ with ureteroscopy and/or pyeloscopy_ with lithotripsy (ureteral catheterization is included) and vacuum aspiration of the kidney_ collecting system and uret","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRF1","description":"ICD-CCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIND1","description":"ICD-JIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGF0","description":"ICD-FIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLF0","description":"ICD-FCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLA0","description":"ICD-EGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antibiot rxd/given","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4120F","description":"Antibiot rxd/given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee orthosis (KO)_ double upright_ thigh and calf_ with adjustable flexion and extension joint (unicentric or polycentric)_ medial-lateral and rotation control_ with or witho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1852","description":"Knee orthosis (KO)_ double upright_ thigh and calf_ with adjustable flexion and extension joint (unicentric or polycentric)_ medial-lateral and rotation control_ with or witho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHE1","description":"ICD-GBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCED0","description":"ICD-NCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Manipulate wrist w/anesthes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25259","description":"Manipulate wrist w/anesthes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDC1","description":"ICD-KCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBD0","description":"ICD-FFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC32","description":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNE0","description":"ICD-GCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWB1","description":"ICD-HAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBF0","description":"ICD-CFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Derma-fat-fascia graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15770","description":"Derma-fat-fascia graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCF0","description":"ICD-ACCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remv&replc pm gen mult leads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33229","description":"Remv&replc pm gen mult leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93965","description":"Extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBD0","description":"ICD-BCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove elctrd transvenously","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33244","description":"Remove elctrd transvenously","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Quinupristin/dalfopristin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2770","description":"Quinupristin/dalfopristin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comm psy sup tx pgm per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0037","description":"Comm psy sup tx pgm per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of foot fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28008","description":"Incision of foot fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJC1","description":"ICD-CDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHD1","description":"ICD-NJHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic shoe w/off set heel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5506","description":"Diabetic shoe w/off set heel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAD0","description":"ICD-CHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Indirect immunofluorescence","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0483","description":"Indirect immunofluorescence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCD0","description":"ICD-MCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIE1","description":"ICD-NKIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphere bifocal 4.12-7.0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2201","description":"Lens sphere bifocal 4.12-7.0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFA0","description":"ICD-CEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAB0","description":"ICD-MIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE105","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUD1","description":"ICD-JFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOE0","description":"ICD-LIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC14C","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSE0","description":"ICD-LCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heat quant sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0109T","description":"Heat quant sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGED0","description":"ICD-FGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sialolithotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7980","description":"Sialolithotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRE1","description":"ICD-KDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray/ct/ultrsnd et al ord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3319F","description":"X-ray/ct/ultrsnd et al ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADD0","description":"ICD-NADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N block inj occipital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64405","description":"N block inj occipital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9702","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental connector bar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6920","description":"Dental connector bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Portable 02 contents_ gas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0443","description":"Portable 02 contents_ gas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC104","description":"Reduced Physical Function _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44378","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74020","description":"X-ray exam of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUD0","description":"ICD-KEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWE0","description":"ICD-CFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYB0","description":"ICD-GBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTB0","description":"ICD-FGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBE1","description":"ICD-IBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMB1","description":"ICD-NKMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSB0","description":"ICD-PBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fem/popl revas w/tla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37224","description":"Fem/popl revas w/tla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUE0","description":"ICD-NBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9945","description":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVD1","description":"ICD-GFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIE1","description":"ICD-EBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYC0","description":"ICD-LCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYC1","description":"ICD-OEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dispensing fee bicros","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5240","description":"Dispensing fee bicros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXE1","description":"ICD-ODXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7172","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","description":"HCPCS-J7172","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHF1","description":"ICD-KAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Forearm crutch platform atta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0153","description":"Forearm crutch platform atta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITD0","description":"ICD-CITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAD0","description":"ICD-IEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWC0","description":"ICD-KIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRB1","description":"ICD-PIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Monosuspension arm/hand supp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2630","description":"Monosuspension arm/hand supp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYF1","description":"ICD-DEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUF0","description":"ICD-OLUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove penis & nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54135","description":"Remove penis & nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWF0","description":"ICD-HFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2001","description":"HCPCS-A2001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Imp/abut rem dent part max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6112","description":"Imp/abut rem dent part max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKD1","description":"ICD-JCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA34","description":"High Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE15A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath place cardio brachytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92974","description":"Cath place cardio brachytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic cholecystectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47562","description":"Laparoscopic cholecystectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX01","description":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Somatosensory testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95925","description":"Somatosensory testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68115","description":"Remove eyelid lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDE0","description":"ICD-NBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSF0","description":"ICD-GGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEB0","description":"ICD-AHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNF1","description":"ICD-FBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUD0","description":"ICD-MDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Afo tib fx cast plaster mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2106","description":"Afo tib fx cast plaster mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD104","description":"Special Care Low _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC214","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIC0","description":"ICD-JDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Close mult vsd w/resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33676","description":"Close mult vsd w/resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXB1","description":"ICD-FDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainable pch w ex wear barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4388","description":"Drainable pch w ex wear barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIE1","description":"ICD-EGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fuse gallbladder & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47740","description":"Fuse gallbladder & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB23D","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDF0","description":"ICD-EHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPB0","description":"ICD-NJPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prednisolone oral per 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7510","description":"Prednisolone oral per 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWD1","description":"ICD-KFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEC1","description":"ICD-BCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome analysis 20-25","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88245","description":"Chromosome analysis 20-25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA116","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1403","description":"HCPCS-C1403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAD1","description":"ICD-NCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cervical head harness/halter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0942","description":"Cervical head harness/halter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWA0","description":"ICD-PFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJA1","description":"ICD-OFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHB1","description":"ICD-OLHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Relocation of testis(es)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54680","description":"Relocation of testis(es)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB1A","description":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAC0","description":"ICD-MIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBF1","description":"ICD-EEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYE0","description":"ICD-PDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEC0","description":"ICD-CDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKA0","description":"ICD-NAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoplasty; for laryngeal stenosis_ with graft_ without indwelling stent placement_ younger than 12 years of age","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31551","description":"Laryngoplasty; for laryngeal stenosis_ with graft_ without indwelling stent placement_ younger than 12 years of age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYF0","description":"ICD-CEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICF0","description":"ICD-IICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGA0","description":"ICD-JIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLE0","description":"ICD-ICLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr fem hernia init blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49553","description":"Rpr fem hernia init blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFF0","description":"ICD-NCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputate hand at wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25922","description":"Amputate hand at wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJF1","description":"ICD-JFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB15C","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nash fibrosure(tm)_ labcorp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0003M","description":"Nash fibrosure(tm)_ labcorp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dermabrasion suprfl any site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15783","description":"Dermabrasion suprfl any site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amikacin sulfate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0278","description":"Amikacin sulfate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLME0","description":"ICD-OLME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWA0","description":"ICD-KHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHC1","description":"ICD-FDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nursing facility care init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99305","description":"Nursing facility care init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit cath repair kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5518","description":"Hit cath repair kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNA1","description":"ICD-NJNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOD1","description":"ICD-OBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIC0","description":"ICD-BGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Carbidopa levodopa enteral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7340","description":"Carbidopa levodopa enteral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUF1","description":"ICD-IIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; interpretation and report only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76989","description":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; interpretation and report only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUB0","description":"ICD-FEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFED1","description":"ICD-IFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIB1","description":"ICD-OCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath cell enhance tech","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88112","description":"Cytopath cell enhance tech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA34","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKE1","description":"ICD-FEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQB0","description":"ICD-CEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"External patient-activated_ physician- or other qualified health care professional-prescribed_ electrocardiographic rhythm derived event recorder without 24 hour attended moni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0497T","description":"External patient-activated_ physician- or other qualified health care professional-prescribed_ electrocardiographic rhythm derived event recorder without 24 hour attended moni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVC1","description":"ICD-GAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ac5 advanced wound system (ac5)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2020","description":"Ac5 advanced wound system (ac5)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPD1","description":"ICD-BEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostomy speaking valve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8501","description":"Tracheostomy speaking valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCE0","description":"ICD-MKCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOA0","description":"ICD-DDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tis trnfr e/n/e/l 10 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14060","description":"Tis trnfr e/n/e/l 10 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of ureter & kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50740","description":"Fusion of ureter & kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHE1","description":"ICD-JDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acupunct w/stimul addl 15m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97814","description":"Acupunct w/stimul addl 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB21C","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA1A","description":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26727","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES160","description":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of gum tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41830","description":"Removal of gum tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC117","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEED0","description":"ICD-OEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES25B","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vincristine sulfate 1 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9370","description":"Vincristine sulfate 1 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBD0","description":"ICD-MFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Upper extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93931","description":"Upper extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWE0","description":"ICD-CCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lefort iii w/fhdw/o lefort i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21159","description":"Lefort iii w/fhdw/o lefort i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA41","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCD1","description":"ICD-IGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSE0","description":"ICD-KCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brain flow imaging only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78610","description":"Brain flow imaging only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAA0","description":"ICD-AEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dicyclomine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0500","description":"Dicyclomine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1902","description":"HCPCS-A1902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRF0","description":"ICD-PJRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB250","description":"Reduced Physical Function _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB115","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISD0","description":"ICD-HISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACF1","description":"ICD-AACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATA0","description":"ICD-KATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBE0","description":"ICD-MIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0220","description":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWA1","description":"ICD-PJWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMC0","description":"ICD-GEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01522","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01522","description":"CPT-01522","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNA1","description":"ICD-KGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27556","description":"Treat knee dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Composite byp grft 2 veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35682","description":"Composite byp grft 2 veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pediatrics (vasculitis_ Kawasaki disease [KD])_ analysis of 3 biomarkers (NT-proBNP_ C-reactive protein_ and T-uptake)_ plasma_ algorithm reported as a risk score for KD","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0310U","description":"Pediatrics (vasculitis_ Kawasaki disease [KD])_ analysis of 3 biomarkers (NT-proBNP_ C-reactive protein_ and T-uptake)_ plasma_ algorithm reported as a risk score for KD","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITD0","description":"ICD-GITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prq card revasc chronic 1vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92943","description":"Prq card revasc chronic 1vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA11","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB25C","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVF1","description":"ICD-KAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC23","description":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of toe tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28010","description":"Incision of toe tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCC0","description":"ICD-CFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHD1","description":"ICD-CHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc prac cond noadd by guide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9061","description":"Onc prac cond noadd by guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home visit new pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99325","description":"Domicil/r-home visit new pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE115","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUF1","description":"ICD-MAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE255","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCA1","description":"ICD-KBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAF0","description":"ICD-BFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLD0","description":"ICD-CHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXD1","description":"ICD-JDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPC0","description":"ICD-OKPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBB1","description":"ICD-NEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYB0","description":"ICD-GIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB20A","description":"Special Care Low _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJB0","description":"ICD-KDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of new or replacement of permanent pacemaker with atrial and ventricular transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for lef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7539","description":"Insertion of new or replacement of permanent pacemaker with atrial and ventricular transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for lef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFB0","description":"ICD-FAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dx duod intub w/asp specs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43757","description":"Dx duod intub w/asp specs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUC0","description":"ICD-CIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENB0","description":"ICD-BENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCF1","description":"ICD-IHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Static str shldr dev rom adj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1841","description":"Static str shldr dev rom adj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unexplained constitutional or other heritable disorders or syndromes_ tissue-specific gene expression by whole-transcriptome and next-generation sequencing_ blood_ formalin-fi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0266U","description":"Unexplained constitutional or other heritable disorders or syndromes_ tissue-specific gene expression by whole-transcriptome and next-generation sequencing_ blood_ formalin-fi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVF1","description":"ICD-JFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCF0","description":"ICD-ADCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGD0","description":"ICD-ODGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBE1","description":"ICD-JDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wrist replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25446","description":"Wrist replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUD1","description":"ICD-JBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No tpa init w/in 3 hrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8602","description":"No tpa init w/in 3 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE22A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSD0","description":"ICD-OBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANE0","description":"ICD-OANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFE1","description":"ICD-BGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pressure pneum appl half leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0673","description":"Pressure pneum appl half leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown resin w/ high noble me","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2720","description":"Crown resin w/ high noble me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aspirate/inj ganglion cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20612","description":"Aspirate/inj ganglion cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLC0","description":"ICD-JCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repositioning Of Previously Implanted Substernal Implantable Defibrillator-Pacing Electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0574T","description":"Repositioning Of Previously Implanted Substernal Implantable Defibrillator-Pacing Electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ any specimen source","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2023","description":"Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ any specimen source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTD0","description":"ICD-JHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA21","description":"Low Rehab_ ADL Index 0-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHB1","description":"ICD-NLHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Denture interm part maxill","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5820","description":"Denture interm part maxill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAE1","description":"ICD-AFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQA0","description":"ICD-HIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJC0","description":"ICD-CIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGB1","description":"ICD-OEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD145","description":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMD1","description":"ICD-OCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Peripheral nerve block (PNB)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9770","description":"Peripheral nerve block (PNB)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEB0","description":"ICD-GEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Health Care Practitioners Rendering Treatment In Place (Tip)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2021","description":"Health Care Practitioners Rendering Treatment In Place (Tip)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELF0","description":"ICD-CELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJC1","description":"ICD-CCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Uri episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to or on the episode date","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2174","description":"Uri episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to or on the episode date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemo prolong infuse w/pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96416","description":"Chemo prolong infuse w/pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Group (2 Or More Patients)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96165","description":"Health Behavior Intervention_ Group (2 Or More Patients)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastrointestinal Tract Imaging_ Intraluminal (Eg_ Capsule Endoscopy)_ Colon_ With Interpretation And Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91113","description":"Gastrointestinal Tract Imaging_ Intraluminal (Eg_ Capsule Endoscopy)_ Colon_ With Interpretation And Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUD0","description":"ICD-ACUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Buprenorphine implant_ 74.2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0570","description":"Buprenorphine implant_ 74.2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBF0","description":"ICD-GFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRE0","description":"ICD-DHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":">=50% of total number of a patient_s outpatient RA encounters assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1007","description":">=50% of total number of a patient_s outpatient RA encounters assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digoxin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1160","description":"Digoxin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX0D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXB1","description":"ICD-BFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFC0","description":"ICD-JBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Visual field examination(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92081","description":"Visual field examination(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove in/ex hem grp w/fistu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46258","description":"Remove in/ex hem grp w/fistu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUB0","description":"ICD-MJUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eardrum revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69450","description":"Eardrum revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28B","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUC0","description":"ICD-ABUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD215","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Herpes simplex type 1 test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86695","description":"Herpes simplex type 1 test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immediate maxillary partial denture - flexible base (including any clasps_ rests and teeth)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5227","description":"Immediate maxillary partial denture - flexible base (including any clasps_ rests and teeth)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTF0","description":"ICD-CDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Asp not presc doc reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9436","description":"Asp not presc doc reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc order given stop antibio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4043F","description":"Doc order given stop antibio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal cancer)_ evaluation for mutations of APC_ BRAF_ CTNNB1_ KRAS_ NRAS_ PIK3CA_ SMAD4_ and TP53_ and methylation markers (MYO1G_ KCNQ5_ C9ORF50_ FLI1_ CLIP4_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0368U","description":"Oncology (colorectal cancer)_ evaluation for mutations of APC_ BRAF_ CTNNB1_ KRAS_ NRAS_ PIK3CA_ SMAD4_ and TP53_ and methylation markers (MYO1G_ KCNQ5_ C9ORF50_ FLI1_ CLIP4_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99215","description":"Office/outpatient visit est","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAF1","description":"ICD-BGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat each add spine fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22328","description":"Treat each add spine fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXF1","description":"ICD-KEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAF0","description":"ICD-GEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1419","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","description":"HCPCS-M1419","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVE0","description":"ICD-JDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTB1","description":"ICD-KFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month) following only one surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9376","description":"Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month) following only one surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-15014","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","description":"CPT-15014","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8H","description":"Medium Rehab _ ADL Index 0-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX07","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAF1","description":"ICD-KHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPD0","description":"ICD-NDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB14D","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No 1dose meni vac btwn 11&13","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9415","description":"No 1dose meni vac btwn 11&13","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"INJECTION_ OCRELIZUMAB_ 1 MG (OCREVUS)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9494","description":"INJECTION_ OCRELIZUMAB_ 1 MG (OCREVUS)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBME0","description":"ICD-IBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFC1","description":"ICD-CFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXD0","description":"ICD-KEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGID0","description":"ICD-GGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD12A","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB36","description":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISB1","description":"ICD-CISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAF0","description":"ICD-OHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iiv3 vaccine 6-35 months im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90657","description":"Iiv3 vaccine 6-35 months im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ diagnostic with cell washing(s) when performed_ with computer-assisted image-guided navigation_ including fluoroscopic guidance when performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7509","description":"Bronchoscopy_ rigid or flexible_ diagnostic with cell washing(s) when performed_ with computer-assisted image-guided navigation_ including fluoroscopic guidance when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMC0","description":"ICD-GCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1130","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vte prophylaxis rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4069F","description":"Vte prophylaxis rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAA0","description":"ICD-CEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGF1","description":"ICD-BDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin substitute_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4100","description":"Skin substitute_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB110","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy thru stoma spx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44388","description":"Colonoscopy thru stoma spx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILF1","description":"ICD-AILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal and replacement of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; transvenous sti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33288","description":"Removal and replacement of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; transvenous sti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ bin_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5259","description":"Hearing aid_ digit_ bin_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pfizer-BioNTech Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC mRNA 30mcg/0.3mL IM DOSE BOOSTER)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1709","description":"Pfizer-BioNTech Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC mRNA 30mcg/0.3mL IM DOSE BOOSTER)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66762","description":"Revision of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILA0","description":"ICD-KILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mast rad urban type","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19306","description":"Mast rad urban type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIA1","description":"ICD-JGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVD0","description":"ICD-OIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sgd sftwre prgrm for pc/pda","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2511","description":"Sgd sftwre prgrm for pc/pda","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove pilonidal cyst exten","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11771","description":"Remove pilonidal cyst exten","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOB0","description":"ICD-LEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOC1","description":"ICD-OIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1123","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMD1","description":"ICD-JCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATB1","description":"ICD-KATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGD0","description":"ICD-NFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Zanamivir_ inh pwdr_ brand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9034","description":"Zanamivir_ inh pwdr_ brand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOB0","description":"ICD-CDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXE1","description":"ICD-NKXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEE0","description":"ICD-NKEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWC0","description":"ICD-GCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLF1","description":"ICD-EBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compression bandage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8431","description":"Compression bandage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAE0","description":"ICD-FDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trim skin lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11055","description":"Trim skin lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMC1","description":"ICD-ADMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOE0","description":"ICD-DBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lab labial veneer porcelain","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2962","description":"Lab labial veneer porcelain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQC0","description":"ICD-CCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPD0","description":"ICD-NLPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx brst stg1-2 noprogres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9072","description":"Onc dx brst stg1-2 noprogres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHD0","description":"ICD-AAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGB0","description":"ICD-NKGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRB0","description":"ICD-PGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGE1","description":"ICD-CIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9808","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9808","description":"HCPCS-C9808","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASD0","description":"ICD-KASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9986","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMC0","description":"ICD-EBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ conforming gauze_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6596","description":"Gradient compression bandaging supply_ conforming gauze_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWF1","description":"ICD-DHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bh ltc res r&b_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2048","description":"Bh ltc res r&b_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABB1","description":"ICD-JABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNA0","description":"ICD-NDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35131","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC250","description":"Reduced Physical Function _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-91323","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","description":"CPT-91323","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Technetium tc-99m teboroxime","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9501","description":"Technetium tc-99m teboroxime","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBE0","description":"ICD-FGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXF1","description":"ICD-FAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMA0","description":"ICD-IDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENE0","description":"ICD-KENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hip arthroscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29860","description":"Hip arthroscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGD0","description":"ICD-JIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC115","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXA1","description":"ICD-NIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of sacroiliac joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27280","description":"Fusion of sacroiliac joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24800","description":"Fusion of elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDF1","description":"ICD-GEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDC0","description":"ICD-AEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQB0","description":"ICD-GHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQB0","description":"ICD-CDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSB0","description":"ICD-LBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair accessory_ foot box_ any type_ includes attachment and mounting hardware_ each foot.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0954","description":"Wheelchair accessory_ foot box_ any type_ includes attachment and mounting hardware_ each foot.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oral prescription drug chemo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8999","description":"Oral prescription drug chemo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mental health service_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0046","description":"Mental health service_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKF1","description":"ICD-NCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair tongue laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41250","description":"Repair tongue laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC54","description":"Medium Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth skull repair/fract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21551","description":"Anesth skull repair/fract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open chest heart massage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32160","description":"Open chest heart massage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Teniposide_ 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2017","description":"Teniposide_ 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARF1","description":"ICD-CARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLD1","description":"ICD-JDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAB1","description":"ICD-ODAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"M.avium-intra dna dir prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87560","description":"M.avium-intra dna dir prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0912T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","description":"CPT-0912T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECA0","description":"ICD-AECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27265","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing care not possible because the patient self-discharged early (e.g._ financial or insurance reasons_ transportation problems_ or reason unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1148","description":"Ongoing care not possible because the patient self-discharged early (e.g._ financial or insurance reasons_ transportation problems_ or reason unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXF1","description":"ICD-OAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Retain crown resin w hi nble","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6720","description":"Retain crown resin w hi nble","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cerliponase alfa_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9014","description":"Injection_ cerliponase alfa_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sincalide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2805","description":"Sincalide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removable soft interface le","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0672","description":"Removable soft interface le","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ethmoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31201","description":"Removal of ethmoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","description":"HCPCS-Q4405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Debridement_ bone including epidermis_ dermis_ subcutaneous tissue_ muscle and/or fascia_ if performed_ first 20 sq cm or less with manual preparation and insertion of deep (e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7500","description":"Debridement_ bone including epidermis_ dermis_ subcutaneous tissue_ muscle and/or fascia_ if performed_ first 20 sq cm or less with manual preparation and insertion of deep (e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tagraxofusp-erzs_ 10 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9269","description":"Injection_ tagraxofusp-erzs_ 10 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (CT) ima","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0808T","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (CT) ima","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARA1","description":"ICD-CARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE14C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ophth us b w/non-quant a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76512","description":"Ophth us b w/non-quant a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"RHD&RHCE GNTYP RHD1-10&RHCE5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0198U","description":"RHD&RHCE GNTYP RHD1-10&RHCE5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWF0","description":"ICD-CCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01234","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01234","description":"CPT-01234","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lso s/c shell/panel prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0639","description":"Lso s/c shell/panel prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","description":"HCPCS-J2601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCB1","description":"ICD-EDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of bile duct tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47712","description":"Excision of bile duct tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Scaling and debridement in the presence of inflammation or mucositis of a single implant_ including cleaning of the implant surfaces_ without flap entry and closure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6081","description":"Scaling and debridement in the presence of inflammation or mucositis of a single implant_ including cleaning of the implant surfaces_ without flap entry and closure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWE1","description":"ICD-LHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITE1","description":"ICD-AITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of artery/vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35761","description":"Exploration of artery/vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAD1","description":"ICD-AGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision (eg_ augmentation_ division of tether)_ replacement_ or removal of thoracolumbar or lumbar vertebral body tethering_ including thoracoscopy_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0790T","description":"Revision (eg_ augmentation_ division of tether)_ replacement_ or removal of thoracolumbar or lumbar vertebral body tethering_ including thoracoscopy_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB13","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUC1","description":"ICD-GHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHF1","description":"ICD-JFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARC1","description":"ICD-OARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYC1","description":"ICD-KAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCED0","description":"ICD-KCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOD0","description":"ICD-DGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNA0","description":"ICD-FBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Max ultrasound image capture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0386","description":"Max ultrasound image capture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWB1","description":"ICD-OJWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC22D","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYE1","description":"ICD-GEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQF0","description":"ICD-GEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFED1","description":"ICD-OFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy remov fb/fibrin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32653","description":"Thoracoscopy remov fb/fibrin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CaregraFT_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4322","description":"CaregraFT_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg 0.6-1 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11601","description":"Exc tr-ext mal+marg 0.6-1 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special radiation dosimetry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77331","description":"Special radiation dosimetry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTE1","description":"ICD-OCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cerv artific diskectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22856","description":"Cerv artific diskectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"External recharg sys intern","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8689","description":"External recharg sys intern","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive brief counseling if identified as an unhealthy alcohol user_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2202","description":"Patient did not receive brief counseling if identified as an unhealthy alcohol user_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"NUDT15 (nudix hydrolase 15) (eg_ drug metabolism) gene analysis_ common variant(s) (eg_ *2_ *3_ *4_ *5_ *6)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81306","description":"NUDT15 (nudix hydrolase 15) (eg_ drug metabolism) gene analysis_ common variant(s) (eg_ *2_ *3_ *4_ *5_ *6)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Albumin (human)_ 25%_ 20 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9046","description":"Albumin (human)_ 25%_ 20 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interprofessional telephone/internet/electronic health record clinical question/request for specialty recommendations by a treating/requesting physician or other qualified hea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9037","description":"Interprofessional telephone/internet/electronic health record clinical question/request for specialty recommendations by a treating/requesting physician or other qualified hea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MSH2 (mutS homolog 2) (eg_ hereditary colon cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0159U","description":"MSH2 (mutS homolog 2) (eg_ hereditary colon cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant tcat pulm vlv perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33477","description":"Implant tcat pulm vlv perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANF0","description":"ICD-GANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Occlusal guard - hard appliance_ full arch","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9944","description":"Occlusal guard - hard appliance_ full arch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB114","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23156","description":"Removal of humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTD0","description":"ICD-GCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMD0","description":"ICD-BFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAD1","description":"ICD-OAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tte w or w/o fol w/con_stres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8928","description":"Tte w or w/o fol w/con_stres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exclusion Of Left Atrial Appendage_ Open_ Performed At The Time Of Other Sternotomy Or Thoracotomy Procedure(S)_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33268","description":"Exclusion Of Left Atrial Appendage_ Open_ Performed At The Time Of Other Sternotomy Or Thoracotomy Procedure(S)_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 22 And Functional Status Measure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2145","description":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 22 And Functional Status Measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE13D","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home ventilator_ dual-function respiratory device_ also performs additional function of cough stimulation_ includes all accessories_ components and supplies for all functions","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0468","description":"Home ventilator_ dual-function respiratory device_ also performs additional function of cough stimulation_ includes all accessories_ components and supplies for all functions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breast cancer dx min invsive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8875","description":"Breast cancer dx min invsive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFND1","description":"ICD-JFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC15B","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Denture reln part maxil chr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5740","description":"Denture reln part maxil chr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKD1","description":"ICD-BCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC25C","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Power module combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0479","description":"Power module combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve (Monarch external Trigeminal Nerve Stimulation (eTNS) System.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1016","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve (Monarch external Trigeminal Nerve Stimulation (eTNS) System.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dolasetron 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0174","description":"Dolasetron 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp4 std sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0877","description":"Pwc gp4 std sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA3B","description":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPE0","description":"ICD-FHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abortion (mpr)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59866","description":"Abortion (mpr)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27441","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bmi is documented within normal parameters and no follow-up plan is required","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1296","description":"Bmi is documented within normal parameters and no follow-up plan is required","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQD1","description":"ICD-HBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Molecular diagnostic test reader_ nonprescription self-administered and self-collected use_ fda approved_ authorized or cleared","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1035","description":"Molecular diagnostic test reader_ nonprescription self-administered and self-collected use_ fda approved_ authorized or cleared","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair esophagus wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43415","description":"Repair esophagus wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0638U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0638U","description":"CPT-0638U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHA0","description":"ICD-MGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDD0","description":"ICD-GHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tens suppl 2 lead per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4595","description":"Tens suppl 2 lead per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extra-oral posterior dental radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0705","description":"Extra-oral posterior dental radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colectomy w/ileoanal anast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44157","description":"Colectomy w/ileoanal anast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOE0","description":"ICD-ODOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ret dev_ insertable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1773","description":"Ret dev_ insertable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onsite Ac C Tx Nsg Fac Res Uti Bill Sid-Benef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9684","description":"Onsite Ac C Tx Nsg Fac Res Uti Bill Sid-Benef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDF1","description":"ICD-IIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRE0","description":"ICD-CIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Viper venom prothrombin time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85612","description":"Viper venom prothrombin time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLD0","description":"ICD-ECLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ASXL1 (additional sex combs like 1_ transcriptional regulator) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms_ chronic myelomonocytic leukemia)_ gene analysis; ta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81176","description":"ASXL1 (additional sex combs like 1_ transcriptional regulator) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms_ chronic myelomonocytic leukemia)_ gene analysis; ta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cus elbo skt in for con/atyp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6696","description":"Cus elbo skt in for con/atyp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contact layer > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6208","description":"Contact layer > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foot single axis ankle/foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5974","description":"Foot single axis ankle/foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEF0","description":"ICD-NDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBA1","description":"ICD-CEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lab labial veneer resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2961","description":"Lab labial veneer resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /No PPS (or OBRA) assessment due to one of the following: Stay is less than 8 days_ or SNF notified untimely of MSP denial_ or SNF notified untimely of revocation of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA00","description":"Default_ /No PPS (or OBRA) assessment due to one of the following: Stay is less than 8 days_ or SNF notified untimely of MSP denial_ or SNF notified untimely of revocation of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-covered item or service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9270","description":"Non-covered item or service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHD0","description":"ICD-KAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLE1","description":"ICD-MJLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKA1","description":"ICD-GHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair palate pharynx/uvula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42145","description":"Repair palate pharynx/uvula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plan of care 4 pain docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0521F","description":"Plan of care 4 pain docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4545","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","description":"HCPCS-A4545","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extraction erupted tooth/exr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7140","description":"Extraction erupted tooth/exr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; known familial variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81190","description":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; known familial variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63251","description":"Anesth removal of nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduction of rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45900","description":"Reduction of rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of fibula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27641","description":"Partial removal of fibula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVE0","description":"ICD-OAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOA0","description":"ICD-OJOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELF0","description":"ICD-FELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUC0","description":"ICD-CFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMD0","description":"ICD-MDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC211","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBND1","description":"ICD-OBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVD1","description":"ICD-CFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBD0","description":"ICD-MJBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBA1","description":"ICD-NFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Generator_ neuro non-recharg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1767","description":"Generator_ neuro non-recharg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPF0","description":"ICD-KHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATC0","description":"ICD-FATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCB1","description":"ICD-ADCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31085","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEF0","description":"ICD-IGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDE0","description":"ICD-BDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fqhc visit new patient","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0466","description":"Fqhc visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"West nile virus ab igm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86788","description":"West nile virus ab igm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFE0","description":"ICD-GIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA5B","description":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00212","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00212","description":"CPT-00212","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYD0","description":"ICD-CHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth abdominal wall surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73051","description":"Anesth abdominal wall surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOE1","description":"ICD-PAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compl gift case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4013","description":"Compl gift case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWF1","description":"ICD-GIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD131","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITA1","description":"ICD-MITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUA0","description":"ICD-MIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSE0","description":"ICD-PGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB112","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-93896","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","description":"CPT-93896","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comparative DNA analysis using multiple selected single-nucleotide polymorphisms (SNPs)_ urine and buccal DNA_ for specimen identity verification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0079U","description":"Comparative DNA analysis using multiple selected single-nucleotide polymorphisms (SNPs)_ urine and buccal DNA_ for specimen identity verification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLD0","description":"ICD-AFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVE0","description":"ICD-NAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce pulmonary artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33690","description":"Reinforce pulmonary artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQD1","description":"ICD-GGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQD1","description":"ICD-KHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Evasc prlng admn rx agnt 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61650","description":"Evasc prlng admn rx agnt 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablate atria lmtd endo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33265","description":"Ablate atria lmtd endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDD1","description":"ICD-IBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLE1","description":"ICD-ADLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27580","description":"Fusion of knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSE1","description":"ICD-KDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Add clasp to partial denture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5660","description":"Add clasp to partial denture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMC0","description":"ICD-FIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36566","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUC0","description":"ICD-CBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter placement of intravascular stent(s)_ central dialysis segment_ performed through dialysis circuit_ including all imaging and radiological supervision and interpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36908","description":"Transcatheter placement of intravascular stent(s)_ central dialysis segment_ performed through dialysis circuit_ including all imaging and radiological supervision and interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo ablate renal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50541","description":"Laparo ablate renal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy belt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4367","description":"Ostomy belt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair umbilical lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49606","description":"Repair umbilical lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXB0","description":"ICD-JHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPA1","description":"ICD-BGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTF0","description":"ICD-ECTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETA1","description":"ICD-BETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1043T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1043T","description":"CPT-1043T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision graft abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35907","description":"Excision graft abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA56","description":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Test socket symes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5618","description":"Test socket symes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHD1","description":"ICD-BHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADD0","description":"ICD-OADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial hosp prog service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0129","description":"Partial hosp prog service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGA0","description":"ICD-NFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABA1","description":"ICD-EABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Computed Tomography_ Thorax_ Low Dose For Lung Cancer Screening_ Without Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71271","description":"Computed Tomography_ Thorax_ Low Dose For Lung Cancer Screening_ Without Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Egd us transmural injxn/mark","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43253","description":"Egd us transmural injxn/mark","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N block spenopalatine gangl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64505","description":"N block spenopalatine gangl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGF0","description":"ICD-FAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chiropract manj xtrspinl 1/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98943","description":"Chiropract manj xtrspinl 1/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ travoprost_ intracameral implant_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7355","description":"Injection_ travoprost_ intracameral implant_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medical nutrition indiv in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97802","description":"Medical nutrition indiv in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBD1","description":"ICD-IBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC02","description":"Ultra High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXF0","description":"ICD-GIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Myelogphy 2/> spine regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72270","description":"Myelogphy 2/> spine regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYB1","description":"ICD-OEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJE1","description":"ICD-JIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28D","description":"Clinically Complex _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIC0","description":"ICD-JBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0673","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0673","description":"HCPCS-G0673","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE10A","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B2005","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2005","description":"HCPCS-B2005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elbow mold doub splt soc ste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6120","description":"Elbow mold doub splt soc ste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB117","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Facial moulage sectional","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5911","description":"Facial moulage sectional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWB0","description":"ICD-KGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01780","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01780","description":"CPT-01780","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMC0","description":"ICD-IDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision pericoronal gingiva","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7971","description":"Excision pericoronal gingiva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging_ breast_ without and with contrast material(s)_ including computer-aided detection (CAD real-time lesion detection_ characterization and pharmacokin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77048","description":"Magnetic resonance imaging_ breast_ without and with contrast material(s)_ including computer-aided detection (CAD real-time lesion detection_ characterization and pharmacokin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope procedure liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47379","description":"Laparoscope procedure liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDC0","description":"ICD-CGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGB1","description":"ICD-JBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ C-1 Esterase Inhibitor (Recombinant) Ruconest_ 10 Units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9445","description":"Injection_ C-1 Esterase Inhibitor (Recombinant) Ruconest_ 10 Units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18F","description":"Special Care Low _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOD0","description":"ICD-CGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Darbepoetin alfa_ non-esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0881","description":"Darbepoetin alfa_ non-esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2GA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GA11","description":"ICD-2GA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSD1","description":"ICD-PGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPE0","description":"ICD-CEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunofluor antb 1st stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88346","description":"Immunofluor antb 1st stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCD0","description":"ICD-JGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKD1","description":"ICD-GIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIC0","description":"ICD-MIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spontaneous nystagmus test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92541","description":"Spontaneous nystagmus test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1271","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","description":"HCPCS-J1271","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pulm function test by gas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94727","description":"Pulm function test by gas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEE1","description":"ICD-JAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDE1","description":"ICD-OGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocortisone sodium succ i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1720","description":"Hydrocortisone sodium succ i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTE0","description":"ICD-CGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVA1","description":"ICD-KGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"After cataract laser surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66821","description":"After cataract laser surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACD1","description":"ICD-CACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Complex lymphedema therapy_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8950","description":"Complex lymphedema therapy_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLD1","description":"ICD-BBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove radius head implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24164","description":"Remove radius head implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient in hospice at any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9758","description":"Patient in hospice at any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBE1","description":"ICD-GGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOC1","description":"ICD-HBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of lumbar spine region fracture at the time of the procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1038","description":"Patients with a diagnosis of lumbar spine region fracture at the time of the procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDA1","description":"ICD-FFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI jnt of lwr extre w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73721","description":"MRI jnt of lwr extre w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLF1","description":"ICD-JCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRB1","description":"ICD-GIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFD1","description":"ICD-BFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Screening mammography_ bilateral (2-view study of each breast)_ including computer-aided detection (CAD) when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77067","description":"Screening mammography_ bilateral (2-view study of each breast)_ including computer-aided detection (CAD) when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stimulants synthetic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80371","description":"Stimulants synthetic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCE1","description":"ICD-GBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"1pc ost pch drain hgh output","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4435","description":"1pc ost pch drain hgh output","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVF0","description":"ICD-KBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEE0","description":"ICD-EHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy clamp_ replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4363","description":"Ostomy clamp_ replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUC1","description":"ICD-CBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUF1","description":"ICD-OKUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Afluria vacc_ 3 yrs & >_ im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2035","description":"Afluria vacc_ 3 yrs & >_ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPF0","description":"ICD-NGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Outpatient_ ed_ or observation visits that result in an inpatient admission","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2176","description":"Outpatient_ ed_ or observation visits that result in an inpatient admission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALE0","description":"ICD-AALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Belinostat_ 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9442","description":"Injection_ Belinostat_ 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Peridontal medicament","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5994","description":"Peridontal medicament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHC0","description":"ICD-OLHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endomysial Antibody (Ema)_ Each Immunoglobulin (Ig) Class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86231","description":"Endomysial Antibody (Ema)_ Each Immunoglobulin (Ig) Class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNB1","description":"ICD-CFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA23B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain open abdom abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49040","description":"Drain open abdom abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Debridement & contouring","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6102","description":"Debridement & contouring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cryopreservation oocyte(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0357T","description":"Cryopreservation oocyte(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERE1","description":"ICD-KERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIE1","description":"ICD-MCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJA1","description":"ICD-KEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0547","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","description":"HCPCS-G0547","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intradermal Cancer Immunotherapy; Each Additional Injection (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0709T","description":"Intradermal Cancer Immunotherapy; Each Additional Injection (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWD1","description":"ICD-GHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal aneuploidy trisom risk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0009M","description":"Fetal aneuploidy trisom risk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEA0","description":"ICD-FFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGE0","description":"ICD-BAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHA1","description":"ICD-NJHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUD1","description":"ICD-EBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25040","description":"Explore/treat wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of protein urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84156","description":"Assay of protein urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUF0","description":"ICD-CEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0902","description":"HCPCS-C0902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIE1","description":"ICD-FDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC120","description":"Clinically Complex _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy rigid trnso","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43180","description":"Esophagoscopy rigid trnso","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX43","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC1B","description":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA42","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJF0","description":"ICD-FCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDE1","description":"ICD-JCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC20C","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8H","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVE0","description":"ICD-FEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOD0","description":"ICD-HEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESA0","description":"ICD-PESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTD0","description":"ICD-ACTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGE0","description":"ICD-CHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB104","description":"Reduced Physical Function _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECD0","description":"ICD-EECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Static or dynami afo pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4397","description":"Static or dynami afo pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXB1","description":"ICD-NEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain external ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69000","description":"Drain external ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFA0","description":"ICD-KBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACF0","description":"ICD-BACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE24A","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARD0","description":"ICD-GARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQF0","description":"ICD-DFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKD1","description":"ICD-BAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc hand les sc 1.5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26111","description":"Exc hand les sc 1.5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hkafo torsion unilat rot str","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2070","description":"Hkafo torsion unilat rot str","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQB1","description":"ICD-OEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"NEURO INH ATAXIA DNA 12 COM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0216U","description":"NEURO INH ATAXIA DNA 12 COM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNA0","description":"ICD-NGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIC1","description":"ICD-BHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWD1","description":"ICD-OFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCE0","description":"ICD-EGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWB0","description":"ICD-KCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Opps/php; train & educ serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0177","description":"Opps/php; train & educ serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray guide for gi tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74340","description":"X-ray guide for gi tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXA1","description":"ICD-OGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD25D","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVB1","description":"ICD-KEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEF1","description":"ICD-KCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCE0","description":"ICD-KFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYE1","description":"ICD-PLYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEC0","description":"ICD-AIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE144","description":"Special Care High _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"PEANUT ALLG ASMT EPI CLIN RX","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0178U","description":"PEANUT ALLG ASMT EPI CLIN RX","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAND1","description":"ICD-JAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise foot tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28086","description":"Excise foot tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTC0","description":"ICD-IFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKA0","description":"ICD-FEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chlorhexidine antisept","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4248","description":"Chlorhexidine antisept","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUD0","description":"ICD-FIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7528","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHD0","description":"ICD-IDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVD0","description":"ICD-GDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig geno no antvir tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8458","description":"Pt inelig geno no antvir tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1904","description":"HCPCS-C1904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRE1","description":"ICD-LGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNA1","description":"ICD-BHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMB0","description":"ICD-IEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0483U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","description":"CPT-0483U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUC1","description":"ICD-NKUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRB0","description":"ICD-KBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDD0","description":"ICD-KEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTF0","description":"ICD-GGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Postsurgical obturator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5932","description":"Postsurgical obturator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMD1","description":"ICD-KHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUF0","description":"ICD-MEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autologous Cellular Implant Derived From Adipose Tissue For The Treatment Of Osteoarthritis Of The Knees; Injection Of Cellular Implant Into Knee Joint Including Ultrasound Gu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0566T","description":"Autologous Cellular Implant Derived From Adipose Tissue For The Treatment Of Osteoarthritis Of The Knees; Injection Of Cellular Implant Into Knee Joint Including Ultrasound Gu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIE1","description":"ICD-OBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No hist type doc on report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9284","description":"No hist type doc on report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQC1","description":"ICD-HIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37267","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","description":"CPT-37267","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC212","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXE0","description":"ICD-CAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXD1","description":"ICD-NFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI pelvis w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72197","description":"MRI pelvis w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cidofovir injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0740","description":"Cidofovir injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1HA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HA21","description":"ICD-1HA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBB1","description":"ICD-JFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQB1","description":"ICD-OGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHF0","description":"ICD-CFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXF0","description":"ICD-KBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTE1","description":"ICD-GCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nephrology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4014","description":"Nephrology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWF0","description":"ICD-HBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hist type doc on report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9283","description":"Hist type doc on report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Forearm or wrist surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25999","description":"Forearm or wrist surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/lesion removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45384","description":"Colonoscopy w/lesion removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRD0","description":"ICD-CCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone imaging limited area","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78300","description":"Bone imaging limited area","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct angio hrt w/3d image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75574","description":"Ct angio hrt w/3d image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy and dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31529","description":"Laryngoscopy and dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDF1","description":"ICD-GHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQF0","description":"ICD-CFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAA1","description":"ICD-JCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Written discharge instr prvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4014F","description":"Written discharge instr prvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIB0","description":"ICD-ACIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSD0","description":"ICD-CCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBB1","description":"ICD-OKBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCA0","description":"ICD-GBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bl exchange/transfuse non-nb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36455","description":"Bl exchange/transfuse non-nb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCB0","description":"ICD-GFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis plan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0505F","description":"Hemodialysis plan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJB1","description":"ICD-GDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIB0","description":"ICD-CFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1904","description":"HCPCS-A1904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXB1","description":"ICD-OAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Back pain was measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 - 20 weeks) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9941","description":"Back pain was measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 - 20 weeks) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGD1","description":"ICD-OFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45135","description":"Excision of rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL56","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx nhl stg 3-4 not relap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9135","description":"Onc dx nhl stg 3-4 not relap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFC0","description":"ICD-FIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILA1","description":"ICD-NILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eye suture during surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67335","description":"Eye suture during surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of permanently implantable aortic counterpulsation ventricular assist system; complete system (aortic counterpulsation device_ vascular hemostatic seal_ mechano-electr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0455T","description":"Removal of permanently implantable aortic counterpulsation ventricular assist system; complete system (aortic counterpulsation device_ vascular hemostatic seal_ mechano-electr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing device_ monaural_ in the canal (ITC)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5172","description":"Hearing aid_ contralateral routing device_ monaural_ in the canal (ITC)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXB0","description":"ICD-FCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC204","description":"Clinically Complex _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52265","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWD0","description":"ICD-CDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD23A","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFF0","description":"ICD-GEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNC1","description":"ICD-NKNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tibial arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29855","description":"Tibial arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Single pivot hinge pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6605","description":"Single pivot hinge pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tis trnfr f/c/c/m/n/a/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14041","description":"Tis trnfr f/c/c/m/n/a/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUB1","description":"ICD-GIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place cath intracranial art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36228","description":"Place cath intracranial art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1806","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1806","description":"HCPCS-B1806","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWA0","description":"ICD-PJWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCC0","description":"ICD-OLCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE25A","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct maxillofacial w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70486","description":"Ct maxillofacial w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oxford w supinat/pronat inf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3201","description":"Oxford w supinat/pronat inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA17","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29881","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGD1","description":"ICD-FFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"M/phmtrc alys ishquant/semiq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88373","description":"M/phmtrc alys ishquant/semiq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEC0","description":"ICD-GCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLA1","description":"ICD-AFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUE0","description":"ICD-GCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILD0","description":"ICD-NILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDC0","description":"ICD-NLDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat metacarpal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26600","description":"Treat metacarpal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALF1","description":"ICD-MALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBID0","description":"ICD-GBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound-based radiofrequency echographic multi-spectrometry (REMS)_ bone-density study and fracture-risk assessment_ 1 or more sites_ hips_ pelvis_ or spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0815T","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (REMS)_ bone-density study and fracture-risk assessment_ 1 or more sites_ hips_ pelvis_ or spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGD0","description":"ICD-NDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQF1","description":"ICD-LFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Correction_ hallux valgus (bunionectomy)_ with sesamoidectomy_ when performed; with proximal metatarsal osteotomy_ any method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28295","description":"Correction_ hallux valgus (bunionectomy)_ with sesamoidectomy_ when performed; with proximal metatarsal osteotomy_ any method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB21B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace aortic valve w/byp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33367","description":"Replace aortic valve w/byp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC25","description":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKD1","description":"ICD-FBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJA0","description":"ICD-CEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of blood chloride","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82435","description":"Assay of blood chloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orbital prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8042","description":"Orbital prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pasrr level i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2010","description":"Pasrr level i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4271","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFB0","description":"ICD-JFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC3D","description":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo guide villus sampling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76945","description":"Echo guide villus sampling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMD1","description":"ICD-JBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD140","description":"Reduced Physical Function _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc xdrl spine lesn crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63275","description":"Bx/exc xdrl spine lesn crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXF0","description":"ICD-JEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMB1","description":"ICD-OKMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary colon cancer (Lynch syndrome)_ targeted mRNA sequence analysis panel (MLH1_ MSH2_ MSH6_ PMS2)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0162U","description":"Hereditary colon cancer (Lynch syndrome)_ targeted mRNA sequence analysis panel (MLH1_ MSH2_ MSH6_ PMS2)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBB0","description":"ICD-KDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIB1","description":"ICD-MHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional_ including physiological and labo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0495T","description":"Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional_ including physiological and labo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N block inj fem single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64447","description":"N block inj fem single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHC0","description":"ICD-JGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hocm 350-399mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9963","description":"Hocm 350-399mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N block inj intercost mlt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64421","description":"N block inj intercost mlt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise excessive skin thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15832","description":"Excise excessive skin thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Statin presc disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9441","description":"Statin presc disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJC0","description":"ICD-JAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATF0","description":"ICD-IATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEE1","description":"ICD-EGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (hematolymphoid neoplasia)_ JAK2 mutation_ DNA_ PCR amplification of exons 12-14 and sequence analysis_ blood or bone marrow_ report of JAK2 mutation not detected or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0017U","description":"Oncology (hematolymphoid neoplasia)_ JAK2 mutation_ DNA_ PCR amplification of exons 12-14 and sequence analysis_ blood or bone marrow_ report of JAK2 mutation not detected or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy fimbrioplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58672","description":"Laparoscopy fimbrioplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA5C","description":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cbt 1st hour","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94644","description":"Cbt 1st hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEF0","description":"ICD-NEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Fixed Bilateral Space Maintainer - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1557","description":"Removal Of Fixed Bilateral Space Maintainer - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAC1","description":"ICD-KIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hip disart canadian sach ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5331","description":"Hip disart canadian sach ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Addl neck spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22552","description":"Addl neck spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVC1","description":"ICD-OFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insrt pulse gen w/dual leads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33230","description":"Insrt pulse gen w/dual leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNF0","description":"ICD-GBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIA0","description":"ICD-NDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGC0","description":"ICD-FBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQA1","description":"ICD-GCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYE1","description":"ICD-CGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBA0","description":"ICD-BDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8H","description":"Very High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA120","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair septal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33814","description":"Repair septal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11606","description":"Exc tr-ext mal+marg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Covid-19 vaccine admin inside a patient_s home; reported only once per individual home per date of service when only covid-19 vaccine admin is performed at the patients home","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0201","description":"Covid-19 vaccine admin inside a patient_s home; reported only once per individual home per date of service when only covid-19 vaccine admin is performed at the patients home","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBB0","description":"ICD-MKBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8F","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJD0","description":"ICD-NFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA0A","description":"Default_ /Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone_ Normal Or Abnormal Native","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93595","description":"Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone_ Normal Or Abnormal Native","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implnt/abut remov dent mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6111","description":"Implnt/abut remov dent mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cer post col occ/man sup adj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0180","description":"Cer post col occ/man sup adj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA0C","description":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment aid(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77333","description":"Radiation treatment aid(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Limited (30 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiaryā€™s home_ d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2002","description":"Limited (30 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiaryā€™s home_ d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cefazolin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0690","description":"Cefazolin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQC1","description":"ICD-ODQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLB1","description":"ICD-MGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAF0","description":"ICD-NDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKE1","description":"ICD-NGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIF0","description":"ICD-IBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAD1","description":"ICD-AHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSA1","description":"ICD-PFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUE0","description":"ICD-CDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHA0","description":"ICD-BDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat fx rad intra-articul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25608","description":"Treat fx rad intra-articul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Retrieval of oocyte","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58970","description":"Retrieval of oocyte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo-asst vag hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58550","description":"Laparo-asst vag hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anchor/screw bn/bn_tis/bn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1713","description":"Anchor/screw bn/bn_tis/bn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat dental ridge fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21445","description":"Treat dental ridge fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGB0","description":"ICD-GAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVB0","description":"ICD-GCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft splenorenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35536","description":"Art byp grft splenorenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28636","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Limited motion knee joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2184","description":"Limited motion knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hip disartic sach thermopls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5595","description":"Hip disartic sach thermopls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDC0","description":"ICD-MKDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endo cholangiopancreatograph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43261","description":"Endo cholangiopancreatograph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hdr elctr ntrst/ntrcv brchtx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0395T","description":"Hdr elctr ntrst/ntrcv brchtx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implt nrostm pls gen dua rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8687","description":"Implt nrostm pls gen dua rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQC1","description":"ICD-CEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMF1","description":"ICD-GFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBD1","description":"ICD-MGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27033","description":"Exploration of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIB0","description":"ICD-EGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTF1","description":"ICD-MHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISC0","description":"ICD-CISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lung perf&ventilat diferentl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78598","description":"Lung perf&ventilat diferentl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj tbo filgrastim 1 microg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1447","description":"Inj tbo filgrastim 1 microg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oral antiplatelet therapy rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4011F","description":"Oral antiplatelet therapy rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQA0","description":"ICD-GBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0623U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","description":"CPT-0623U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Uvl sys panel 6 ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0693","description":"Uvl sys panel 6 ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLB0","description":"ICD-MJLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not die within 30 days of the procedure or during the index hospitalization","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9813","description":"Patient did not die within 30 days of the procedure or during the index hospitalization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOD0","description":"ICD-LEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Socket insert knee articulat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5656","description":"Socket insert knee articulat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQA1","description":"ICD-DCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJA1","description":"ICD-CGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLB1","description":"ICD-MHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYB1","description":"ICD-KCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYF0","description":"ICD-PGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBB1","description":"ICD-CFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSD1","description":"ICD-PBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMA1","description":"ICD-MDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWF0","description":"ICD-DIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKED1","description":"ICD-OKED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Manual wc hand rim w project","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0967","description":"Manual wc hand rim w project","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODED0","description":"ICD-ODED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sales tax","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9985","description":"Sales tax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5147","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","description":"HCPCS-Q5147","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILB1","description":"ICD-GILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55868","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","description":"CPT-55868","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pulpal regeneration initial","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3355","description":"Pulpal regeneration initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Norsn for gc chl syp test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9230","description":"Norsn for gc chl syp test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0907T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","description":"CPT-0907T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPC1","description":"ICD-FGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on facial bones or skull; radical surgery (includ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0127U","description":"Anesthesia for procedures on facial bones or skull; radical surgery (includ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC112","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEB1","description":"ICD-EFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB13B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWC0","description":"ICD-OLWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIND0","description":"ICD-JIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHD1","description":"ICD-NKHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQE0","description":"ICD-DDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTF0","description":"ICD-BDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic bone marrow; biopsy(ies) and aspiration(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38222","description":"Diagnostic bone marrow; biopsy(ies) and aspiration(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIF0","description":"ICD-EIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEA0","description":"ICD-CIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAD1","description":"ICD-JGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21263","description":"Revise eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXA1","description":"ICD-NEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spec stains for microorganis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0476","description":"Spec stains for microorganis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nonpneumatic compression controller with sequential calibrated gradient pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1024","description":"Nonpneumatic compression controller with sequential calibrated gradient pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFF1","description":"ICD-BGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDND0","description":"ICD-NDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Recement supp crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6092","description":"Recement supp crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRA1","description":"ICD-LFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Afo molded ankle gauntlet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1904","description":"Afo molded ankle gauntlet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0691U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691U","description":"CPT-0691U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special supplies phys/qhp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99070","description":"Special supplies phys/qhp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Penis plastic surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54360","description":"Penis plastic surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX50","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"TB screening performed and results interpreted within 12 months prior to initiation of first-time biologic disease modifying an","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1003","description":"TB screening performed and results interpreted within 12 months prior to initiation of first-time biologic disease modifying an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTE0","description":"ICD-GFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDE1","description":"ICD-JDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bk pain & fxn assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1130F","description":"Bk pain & fxn assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKC0","description":"ICD-CBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37279","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","description":"CPT-37279","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCE0","description":"ICD-IFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFB0","description":"ICD-FHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEC0","description":"ICD-CEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWC1","description":"ICD-PDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastric bypass for obesity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43846","description":"Gastric bypass for obesity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0653U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0653U","description":"CPT-0653U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intravasc us heart add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92978","description":"Intravasc us heart add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVC1","description":"ICD-KHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIE0","description":"ICD-KEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies); with intravascular lithotripsy and transluminal stent placement(s)_ and atherectomy_ includ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9775","description":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies); with intravascular lithotripsy and transluminal stent placement(s)_ and atherectomy_ includ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTC1","description":"ICD-FGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYB1","description":"ICD-PHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fuse esophagus & intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43340","description":"Fuse esophagus & intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastrin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82938","description":"Gastrin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARF1","description":"ICD-LARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"G6pc gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81250","description":"G6pc gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUC0","description":"ICD-OJUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMC1","description":"ICD-AEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radium ra223 dichloride ther","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9606","description":"Radium ra223 dichloride ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPE1","description":"ICD-GCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWB1","description":"ICD-KIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOA1","description":"ICD-PBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cep72 (Centrosomal Protein_ 72-Kda)_ Nudt15 (Nudix Hydrolase 15) And Tpmt (Thiopurine S-Methyltransferase) (Eg_ Drug Metabolism) Gene Analysis_ Common Variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0286U","description":"Cep72 (Centrosomal Protein_ 72-Kda)_ Nudt15 (Nudix Hydrolase 15) And Tpmt (Thiopurine S-Methyltransferase) (Eg_ Drug Metabolism) Gene Analysis_ Common Variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0868T","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNB0","description":"ICD-FGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of semen fructose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82757","description":"Assay of semen fructose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2027","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","description":"HCPCS-A2027","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEF0","description":"ICD-CBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBME0","description":"ICD-EBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB10","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUA1","description":"ICD-CHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esrd home pt serv p mo 2-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90964","description":"Esrd home pt serv p mo 2-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUE1","description":"ICD-JAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cholinesterase challenge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95857","description":"Cholinesterase challenge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of ureter lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51535","description":"Repair of ureter lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor intestine/venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44720","description":"Prep donor intestine/venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX21","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl vagus nerve pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0315T","description":"Rmvl vagus nerve pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No sig dep symp by dep tool","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3352F","description":"No sig dep symp by dep tool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A5103","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5103","description":"HCPCS-A5103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHED0","description":"ICD-EHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0001","description":"Alcohol and/or drug assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFE0","description":"ICD-NIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52234","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUF0","description":"ICD-CIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA44","description":"High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISE0","description":"ICD-LISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWD0","description":"ICD-PJWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGB0","description":"ICD-GHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Occupational multifocal lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2786","description":"Occupational multifocal lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDA1","description":"ICD-IEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTD1","description":"ICD-ICTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUE1","description":"ICD-EGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breast prosthes w/o adhesive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8030","description":"Breast prosthes w/o adhesive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBB1","description":"ICD-JCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rev/remvl crtd sns dev gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0271T","description":"Rev/remvl crtd sns dev gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUA0","description":"ICD-EIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ace/arb thxpy for mos/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4210F","description":"Ace/arb thxpy for mos/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAA1","description":"ICD-KBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIB0","description":"ICD-MKIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism Agile MD_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1012","description":"Clinical decision support mechanism Agile MD_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecg monit/reprt up to 48 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93224","description":"Ecg monit/reprt up to 48 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWF0","description":"ICD-KAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC24C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKC1","description":"ICD-GCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATA1","description":"ICD-CATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQE1","description":"ICD-KCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJE0","description":"ICD-CFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPB1","description":"ICD-JDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of cpk in blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82552","description":"Assay of cpk in blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ascending aortic graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33863","description":"Ascending aortic graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Symp aaa urgent repair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9600","description":"Symp aaa urgent repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tensix_ 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4146","description":"Tensix_ 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUF1","description":"ICD-GFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPF1","description":"ICD-CEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEED0","description":"ICD-KEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIA1","description":"ICD-OGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMB0","description":"ICD-MJMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autgrft implnt knee w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29866","description":"Autgrft implnt knee w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pancreatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48146","description":"Pancreatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"AmnioBand_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4168","description":"AmnioBand_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDB1","description":"ICD-GFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Control of nosebleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30901","description":"Control of nosebleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2291","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","description":"HCPCS-J2291","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28299","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8E","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8F","description":"Medium Rehab _ ADL Index 0-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC220","description":"Special Care Low _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit sympathomim diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9348","description":"Hit sympathomim diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEA0","description":"ICD-FGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPF0","description":"ICD-GBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgraft tl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4263","description":"Surgraft tl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHC0","description":"ICD-CCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKB1","description":"ICD-GBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPC0","description":"ICD-KBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap enterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44202","description":"Lap enterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTC0","description":"ICD-BDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCA0","description":"ICD-ADCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUD1","description":"ICD-OCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ipratropium bromide comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7645","description":"Ipratropium bromide comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair anti-tipping devi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0971","description":"Wheelchair anti-tipping devi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HTT (huntingtin) (eg_ Huntington disease) gene analysis; characterization of alleles (eg_ expanded size)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81274","description":"HTT (huntingtin) (eg_ Huntington disease) gene analysis; characterization of alleles (eg_ expanded size)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXC0","description":"ICD-FDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBB0","description":"ICD-OEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCE1","description":"ICD-MCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sperm identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89257","description":"Sperm identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDB1","description":"ICD-JHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDC0","description":"ICD-FBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOD1","description":"ICD-LCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0903","description":"HCPCS-C0903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5945","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5945","description":"CDT-D5945","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWB1","description":"ICD-CDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEA0","description":"ICD-EHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSB1","description":"ICD-PFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMA0","description":"ICD-FFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE246","description":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBE1","description":"ICD-KGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQE0","description":"ICD-HEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat larynx fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31584","description":"Treat larynx fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anoscpy inj agent for incont","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0377T","description":"Anoscpy inj agent for incont","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEB0","description":"ICD-OBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIED1","description":"ICD-BIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98010","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","description":"CPT-98010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGD1","description":"ICD-JEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIE1","description":"ICD-KAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGE1","description":"ICD-FCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABA0","description":"ICD-CABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Filleted finger/toe flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14350","description":"Filleted finger/toe flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No transfercare chklist used","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0584F","description":"No transfercare chklist used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise leg vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37700","description":"Revise leg vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Voice d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9173","description":"Voice d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCE1","description":"ICD-OBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Closure ureter/skin fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50920","description":"Closure ureter/skin fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation of multivisc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2054","description":"Transplantation of multivisc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHA0","description":"ICD-FGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kanamycin sulfate 500 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1840","description":"Kanamycin sulfate 500 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIE1","description":"ICD-OKIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIC0","description":"ICD-AAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBB1","description":"ICD-JEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacteria_ fungi_ parasites_ and DNA viruses)_ DNA_ PCR and next-generation sequencing_ plasma_ detection of >1_000 potential microbial organisms for signif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0152U","description":"Infectious disease (bacteria_ fungi_ parasites_ and DNA viruses)_ DNA_ PCR and next-generation sequencing_ plasma_ detection of >1_000 potential microbial organisms for signif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAF0","description":"ICD-CFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYF1","description":"ICD-DHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE13B","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL42","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61608","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAB0","description":"ICD-BAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAB0","description":"ICD-IFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Donor hysterectomy (including cold preservation); open_ from living donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0665T","description":"Donor hysterectomy (including cold preservation); open_ from living donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXD0","description":"ICD-OFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non coring needle or stylet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4212","description":"Non coring needle or stylet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHC1","description":"ICD-JHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSA0","description":"ICD-GHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEB1","description":"ICD-ADEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBB0","description":"ICD-ACBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1126","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ring flange plas/leather mol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1110","description":"Ring flange plas/leather mol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"C motor evoked upr&lwr limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95939","description":"C motor evoked upr&lwr limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown 3/4 high noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6780","description":"Crown 3/4 high noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDE0","description":"ICD-ACDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Modification of contact lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92325","description":"Modification of contact lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct lumbar spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72131","description":"Ct lumbar spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINA0","description":"ICD-OINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVD0","description":"ICD-OCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone biopsy excisional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20245","description":"Bone biopsy excisional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALF1","description":"ICD-IALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interspinous implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1821","description":"Interspinous implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAF0","description":"ICD-NLAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARA0","description":"ICD-GARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental cephalometric film","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0340","description":"Dental cephalometric film","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB211","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42300","description":"Drainage of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOD1","description":"ICD-GFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFA1","description":"ICD-BFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSE0","description":"ICD-HFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFA0","description":"ICD-GFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lovotibeglogene autotemcel_ per treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3394","description":"Injection_ lovotibeglogene autotemcel_ per treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB236","description":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1046T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1046T","description":"CPT-1046T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Body Surface-Activation Mapping Of Pacemaker Or Pacing Cardioverter-Defibrillator Lead(S) To Optimize Electrical Synchrony_ Cardiac Resynchronization Therapy Device_ Including","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0696T","description":"Body Surface-Activation Mapping Of Pacemaker Or Pacing Cardioverter-Defibrillator Lead(S) To Optimize Electrical Synchrony_ Cardiac Resynchronization Therapy Device_ Including","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFE0","description":"ICD-NCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Factor viia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7189","description":"Factor viia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fomepizole_ 15 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1451","description":"Fomepizole_ 15 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVC0","description":"ICD-KGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUD0","description":"ICD-NGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJD0","description":"ICD-FHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABE1","description":"ICD-NABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSA0","description":"ICD-OKSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDF1","description":"ICD-MLDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKD1","description":"ICD-BEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDB1","description":"ICD-FBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIME0","description":"ICD-FIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Recd scrn hcv infec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9383","description":"Recd scrn hcv infec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCA1","description":"ICD-OLCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALB0","description":"ICD-GALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLC1","description":"ICD-MJLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Women who had an endometrial ablation procedure during the year prior to the index date (exclusive of the index date)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9822","description":"Women who had an endometrial ablation procedure during the year prior to the index date (exclusive of the index date)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQD0","description":"ICD-PLQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Allergy/immunology mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0060","description":"Allergy/immunology mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUE0","description":"ICD-GEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score shdl pt no el","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8665","description":"Fun stat score shdl pt no el","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 27 gene report_ with variant analysis and reported phenotypes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0350U","description":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 27 gene report_ with variant analysis and reported phenotypes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant mid ear hearing pros","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5095","description":"Implant mid ear hearing pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHA1","description":"ICD-BEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone/skin graft iliac crest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20970","description":"Bone/skin graft iliac crest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB135","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Splicing of ureters","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50770","description":"Splicing of ureters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crutch forearm pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0110","description":"Crutch forearm pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis procedure at a Medicare certified ESRD facility for acute kidney injury without ESRD","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0491","description":"Dialysis procedure at a Medicare certified ESRD facility for acute kidney injury without ESRD","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Factor inhibitor test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85335","description":"Factor inhibitor test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOC0","description":"ICD-CCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ho flex frejka w/cov pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1600","description":"Ho flex frejka w/cov pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alpha-1-antitrypsin total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82103","description":"Alpha-1-antitrypsin total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBE1","description":"ICD-NHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28X","description":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exercise equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9300","description":"Exercise equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation patient unable to communicate and informant not available","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2183","description":"Documentation patient unable to communicate and informant not available","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73130","description":"X-ray exam of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electron elbow child switch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7186","description":"Electron elbow child switch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy w/exc of tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31540","description":"Laryngoscopy w/exc of tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJE1","description":"ICD-BHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOC1","description":"ICD-LBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repr per/vag pouch sngl proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46710","description":"Repr per/vag pouch sngl proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic management program_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9460","description":"Diabetic management program_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMD0","description":"ICD-BBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ pelvis and hips_ infant or child_ minimum of two views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73540","description":"Radiologic examination_ pelvis and hips_ infant or child_ minimum of two views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraop cyto path consult 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88334","description":"Intraop cyto path consult 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9811","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9811","description":"HCPCS-C9811","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGC0","description":"ICD-OAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSA0","description":"ICD-KFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCA1","description":"ICD-BCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMC0","description":"ICD-NBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVC0","description":"ICD-FAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 3","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA36","description":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Performance Met: Multimodal Pain Management Was Used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2148","description":"Performance Met: Multimodal Pain Management Was Used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVD0","description":"ICD-GBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCME1","description":"ICD-JCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXD1","description":"ICD-BEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise/remove sling repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57287","description":"Revise/remove sling repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemi-wheelchair fixed arms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1083","description":"Hemi-wheelchair fixed arms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27702","description":"Reconstruct ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ferric pyrophosphate citrate powder_ 0.1mg of iron","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1444","description":"Injection_ ferric pyrophosphate citrate powder_ 0.1mg of iron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIB0","description":"ICD-GEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPE0","description":"ICD-NLPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCE1","description":"ICD-GFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPE1","description":"ICD-OFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA225","description":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20606","description":"Drain/inj joint/bursa w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES250","description":"Extensive Services _ ADL Index 2-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eye allergy tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95060","description":"Eye allergy tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPF0","description":"ICD-BHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAB1","description":"ICD-FFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38H","description":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKB1","description":"ICD-NAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVF1","description":"ICD-KCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDE1","description":"ICD-OJDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal septal prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5922","description":"Nasal septal prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFD1","description":"ICD-ODFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYF0","description":"ICD-DEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-81558","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","description":"CPT-81558","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj tendon origin/insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20551","description":"Inj tendon origin/insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal biophys profil w/o nst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76819","description":"Fetal biophys profil w/o nst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cover eye w/membrane","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65778","description":"Cover eye w/membrane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCD1","description":"ICD-EDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18I","description":"Special Care High _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"22nf sealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2361","description":"22nf sealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28I","description":"Special Care High _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHD1","description":"ICD-OFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Px sup fee anti-can sub pres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0512","description":"Px sup fee anti-can sub pres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUE0","description":"ICD-JBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB14","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDF0","description":"ICD-ECDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWB1","description":"ICD-DGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCED1","description":"ICD-GCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37273","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","description":"CPT-37273","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOC1","description":"ICD-GBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKA0","description":"ICD-KDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMB0","description":"ICD-ODMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Morcellator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1782","description":"Morcellator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB22","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Zoledronic acid 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3489","description":"Zoledronic acid 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL2A","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA13D","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAE1","description":"ICD-AGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMA0","description":"ICD-ABMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCD1","description":"ICD-KFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLF1","description":"ICD-ACLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHED1","description":"ICD-JHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVE0","description":"ICD-GFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWE1","description":"ICD-OGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8E","description":"Very High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIF0","description":"ICD-ICIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; Without Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0636T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; Without Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sinus caus bac inx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9364","description":"Sinus caus bac inx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient education materials","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99071","description":"Patient education materials","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colistimethate sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0770","description":"Colistimethate sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special supply_ nos waiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2028","description":"Special supply_ nos waiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIE1","description":"ICD-JBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNE0","description":"ICD-CCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALC1","description":"ICD-OALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vestibuloplasty ridge extens","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7340","description":"Vestibuloplasty ridge extens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML06","description":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINC0","description":"ICD-BINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cervical collar molded to pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0170","description":"Cervical collar molded to pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breast milk proc/store/dist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2101","description":"Breast milk proc/store/dist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQD0","description":"ICD-CGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFC1","description":"ICD-JHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Albuterol comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7610","description":"Albuterol comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leukocyte histamine release","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86343","description":"Leukocyte histamine release","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLC1","description":"ICD-OKLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prep bk ptb open end socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5535","description":"Prep bk ptb open end socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIC0","description":"ICD-FFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGE1","description":"ICD-OJGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disposable compressor filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7013","description":"Disposable compressor filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYE0","description":"ICD-DAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAC0","description":"ICD-KDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repos prev impltbl subq dfb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33273","description":"Repos prev impltbl subq dfb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUA1","description":"ICD-CAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Organic acid single quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83921","description":"Organic acid single quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGME0","description":"ICD-JGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUC0","description":"ICD-MIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Screening proctoscopy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0601","description":"Screening proctoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic pancreatoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43273","description":"Endoscopic pancreatoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWD0","description":"ICD-LEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo total proctocolectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44210","description":"Laparo total proctocolectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMF1","description":"ICD-KEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJA1","description":"ICD-BBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drugs unclassified injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3490","description":"Drugs unclassified injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40530","description":"Partial removal of lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMD0","description":"ICD-MKMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYB1","description":"ICD-PCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA105","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYA1","description":"ICD-KHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brief alcohol misuse counsel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0443","description":"Brief alcohol misuse counsel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAA0","description":"ICD-BCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEC0","description":"ICD-AAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"M.pneumon dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87582","description":"M.pneumon dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPF0","description":"ICD-CDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHB1","description":"ICD-JEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0063","description":"Cardiology mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt no elig for bp assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8784","description":"Pt no elig for bp assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIC1","description":"ICD-EIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tymp memb motion examd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2035F","description":"Tymp memb motion examd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBD1","description":"ICD-AHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEE1","description":"ICD-NGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYE1","description":"ICD-PHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rh ig minidose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90385","description":"Rh ig minidose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28C","description":"Special Care Low _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ace inhibitor or arb therapy not prescribed during the measurement period_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1203","description":"Ace inhibitor or arb therapy not prescribed during the measurement period_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBE1","description":"ICD-BEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPC1","description":"ICD-NFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/cont_ abd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8900","description":"Mra w/cont_ abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGND0","description":"ICD-OGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQC0","description":"ICD-KGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHF1","description":"ICD-BCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXE1","description":"ICD-NEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD23C","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-cov proc_ clinical trial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0294","description":"Non-cov proc_ clinical trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0104","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0104","description":"HCPCS-C0104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Telehealth inpt pharm mgmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0459","description":"Telehealth inpt pharm mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOB1","description":"ICD-PFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIF1","description":"ICD-MJIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOC0","description":"ICD-PBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic bone marrow; aspiration(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38220","description":"Diagnostic bone marrow; aspiration(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJD0","description":"ICD-BDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOB1","description":"ICD-OBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDF0","description":"ICD-OKDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score knee < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8648","description":"Fun stat score knee < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trh stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80439","description":"Trh stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of neck artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37606","description":"Ligation of neck artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression wrap with adjustable straps_ not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6584","description":"Gradient compression wrap with adjustable straps_ not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of pregnanediol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84135","description":"Assay of pregnanediol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJA0","description":"ICD-GAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgery to stop leg growth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27479","description":"Surgery to stop leg growth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28B","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gauze <=16 in no w/sal w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6222","description":"Gauze <=16 in no w/sal w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVB1","description":"ICD-CAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompress forearm 2 spaces","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25024","description":"Decompress forearm 2 spaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rebuild eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69636","description":"Rebuild eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHD1","description":"ICD-CCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYE0","description":"ICD-DDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTA0","description":"ICD-AFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous Transcatheter Ultrasound Ablation Of Nerves Innervating The Pulmonary Arteries_ Including Right Heart Catheterization_ Pulmonary Artery Angiography_ And All Imagi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0632T","description":"Percutaneous Transcatheter Ultrasound Ablation Of Nerves Innervating The Pulmonary Arteries_ Including Right Heart Catheterization_ Pulmonary Artery Angiography_ And All Imagi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37285","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","description":"CPT-37285","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Multiple-family group adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)_ face-to-face w","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97157","description":"Multiple-family group adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)_ face-to-face w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALD0","description":"ICD-MALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGB1","description":"ICD-CCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUD0","description":"ICD-JIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thyroid imaging w/blood flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78014","description":"Thyroid imaging w/blood flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAE0","description":"ICD-CEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQE0","description":"ICD-GIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth biopsy of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16451","description":"Anesth biopsy of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTD1","description":"ICD-BFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion/graft of hand joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26844","description":"Fusion/graft of hand joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIF1","description":"ICD-FFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHE1","description":"ICD-FIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBF1","description":"ICD-AHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Belt_ strap_ sleeve_ garment_ or covering_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4467","description":"Belt_ strap_ sleeve_ garment_ or covering_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB11A","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Battery charger_ dual mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2367","description":"Battery charger_ dual mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Debride genit/per/abdom wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11006","description":"Debride genit/per/abdom wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Up ext fx orthos humeral nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3980","description":"Up ext fx orthos humeral nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA SEVERE AQT RESPIR SYND CORONAVIRUS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87426","description":"IAAD IA SEVERE AQT RESPIR SYND CORONAVIRUS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADE0","description":"ICD-AADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATE0","description":"ICD-OATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEC1","description":"ICD-GCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDB1","description":"ICD-CCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kneecap bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27340","description":"Removal of kneecap bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical; with dilation of frontal and sphenoid sinus ostia (eg_ balloon dilation)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31298","description":"Nasal/sinus endoscopy_ surgical; with dilation of frontal and sphenoid sinus ostia (eg_ balloon dilation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Serpina1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81332","description":"Serpina1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar spine proces distract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0171T","description":"Lumbar spine proces distract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLE0","description":"ICD-JDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surface emg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3900","description":"Surface emg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJC1","description":"ICD-CIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICB0","description":"ICD-IICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITD1","description":"ICD-KITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Formoterol comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7640","description":"Formoterol comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breast diep or siea flap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2068","description":"Breast diep or siea flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Air fluidized bed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0194","description":"Air fluidized bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ther/proph/diag iv inf addon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96366","description":"Ther/proph/diag iv inf addon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext b9+marg 0.5 cm<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11400","description":"Exc tr-ext b9+marg 0.5 cm<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB03","description":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJF1","description":"ICD-ODJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRA1","description":"ICD-KCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXB0","description":"ICD-GIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB230","description":"Special Care Low _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDD1","description":"ICD-ODDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA12B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLC0","description":"ICD-IBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic lightbox tabletp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0203","description":"Therapeutic lightbox tabletp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDC0","description":"ICD-BEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEF0","description":"ICD-OJEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Janssen (Johnson & Johnson) COVID-19 vaccine administration","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1707","description":"Janssen (Johnson & Johnson) COVID-19 vaccine administration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0955T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","description":"CPT-0955T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ped crit care age 2-5 init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99475","description":"Ped crit care age 2-5 init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUA1","description":"ICD-EFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOE1","description":"ICD-CAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nrv cndj tst 5-6 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95909","description":"Nrv cndj tst 5-6 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJB0","description":"ICD-BFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tens four lead","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0730","description":"Tens four lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No hepc rna after med no rsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9211","description":"No hepc rna after med no rsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWD1","description":"ICD-CIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBED1","description":"ICD-GBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAC1","description":"ICD-OHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUB1","description":"ICD-KCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18G","description":"Extensive Services _ ADL Index 2-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMB0","description":"ICD-BEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0202","description":"HCPCS-A0202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWE0","description":"ICD-OBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTC1","description":"ICD-ADTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJB1","description":"ICD-CBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBC1","description":"ICD-BFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYB0","description":"ICD-CGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHD0","description":"ICD-EDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXB1","description":"ICD-BHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc prosth taa add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33884","description":"Endovasc prosth taa add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assist oocyte fertilization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89280","description":"Assist oocyte fertilization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCE1","description":"ICD-EDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKE0","description":"ICD-GCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITB0","description":"ICD-GITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAC0","description":"ICD-CHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRF0","description":"ICD-HGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ortho shoe add half sole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3530","description":"Ortho shoe add half sole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYA1","description":"ICD-GGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35331","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCD1","description":"ICD-AHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWA0","description":"ICD-CAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLC0","description":"ICD-BDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEC0","description":"ICD-FDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28208","description":"Repair of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemo iv infus each addl seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96417","description":"Chemo iv infus each addl seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open skull for exploration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61305","description":"Open skull for exploration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Splint supplies misc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4051","description":"Splint supplies misc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who have a diagnosis of rhabdomyolysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9780","description":"Patients who have a diagnosis of rhabdomyolysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hkafo unilat torsion ball br","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2090","description":"Hkafo unilat torsion ball br","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Denture reln cmplt mand chr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5731","description":"Denture reln cmplt mand chr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ak/bk self-aligning unit ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5617","description":"Ak/bk self-aligning unit ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA144","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Supplies for home delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8415","description":"Supplies for home delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Single energy x-ray study","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0130","description":"Single energy x-ray study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; common variant(s) (eg_ A_ A-)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81247","description":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; common variant(s) (eg_ A_ A-)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ ado-trastuzumab emt 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9354","description":"Inj_ ado-trastuzumab emt 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAA0","description":"ICD-KHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient Refused To Participate At Admission And/Or Discharge; Patient Unable To Complete The Neck Fs Prom At Admission Or Discharge Due To Cognitive Deficit_ Visual Deficit_ M","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2166","description":"Patient Refused To Participate At Admission And/Or Discharge; Patient Unable To Complete The Neck Fs Prom At Admission Or Discharge Due To Cognitive Deficit_ Visual Deficit_ M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hla ii type 1 ag equiv lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81377","description":"Hla ii type 1 ag equiv lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aortic hemiarch graft including isolation and control of the arch vessels_ beveled open distal aortic anastomosis extending under one or more of the arch vessels_ and total ci","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33866","description":"Aortic hemiarch graft including isolation and control of the arch vessels_ beveled open distal aortic anastomosis extending under one or more of the arch vessels_ and total ci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFF0","description":"ICD-GIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-pneumatic sequential compression garment_ half leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0679","description":"Non-pneumatic sequential compression garment_ half leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prostate saturation sampling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55706","description":"Prostate saturation sampling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ retifanlimab-dlwr_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9345","description":"Injection_ retifanlimab-dlwr_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANA0","description":"ICD-JANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHE1","description":"ICD-NLHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent psychiatric collaborative care management_ first 60 minutes in a subsequent month of behavioral health care manager activities_ in consultation with a psychiatric c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0503","description":"Subsequent psychiatric collaborative care management_ first 60 minutes in a subsequent month of behavioral health care manager activities_ in consultation with a psychiatric c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Salivary gland imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78230","description":"Salivary gland imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4DB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DB11","description":"ICD-4DB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWC0","description":"ICD-KAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/ coronary artery stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4561F","description":"Pt w/ coronary artery stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chimeric antigen receptor T-cell (CAR-T) therapy; CAR-T cell administration_ autologous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0540T","description":"Chimeric antigen receptor T-cell (CAR-T) therapy; CAR-T cell administration_ autologous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARB0","description":"ICD-CARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVE0","description":"ICD-KFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMF0","description":"ICD-IGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of a modality to 1 or more areas; low-level laser therapy (ie_ nonthermal and non-ablative) for post-operative pain reduction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97037","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie_ nonthermal and non-ablative) for post-operative pain reduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iodine i-123 sod iodide mil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9509","description":"Iodine i-123 sod iodide mil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGA0","description":"ICD-OFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Feeding aid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5951","description":"Feeding aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMF0","description":"ICD-JBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Establish inner ear window","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69820","description":"Establish inner ear window","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJC1","description":"ICD-JEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPB1","description":"ICD-ODPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX2D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dexamethasone sodium phos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1100","description":"Dexamethasone sodium phos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA21A","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ost clsd pouch w att st barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4387","description":"Ost clsd pouch w att st barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBA0","description":"ICD-ECBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) of intracardiac ischemia monitoring system with iterative adjustment of programmed values_ with analysis_ review_ and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0528T","description":"Programming device evaluation (in person) of intracardiac ischemia monitoring system with iterative adjustment of programmed values_ with analysis_ review_ and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive (75 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiaryā€™s home_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2005","description":"Extensive (75 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiaryā€™s home_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hep c rna done prior to med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9203","description":"Hep c rna done prior to med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D2956","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2956","description":"CDT-D2956","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILD1","description":"ICD-JILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX0C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUD0","description":"ICD-MHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAB1","description":"ICD-OGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQC1","description":"ICD-DIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1501","description":"HCPCS-B1501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove spinal canal catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62355","description":"Remove spinal canal catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAA1","description":"ICD-OJAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug admin & hemodynmic meas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93463","description":"Drug admin & hemodynmic meas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sewho cap design w/jnt(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3971","description":"Sewho cap design w/jnt(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEA0","description":"ICD-NJEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIND0","description":"ICD-CIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcyl trifocal 4.00/>6","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2306","description":"Lens sphcyl trifocal 4.00/>6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIC1","description":"ICD-EEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETF1","description":"ICD-GETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pos air press adhere no perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8855","description":"Pos air press adhere no perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB104","description":"Special Care Low _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABD1","description":"ICD-MABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tee w or w/o fol w/cont_cong","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8926","description":"Tee w or w/o fol w/cont_cong","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC23B","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adj skin pro/pos cus<22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2624","description":"Adj skin pro/pos cus<22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDC1","description":"ICD-MHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXE1","description":"ICD-NHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADA0","description":"ICD-IADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANC0","description":"ICD-FANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eeg digital analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95957","description":"Eeg digital analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5878","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5878","description":"CDT-D5878","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open biopsy of lung pleura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32098","description":"Open biopsy of lung pleura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal foreign body gum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41805","description":"Removal foreign body gum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam neck spine 6/>vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72052","description":"X-ray exam neck spine 6/>vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC20D","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA1A","description":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIF1","description":"ICD-AEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJD1","description":"ICD-CGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC0B","description":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28435","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cesarean delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59510","description":"Cesarean delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient pressure wrap with adjustable straps_ arm_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6588","description":"Gradient pressure wrap with adjustable straps_ arm_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01630","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01630","description":"CPT-01630","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJE0","description":"ICD-FDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration behind abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49010","description":"Exploration behind abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0877T","description":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKE1","description":"ICD-FGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMB0","description":"ICD-EHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOD1","description":"ICD-HCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEA0","description":"ICD-BCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI pelvis w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72196","description":"MRI pelvis w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of arm foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24200","description":"Removal of arm foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA217","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIE0","description":"ICD-BCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01992","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01992","description":"CPT-01992","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1051","description":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vitamin B-12 absorption study (eg_ Schilling test); without intrinsic factor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78270","description":"Vitamin B-12 absorption study (eg_ Schilling test); without intrinsic factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foot longitudinal arch suppo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3010","description":"Foot longitudinal arch suppo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01716","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01716","description":"CPT-01716","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMF1","description":"ICD-NCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Term dev precision pinch dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6810","description":"Term dev precision pinch dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTD1","description":"ICD-AHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stent_ non-coat/cov w/o del","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1877","description":"Stent_ non-coat/cov w/o del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGC1","description":"ICD-BBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUF1","description":"ICD-EEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRE0","description":"ICD-HCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cyclosporine oral 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7502","description":"Cyclosporine oral 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE236","description":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEF0","description":"ICD-BEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Myelography thoracic spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72255","description":"Myelography thoracic spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adjv thxpyrxd/rcvd colon ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4180F","description":"Adjv thxpyrxd/rcvd colon ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES35B","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of non-biodegradable drug delivery implants_ 4 or more (services for subdermal implants)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0517","description":"Removal of non-biodegradable drug delivery implants_ 4 or more (services for subdermal implants)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAF1","description":"ICD-NBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heart flow reserve measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93571","description":"Heart flow reserve measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTC1","description":"ICD-GDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMD1","description":"ICD-AHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRB0","description":"ICD-OIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 2 genotyping (HPA-2)_ GP1BA (glycoprotein Ib [platelet]_ alpha polypeptide [GPIba]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post-transfusion p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81106","description":"Human Platelet Antigen 2 genotyping (HPA-2)_ GP1BA (glycoprotein Ib [platelet]_ alpha polypeptide [GPIba]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post-transfusion p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat/graft heel fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28420","description":"Treat/graft heel fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCE1","description":"ICD-CDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBF1","description":"ICD-EFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIB0","description":"ICD-NGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPB0","description":"ICD-JFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB226","description":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHE1","description":"ICD-BGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGB1","description":"ICD-NCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ramucirumab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9308","description":"Injection_ ramucirumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amp no reqd in48h ieler proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9639","description":"Amp no reqd in48h ieler proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine urobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84580","description":"Assay of urine urobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C7566","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7566","description":"HCPCS-C7566","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILF0","description":"ICD-BILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral - periapical radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0707","description":"Intraoral - periapical radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBC0","description":"ICD-KEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Create new tubal opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58770","description":"Create new tubal opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orthotic(s) management and training (including assessment and fitting when not otherwise reported)_ upper extremity(ies)_ lower extremity(ies) and/or trunk_ initial orthotic(s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97760","description":"Orthotic(s) management and training (including assessment and fitting when not otherwise reported)_ upper extremity(ies)_ lower extremity(ies) and/or trunk_ initial orthotic(s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJE0","description":"ICD-NFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRB1","description":"ICD-KCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Measles and rubella virus vaccine_ live_ for subcutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90708","description":"Measles and rubella virus vaccine_ live_ for subcutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEB0","description":"ICD-CAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00404","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00404","description":"CPT-00404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDD1","description":"ICD-CGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8X","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Generator_ Cardiac Contractility Modulation (Implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1824","description":"Generator_ Cardiac Contractility Modulation (Implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aor ane 5.5-5.9 cm max diam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9598","description":"Aor ane 5.5-5.9 cm max diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKA1","description":"ICD-KGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDC0","description":"ICD-EIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exercise test for bronchospasm_ including pre- and post-spirometry_ electrocardiographic recording(s)_ and pulse oximetry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94617","description":"Exercise test for bronchospasm_ including pre- and post-spirometry_ electrocardiographic recording(s)_ and pulse oximetry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES346","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKB1","description":"ICD-CGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHA1","description":"ICD-FGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB134","description":"Clinically Complex _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAF0","description":"ICD-GIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4CC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CC11","description":"ICD-4CC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCB1","description":"ICD-AHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLF0","description":"ICD-AHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJA1","description":"ICD-NDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology_ Response To Radiation_ Cell-Free Dna_ Quantitative Branched Chain Dna Amplification_ Plasma_ Reported As A Radiation Toxicity Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0285U","description":"Oncology_ Response To Radiation_ Cell-Free Dna_ Quantitative Branched Chain Dna Amplification_ Plasma_ Reported As A Radiation Toxicity Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dalteparin sodium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1645","description":"Dalteparin sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair urethrovaginal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57310","description":"Repair urethrovaginal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pos airway press headgear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7035","description":"Pos airway press headgear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRD1","description":"ICD-LFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegunigalsidase alfa-iwxj_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2508","description":"Injection_ pegunigalsidase alfa-iwxj_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEE0","description":"ICD-GDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert electrd/pm cath sngl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33210","description":"Insert electrd/pm cath sngl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch for bar w lk fl/fltr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4423","description":"Ost pch for bar w lk fl/fltr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHD1","description":"ICD-ICHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepb vaccine 3 dose adult im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90746","description":"Hepb vaccine 3 dose adult im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDD1","description":"ICD-AEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISD1","description":"ICD-OISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-molded lacer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2320","description":"Non-molded lacer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brompheniramine maleate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0945","description":"Brompheniramine maleate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIC1","description":"ICD-OCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTE0","description":"ICD-NKTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWB1","description":"ICD-CCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"FlowerAmnioFlo_ 0.1 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4177","description":"FlowerAmnioFlo_ 0.1 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHF1","description":"ICD-BEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJF0","description":"ICD-NAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLF1","description":"ICD-KDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Culture aerobic quant other","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87071","description":"Culture aerobic quant other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUD1","description":"ICD-JGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88012","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEF0","description":"ICD-AEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Charger elec/combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0495","description":"Charger elec/combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adults who are not ambulatory","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1068","description":"Adults who are not ambulatory","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETE1","description":"ICD-BETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Below elbow prosth tiss shap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6400","description":"Below elbow prosth tiss shap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repl met band kafo-afo prox","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4080","description":"Repl met band kafo-afo prox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCE1","description":"ICD-MJCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGB1","description":"ICD-NFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tmj condyle","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7840","description":"Removal of tmj condyle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVB0","description":"ICD-JGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOF0","description":"ICD-HDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLB1","description":"ICD-JBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBF0","description":"ICD-FEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHA1","description":"ICD-EAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNF0","description":"ICD-FGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOC0","description":"ICD-CEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKE1","description":"ICD-NJKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSA1","description":"ICD-KCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJB1","description":"ICD-JIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ht muscle image planar sing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78453","description":"Ht muscle image planar sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4AA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AA31","description":"ICD-4AA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA15","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy trifocal 4.25-7/.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2307","description":"Lens sphcy trifocal 4.25-7/.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contraceptive vaginal ring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7303","description":"Contraceptive vaginal ring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24566","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Benzodiazepines","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6031","description":"Benzodiazepines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUF1","description":"ICD-MGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBF0","description":"ICD-NLBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"O shoe add horseshoe toe tap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3560","description":"O shoe add horseshoe toe tap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 BIVALENT 10 MCG/0.2 ML ADDL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0154A","description":"IMM ADMN SARSCOV2 BIVALENT 10 MCG/0.2 ML ADDL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Afo sing upright w/ adjust s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1920","description":"Afo sing upright w/ adjust s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB2B","description":"Low Rehab_ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVC0","description":"ICD-OLVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGE1","description":"ICD-BFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUC0","description":"ICD-OEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITD0","description":"ICD-OITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLF0","description":"ICD-NDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brachytherapy radioelements","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q3001","description":"Brachytherapy radioelements","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEF0","description":"ICD-OHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGB0","description":"ICD-NLGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPD0","description":"ICD-KIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLD0","description":"ICD-FBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYF1","description":"ICD-PBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00908","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00908","description":"CPT-00908","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HPYLORI STOOL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87338","description":"IAAD IA HPYLORI STOOL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neutralization test viral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86382","description":"Neutralization test viral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADF1","description":"ICD-CADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mogamulizumab-kpkc_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9204","description":"Injection_ mogamulizumab-kpkc_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Egd endoscopic stent place","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43266","description":"Egd endoscopic stent place","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal monitor w/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59050","description":"Fetal monitor w/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJC1","description":"ICD-FBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABA0","description":"ICD-AABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dermal filler injection(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0429","description":"Dermal filler injection(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPD0","description":"ICD-NIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHC1","description":"ICD-GCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES221","description":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMA1","description":"ICD-AGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of rectal stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45150","description":"Excision of rectal stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIF0","description":"ICD-KAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE125","description":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc no comp or mort w in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9269","description":"Doc no comp or mort w in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTE0","description":"ICD-KHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXB0","description":"ICD-FBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKA0","description":"ICD-OHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBB1","description":"ICD-OLBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Loop heel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0951","description":"Loop heel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVC0","description":"ICD-KDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNB1","description":"ICD-GDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITC0","description":"ICD-FITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES334","description":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWD0","description":"ICD-CEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adrenal cortical tumor_ biochemical assay of 25 steroid markers_ utilizing 24-hour urine specimen and clinical parameters_ prognostic algorithm reported as a clinical risk and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0015M","description":"Adrenal cortical tumor_ biochemical assay of 25 steroid markers_ utilizing 24-hour urine specimen and clinical parameters_ prognostic algorithm reported as a clinical risk and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heavy duty wheeled walker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0149","description":"Heavy duty wheeled walker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic deluxe shoe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5508","description":"Diabetic deluxe shoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crutch forearm each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0111","description":"Crutch forearm each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDB1","description":"ICD-NDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism (depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ gene-drug interactions_ variant analysis of 16 genes_ including deletion/duplication an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0392U","description":"Drug metabolism (depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ gene-drug interactions_ variant analysis of 16 genes_ including deletion/duplication an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVA0","description":"ICD-NDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHID1","description":"ICD-KHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB110","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apply rigid leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29445","description":"Apply rigid leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGID1","description":"ICD-MGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCD1","description":"ICD-KBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert epicard eltrd endo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33203","description":"Insert epicard eltrd endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCF1","description":"ICD-JFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJB0","description":"ICD-CDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"non - surgical sialolithotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7979","description":"non - surgical sialolithotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEA1","description":"ICD-BHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHE1","description":"ICD-JGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCND0","description":"ICD-BCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVC1","description":"ICD-GDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIA0","description":"ICD-GFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin ext jnts fld swg e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5726","description":"Knee-shin ext jnts fld swg e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESE0","description":"ICD-GESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC53","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNA1","description":"ICD-FGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYF0","description":"ICD-KFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx rectal t4_n_m0 no prg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9093","description":"Onc dx rectal t4_n_m0 no prg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lefort i-1 piece w/ graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21145","description":"Lefort i-1 piece w/ graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL3C","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bupivacaine_ Collagen-Matrix Implant_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9089","description":"Bupivacaine_ Collagen-Matrix Implant_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0976T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","description":"CPT-0976T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSE0","description":"ICD-OJSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compression stocking bk30-40","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6531","description":"Compression stocking bk30-40","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWC0","description":"ICD-DCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPD1","description":"ICD-BDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE23A","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWE1","description":"ICD-KFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKC1","description":"ICD-OCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML33","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEE1","description":"ICD-KIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brain aneurysm repr complx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61697","description":"Brain aneurysm repr complx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAD1","description":"ICD-OFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair amputee w/ foot r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1180","description":"Wheelchair amputee w/ foot r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cerebrospinal fluid scan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78630","description":"Cerebrospinal fluid scan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient progr_ neurostim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1787","description":"Patient progr_ neurostim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Closd rductn splint alveolus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7670","description":"Closd rductn splint alveolus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcvng esa thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4171F","description":"Pt rcvng esa thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgery for urethra pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53240","description":"Surgery for urethra pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAB1","description":"ICD-EEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMA1","description":"ICD-KCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLA0","description":"ICD-IBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFA1","description":"ICD-GCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOB0","description":"ICD-OGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSE1","description":"ICD-HCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB16","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJF0","description":"ICD-OLJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDC1","description":"ICD-FHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Homemaker service nos /diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5131","description":"Homemaker service nos /diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tte w or wo fol wcon_doppler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8929","description":"Tte w or wo fol wcon_doppler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKF0","description":"ICD-BFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA45","description":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC22C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHB0","description":"ICD-JIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAB1","description":"ICD-ABAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDD0","description":"ICD-NFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Upper extremity prosthes nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7499","description":"Upper extremity prosthes nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28F","description":"Special Care High _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16075","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16075","description":"CPT-16075","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCA1","description":"ICD-EBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise kneecap with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27438","description":"Revise kneecap with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILB0","description":"ICD-FILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKE1","description":"ICD-OEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNC0","description":"ICD-GGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNE1","description":"ICD-JHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit intermit chemo diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9331","description":"Hit intermit chemo diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acesso tl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4300","description":"Acesso tl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of troponin qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84512","description":"Assay of troponin qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_ risk adj lo_ initial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9004","description":"Mccd_ risk adj lo_ initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0183","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","description":"HCPCS-G0183","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDC1","description":"ICD-NHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0205","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0205","description":"HCPCS-A0205","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB42","description":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC52","description":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extrnl bleaching per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9973","description":"Extrnl bleaching per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onlay cst hgh nbl mtl >=3srf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6611","description":"Onlay cst hgh nbl mtl >=3srf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33692","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEF0","description":"ICD-JFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGC1","description":"ICD-NGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foot/toes surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28899","description":"Foot/toes surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft axillary-axilry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35518","description":"Art byp grft axillary-axilry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIE1","description":"ICD-OLIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGC0","description":"ICD-FAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ptnotrcvngsteroid>/=10mg/day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3750F","description":"Ptnotrcvngsteroid>/=10mg/day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYD0","description":"ICD-KAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"So vest canvas/web pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3675","description":"So vest canvas/web pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ctlso a-p-l control w/ inter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0710","description":"Ctlso a-p-l control w/ inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray upper gi delay w/o kub","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74240","description":"X-ray upper gi delay w/o kub","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of pyruvate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84210","description":"Assay of pyruvate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOB0","description":"ICD-KAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRE0","description":"ICD-LHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0802","description":"HCPCS-A0802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shorten/lengthen thighs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27468","description":"Shorten/lengthen thighs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFF0","description":"ICD-JIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert body dcmprn thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63085","description":"Remove vert body dcmprn thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No smok b/4 anes day of surg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9644","description":"No smok b/4 anes day of surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYF1","description":"ICD-KAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx esophag t1-t3 noprog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9096","description":"Onc dx esophag t1-t3 noprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWF1","description":"ICD-PEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1818","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1818","description":"HCPCS-J1818","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWC0","description":"ICD-OKWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDE0","description":"ICD-NLDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQB0","description":"ICD-GBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATC0","description":"ICD-KATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHB0","description":"ICD-NBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCB0","description":"ICD-CCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALC0","description":"ICD-BALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0592","description":"Hospital Special Treatment Room Support Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPD0","description":"ICD-BHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLE0","description":"ICD-NFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRA1","description":"ICD-GCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Srch for ct w in 12 mos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9341","description":"Srch for ct w in 12 mos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEC0","description":"ICD-MLEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Frame typ sock above elb/dis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6688","description":"Frame typ sock above elb/dis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVB1","description":"ICD-KHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNB0","description":"ICD-KFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rcmnd flw-up 10 yrs docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0528F","description":"Rcmnd flw-up 10 yrs docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3FC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FC31","description":"ICD-3FC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28292","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging without contrast_ breast; unilateral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8904","description":"Magnetic resonance imaging without contrast_ breast; unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine sodium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84300","description":"Assay of urine sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00794","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00794","description":"CPT-00794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95984","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of lower eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15821","description":"Revision of lower eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pathologists/dermatopathologists providing a second opinion on a biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9784","description":"Pathologists/dermatopathologists providing a second opinion on a biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCD0","description":"ICD-GGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCB0","description":"ICD-CBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"1 pc ost pouch w filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5056","description":"1 pc ost pouch w filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSF0","description":"ICD-GBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWB1","description":"ICD-PEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Computer-Aided Mapping Of Cervix Uteri During Colposcopy_ Including Optical Dynamic Spectral Imaging And Algorithmic Quantification Of The Acetowhitening Effect (List Separate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57465","description":"Computer-Aided Mapping Of Cervix Uteri During Colposcopy_ Including Optical Dynamic Spectral Imaging And Algorithmic Quantification Of The Acetowhitening Effect (List Separate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSA1","description":"ICD-ODSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPF0","description":"ICD-BFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFD1","description":"ICD-CIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/o us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20610","description":"Drain/inj joint/bursa w/o us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGE0","description":"ICD-KAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIB0","description":"ICD-IBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC5A","description":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mass spectrometry and tandem mass spectrometry (ms_ ms/ms)_ analyte notelsewhere specified; qualitative_ each specimen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83788","description":"Mass spectrometry and tandem mass spectrometry (ms_ ms/ms)_ analyte notelsewhere specified; qualitative_ each specimen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCB1","description":"ICD-KGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQC1","description":"ICD-DBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ped term dev_ hand_ vol open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6713","description":"Ped term dev_ hand_ vol open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE121","description":"Special Care High _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shlder disart int lock elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6300","description":"Shlder disart int lock elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTE1","description":"ICD-JBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQA0","description":"ICD-PAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSC0","description":"ICD-OJSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Celera Dual Layer or Celera Dual Membrane_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4259","description":"Celera Dual Layer or Celera Dual Membrane_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUD1","description":"ICD-CIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Change stent via transureth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50385","description":"Change stent via transureth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Belt/harness extremity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0945","description":"Belt/harness extremity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJA0","description":"ICD-BGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEF0","description":"ICD-OIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVA0","description":"ICD-OGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD135","description":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N.gonorrhoeae dna amp prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87591","description":"N.gonorrhoeae dna amp prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJC1","description":"ICD-NLJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPE0","description":"ICD-BCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRB0","description":"ICD-PFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGF0","description":"ICD-KCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSE0","description":"ICD-KDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHE1","description":"ICD-GIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Initial observation care_ per day_ for the evaluation and management of a patient_ which requires these 3 key components: A comprehensive history; A comprehensive examination;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99219","description":"Initial observation care_ per day_ for the evaluation and management of a patient_ which requires these 3 key components: A comprehensive history; A comprehensive examination;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LC11","description":"ICD-3LC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASD1","description":"ICD-DASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBE0","description":"ICD-IBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct head of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24366","description":"Reconstruct head of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGB1","description":"ICD-KAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWC1","description":"ICD-OBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18E","description":"Special Care High _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICC1","description":"ICD-CICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHE0","description":"ICD-CIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clsd ostomy pouch w/o barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5052","description":"Clsd ostomy pouch w/o barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foot_ adductus positioning device_ adjustable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1015","description":"Foot_ adductus positioning device_ adjustable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD230","description":"Special Care Low _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMF1","description":"ICD-JBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLC0","description":"ICD-ADLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ faricimab-svoa_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2777","description":"Injection_ faricimab-svoa_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCA1","description":"ICD-IFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELF1","description":"ICD-GELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPB0","description":"ICD-CIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA146","description":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPB1","description":"ICD-GDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRF0","description":"ICD-HFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESF0","description":"ICD-PESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADC0","description":"ICD-OADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERA1","description":"ICD-PERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMB1","description":"ICD-GHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECE1","description":"ICD-CECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Robt lin-radsurg fractx 2-5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0340","description":"Robt lin-radsurg fractx 2-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart chambers","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33670","description":"Repair of heart chambers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOD0","description":"ICD-OEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJE0","description":"ICD-JDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECE1","description":"ICD-OECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pov group 2 std up to 300lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0806","description":"Pov group 2 std up to 300lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLA0","description":"ICD-AGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thromboplastin time partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85732","description":"Thromboplastin time partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGF1","description":"ICD-OIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Speech/hearing therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92508","description":"Speech/hearing therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE105","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28A","description":"Special Care Low _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWE0","description":"ICD-LAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Safety frames","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0516","description":"Safety frames","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair double ventricle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33611","description":"Repair double ventricle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPA0","description":"ICD-JGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of jaw <4views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70100","description":"X-ray exam of jaw <4views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foot exam performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2028F","description":"Foot exam performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEC1","description":"ICD-GFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA22B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m disofenin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9510","description":"Tc99m disofenin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLD1","description":"ICD-NFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of forearm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25915","description":"Amputation of forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychophysiological therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90876","description":"Psychophysiological therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablate heart dysrhythm focus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33250","description":"Ablate heart dysrhythm focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ntiol category 4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q1004","description":"Ntiol category 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection abdominal shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49427","description":"Injection abdominal shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Offset knee joint heavy duty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2395","description":"Offset knee joint heavy duty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFID0","description":"ICD-EFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGD0","description":"ICD-NCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Midface flap (ie_ zygomaticofacial flap) with preservation of vascular pedicle(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15730","description":"Midface flap (ie_ zygomaticofacial flap) with preservation of vascular pedicle(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDC0","description":"ICD-CDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD23D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICF0","description":"ICD-EICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2IB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IB21","description":"ICD-2IB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pamidronate disodium /30 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2430","description":"Pamidronate disodium /30 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWB1","description":"ICD-CIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSC0","description":"ICD-KCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pin finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26756","description":"Pin finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Seat/back cus no dmepdac ver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0669","description":"Seat/back cus no dmepdac ver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5930","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5930","description":"CDT-D5930","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMC0","description":"ICD-GAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPC1","description":"ICD-FIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQB0","description":"ICD-KHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKC1","description":"ICD-JEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dysphagia screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5364","description":"Dysphagia screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGC1","description":"ICD-BEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEC0","description":"ICD-EIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"RARE DS GEN DNA ALYS PROBAND","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0212U","description":"RARE DS GEN DNA ALYS PROBAND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urine bacteria culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87088","description":"Urine bacteria culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCA0","description":"ICD-BHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Forensic cytopathology","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88125","description":"Forensic cytopathology","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIA0","description":"ICD-FBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWB1","description":"ICD-GAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX54","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINE1","description":"ICD-NINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVD1","description":"ICD-GGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELF1","description":"ICD-MELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPB1","description":"ICD-NJPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSD1","description":"ICD-OHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9812","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9812","description":"HCPCS-C9812","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEC1","description":"ICD-EHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Death did not occur after discharge from the hospital within 30 days post procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9817","description":"Death did not occur after discharge from the hospital within 30 days post procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXC0","description":"ICD-KAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove inner ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69970","description":"Remove inner ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB25B","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGA1","description":"ICD-NHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCB0","description":"ICD-IFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVE0","description":"ICD-KGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKF0","description":"ICD-BCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRE0","description":"ICD-KGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKED0","description":"ICD-MKED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Long-acting inhaled bronchodilator not prescribed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9699","description":"Long-acting inhaled bronchodilator not prescribed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0092A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCD1","description":"ICD-FDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWC0","description":"ICD-KFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQC0","description":"ICD-GDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urokinase 5000 iu injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3364","description":"Urokinase 5000 iu injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAE1","description":"ICD-OLAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQB0","description":"ICD-HFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair venous anomaly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33724","description":"Repair venous anomaly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Azacitidine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9025","description":"Azacitidine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray of mammary ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77054","description":"X-ray of mammary ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LB11","description":"ICD-3LB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Back pain was not measured by the visual analog scale (VAS) within three months preoperatively and at one year (9 to 15 months) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9946","description":"Back pain was not measured by the visual analog scale (VAS) within three months preoperatively and at one year (9 to 15 months) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ mRNA_ microarray gene expression profiling of 209 genes_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as molecular subtype (lumina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0016M","description":"Oncology (bladder)_ mRNA_ microarray gene expression profiling of 209 genes_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as molecular subtype (lumina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29876","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHC0","description":"ICD-KCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDB0","description":"ICD-OKDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMF0","description":"ICD-OBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMC0","description":"ICD-IAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Care of miscarriage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59820","description":"Care of miscarriage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gingival flap proc w/ planin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4240","description":"Gingival flap proc w/ planin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4436","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","description":"HCPCS-Q4436","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0968T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","description":"CPT-0968T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kidney imaging with flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78701","description":"Kidney imaging with flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFB0","description":"ICD-KHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0172A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18D","description":"Clinically Complex _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEB0","description":"ICD-IAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mometasone sinus implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1090","description":"Mometasone sinus implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJC0","description":"ICD-KAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray upper gi delay w/kub","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74241","description":"X-ray upper gi delay w/kub","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61686","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cimetidine hydroc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0023","description":"Injection_ cimetidine hydroc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD15D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Buprenorphine (Implant Removal); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2071","description":"Medication Assisted Treatment_ Buprenorphine (Implant Removal); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1030","description":"Patients with clinical indications for imaging of the head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC3A","description":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHD0","description":"ICD-OKHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOA0","description":"ICD-LHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQB0","description":"ICD-LHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"RUNX1 (runt related transcription factor 1) (eg_ acute myeloid leukemia_ familial platelet disorder with associated myeloid malignancy)_ gene analysis_ targeted sequence analy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81334","description":"RUNX1 (runt related transcription factor 1) (eg_ acute myeloid leukemia_ familial platelet disorder with associated myeloid malignancy)_ gene analysis_ targeted sequence analy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prefab post/core + crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2954","description":"Prefab post/core + crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HISTOPLASM CAPSULATUM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87385","description":"IAAD IA HISTOPLASM CAPSULATUM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1KB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KB31","description":"ICD-1KB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCE0","description":"ICD-KGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBA1","description":"ICD-JCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","description":"HCPCS-J0602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Optical coherence tomography (OCT) for microstructural and morphological imaging of skin_ image acquisition_ interpretation_ and report; first lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0470T","description":"Optical coherence tomography (OCT) for microstructural and morphological imaging of skin_ image acquisition_ interpretation_ and report; first lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUC1","description":"ICD-EIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKB0","description":"ICD-JHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYE0","description":"ICD-HBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Asthma symptoms evaluate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1005F","description":"Asthma symptoms evaluate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heterophile antibody screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86308","description":"Heterophile antibody screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair tongue laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41251","description":"Repair tongue laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQC0","description":"ICD-KHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOD0","description":"ICD-GAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair detached retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67107","description":"Repair detached retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hysteroscopy ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58563","description":"Hysteroscopy ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0403","description":"HCPCS-A0403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEE0","description":"ICD-ECEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay quant nos nonab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83520","description":"Immunoassay quant nos nonab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOB0","description":"ICD-PLOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUA1","description":"ICD-FIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMA0","description":"ICD-AAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATD1","description":"ICD-MATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ crizanlizumab-tmca_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9053","description":"Injection_ crizanlizumab-tmca_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWA1","description":"ICD-CBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCC1","description":"ICD-BBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHC1","description":"ICD-BIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINA1","description":"ICD-BINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9300","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9300","description":"HCPCS-C9300","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOB0","description":"ICD-HGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neurectomy foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28055","description":"Neurectomy foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Facial nerve function test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92516","description":"Facial nerve function test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELC1","description":"ICD-EELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERB1","description":"ICD-GERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDE0","description":"ICD-EBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc cncr 0/ia melan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3321F","description":"Ajcc cncr 0/ia melan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITD0","description":"ICD-NITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear rx intra-articular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79440","description":"Nuclear rx intra-articular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEE0","description":"ICD-BGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMB1","description":"ICD-FAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTA1","description":"ICD-MBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18B","description":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQD1","description":"ICD-LAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect talus/calcaneus tum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27647","description":"Resect talus/calcaneus tum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00936","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00936","description":"CPT-00936","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of permanently implantable aortic counterpulsation ventricular assist system; subcutaneous electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0458T","description":"Removal of permanently implantable aortic counterpulsation ventricular assist system; subcutaneous electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Structured Day Habilitation Group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0104","description":"Structured Day Habilitation Group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVC1","description":"ICD-JCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HA21","description":"ICD-4HA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHB1","description":"ICD-ODHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOB0","description":"ICD-ODOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrst x-ray exam of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74210","description":"Contrst x-ray exam of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWE0","description":"ICD-LBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1499","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","description":"HCPCS-M1499","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMB1","description":"ICD-IIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUD0","description":"ICD-KHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medroxyprogesterone acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1050","description":"Medroxyprogesterone acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place cath subclavian art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36225","description":"Place cath subclavian art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEE1","description":"ICD-MBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement facemask interfa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7031","description":"Replacement facemask interfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8F","description":"Low Rehab_ ADL Index 0-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD213","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOC1","description":"ICD-LDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60100","description":"Biopsy of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDA0","description":"ICD-EIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWF1","description":"ICD-DCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTA1","description":"ICD-OFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELA1","description":"ICD-FELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPB0","description":"ICD-OLPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65400","description":"Removal of eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tacrol astagraf ex rel oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7508","description":"Tacrol astagraf ex rel oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTB1","description":"ICD-KBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUC1","description":"ICD-BDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26775","description":"Treat finger dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUF0","description":"ICD-KAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flexible metal hinge pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6610","description":"Flexible metal hinge pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYD0","description":"ICD-PEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMA1","description":"ICD-MIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95724","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKA1","description":"ICD-GGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB201","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGF0","description":"ICD-JBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Test rbc protoporphyrin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84203","description":"Test rbc protoporphyrin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUD0","description":"ICD-KBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGA0","description":"ICD-KHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunotherapy one injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95115","description":"Immunotherapy one injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUA0","description":"ICD-GIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88029","description":"Autopsy (necropsy) complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gsc >15 & hd ct by ed md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9594","description":"Gsc >15 & hd ct by ed md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise tendon(s) & muscle(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23406","description":"Incise tendon(s) & muscle(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pancreatic stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48020","description":"Removal of pancreatic stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES25A","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFF0","description":"ICD-FEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBF0","description":"ICD-AEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation at shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23920","description":"Amputation at shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIE0","description":"ICD-FIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sperm isolation simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89260","description":"Sperm isolation simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of foot fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28250","description":"Revision of foot fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATD0","description":"ICD-FATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laminotomy (Hemilaminectomy)_ With Decompression Of Nerve Root(S)_ Including Partial Facetectomy_ Foraminotomy And Excision Of Herniated Intervertebral Disc_ And Repair Of Ann","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9757","description":"Laminotomy (Hemilaminectomy)_ With Decompression Of Nerve Root(S)_ Including Partial Facetectomy_ Foraminotomy And Excision Of Herniated Intervertebral Disc_ And Repair Of Ann","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB225","description":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILC1","description":"ICD-OILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADC1","description":"ICD-AADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit pain mgmt per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9325","description":"Hit pain mgmt per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneumococcal conjugate vaccine_ polyvalent_ for children under 5 years_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90669","description":"Pneumococcal conjugate vaccine_ polyvalent_ for children under 5 years_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVB1","description":"ICD-NJVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA42","description":"Default_ /60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ oritavancin (Kimyrsa)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2406","description":"Injection_ oritavancin (Kimyrsa)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HB31","description":"ICD-2HB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rectal control system for vaginal insertion_ for long term use_ includes pump and all supplies and accessories_ any type each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4563","description":"Rectal control system for vaginal insertion_ for long term use_ includes pump and all supplies and accessories_ any type each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBC0","description":"ICD-KIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIB1","description":"ICD-IBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42220","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBB0","description":"ICD-OFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stent_ coated/cov w/del sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1874","description":"Stent_ coated/cov w/del sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62323","description":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4391","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","description":"HCPCS-Q4391","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0303","description":"HCPCS-C0303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth cleft palate repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17251","description":"Anesth cleft palate repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQE1","description":"ICD-LCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo guide cardiocentesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76930","description":"Echo guide cardiocentesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dna antibody native","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86225","description":"Dna antibody native","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Naltrexone; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Tes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2073","description":"Medication Assisted Treatment_ Naltrexone; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Tes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30430","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILF0","description":"ICD-EILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILF1","description":"ICD-KILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMA1","description":"ICD-GHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKF0","description":"ICD-BEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB11C","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal invas px w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59897","description":"Fetal invas px w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOD0","description":"ICD-PCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKID1","description":"ICD-MKID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD25D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27880","description":"Amputation of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB206","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise parotid gland/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42410","description":"Excise parotid gland/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Srs cran les complex addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61799","description":"Srs cran les complex addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of spermatic ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54901","description":"Fusion of spermatic ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parkinsons disease mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8903","description":"Parkinsons disease mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHF0","description":"ICD-BGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 5-10 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99421","description":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 5-10 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUD1","description":"ICD-MCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHE1","description":"ICD-CHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1244","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-75577","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","description":"CPT-75577","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALE1","description":"ICD-BALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tumor imaging (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78803","description":"Tumor imaging (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVB0","description":"ICD-FAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc funct and care plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8539","description":"Doc funct and care plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1001T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","description":"CPT-1001T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCD0","description":"ICD-MJCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies); with intravascular lithotripsy and atherectomy_ includes angioplasty within the same vessel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9774","description":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies); with intravascular lithotripsy and atherectomy_ includes angioplasty within the same vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32100","description":"Exploration of chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28G","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAA1","description":"ICD-JHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of extremity artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37618","description":"Ligation of extremity artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFND1","description":"ICD-KFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of collar bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23485","description":"Revision of collar bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Routine ophthalmological exa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0620","description":"Routine ophthalmological exa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise ventricle muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33416","description":"Revise ventricle muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inject trigger points 3/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20553","description":"Inject trigger points 3/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYC1","description":"ICD-HGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRF0","description":"ICD-KHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAID1","description":"ICD-EAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain pancreatic pseudocyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48510","description":"Drain pancreatic pseudocyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTF0","description":"ICD-BHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fuse bile ducts and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47760","description":"Fuse bile ducts and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Actigraphy testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95803","description":"Actigraphy testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQA0","description":"ICD-HDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gen use back cush wdth <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2611","description":"Gen use back cush wdth <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADD1","description":"ICD-IADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEA0","description":"ICD-MAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9711","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Refer to hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9524","description":"Refer to hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEE1","description":"ICD-BAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Core Needle Biopsy_ Lung Or Mediastinum_ Percutaneous_ Including Imaging Guidance_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32408","description":"Core Needle Biopsy_ Lung Or Mediastinum_ Percutaneous_ Including Imaging Guidance_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD23B","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPF1","description":"ICD-KFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Njx paravert w/us lumb/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0218T","description":"Njx paravert w/us lumb/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXD1","description":"ICD-GIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inject pulm art hrt cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93568","description":"Inject pulm art hrt cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPA1","description":"ICD-OIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAC1","description":"ICD-KHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIB1","description":"ICD-MIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0721","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0721","description":"HCPCS-E0721","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKA1","description":"ICD-CHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKC0","description":"ICD-JHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1270","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antid glbln rcvd w/in 26wks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4178F","description":"Antid glbln rcvd w/in 26wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX0A","description":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision subvalvular tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33415","description":"Revision subvalvular tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL4A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVE1","description":"ICD-GHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGF1","description":"ICD-JGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDF1","description":"ICD-NLDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insj/rplc nstim apnea compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0424T","description":"Insj/rplc nstim apnea compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1128","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Icm device interrogat remote","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93297","description":"Icm device interrogat remote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ureter endoscopy & catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50972","description":"Ureter endoscopy & catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXD0","description":"ICD-FBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE25D","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWD1","description":"ICD-LBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAC1","description":"ICD-OKAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGD0","description":"ICD-JCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Convert nephrostomy catheter to nephroureteral catheter_ percutaneous via pre-existing nephrostomy tract_ with ureteral stricture balloon dialation_ including diagnostic nephr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7547","description":"Convert nephrostomy catheter to nephroureteral catheter_ percutaneous via pre-existing nephrostomy tract_ with ureteral stricture balloon dialation_ including diagnostic nephr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXD0","description":"ICD-NGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat midfoot fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28455","description":"Treat midfoot fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of idh enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83570","description":"Assay of idh enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVB0","description":"ICD-OGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVA1","description":"ICD-CHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise bile duct sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47460","description":"Incise bile duct sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Manipulate elbow w/anesth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24300","description":"Manipulate elbow w/anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58700","description":"Removal of fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace vad pump ext","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33981","description":"Replace vad pump ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB213","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA4A","description":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"7 field photo interp doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2024F","description":"7 field photo interp doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth fat layer removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80251","description":"Anesth fat layer removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFND1","description":"ICD-BFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHF1","description":"ICD-JCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOD0","description":"ICD-DEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laps rmvl vgl arry&pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0314T","description":"Laps rmvl vgl arry&pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHA0","description":"ICD-ECHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJC1","description":"ICD-NAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOE0","description":"ICD-KIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tobramycin non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7682","description":"Tobramycin non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIC1","description":"ICD-JFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBE1","description":"ICD-EEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ spesolimab-sbzo_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1747","description":"Injection_ spesolimab-sbzo_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMD0","description":"ICD-OBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABB1","description":"ICD-IABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EC31","description":"ICD-2EC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHE1","description":"ICD-OLHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGC1","description":"ICD-JBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYB0","description":"ICD-CEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE14D","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bk knee joints polycentric p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5677","description":"Bk knee joints polycentric p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNA1","description":"ICD-GFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC101","description":"Special Care High _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ anesthetic agent; carotid sinus (separate procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64508","description":"Injection_ anesthetic agent; carotid sinus (separate procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41825","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA15C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATC1","description":"ICD-FATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBA1","description":"ICD-CFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aspiration orbital contents","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67415","description":"Aspiration orbital contents","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam thorac spine4/>vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72074","description":"X-ray exam thorac spine4/>vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPD1","description":"ICD-GBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDF0","description":"ICD-IBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSC0","description":"ICD-HDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5152","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","description":"HCPCS-Q5152","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tongue mouth jaw surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41150","description":"Tongue mouth jaw surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB220","description":"Clinically Complex _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKA0","description":"ICD-JHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth vitreoretinal surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14551","description":"Anesth vitreoretinal surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA60","description":"Default_ /OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Construct vagina with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57292","description":"Construct vagina with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove/repair hearing aid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69711","description":"Remove/repair hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX05","description":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYC0","description":"ICD-HBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXD1","description":"ICD-CFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD115","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFE0","description":"ICD-OLFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYD1","description":"ICD-KAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Injection/Nerve Block Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0620","description":"Hospital Special Treatment Room Support Component (Hstrsc) Injection/Nerve Block Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE116","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spin/brain pump refil & main","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95991","description":"Spin/brain pump refil & main","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOA1","description":"ICD-OAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUE1","description":"ICD-JBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0605","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","description":"HCPCS-J0605","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ high density foam pad_ any size or shape_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6601","description":"Gradient compression bandaging supply_ high density foam pad_ any size or shape_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLD1","description":"ICD-ECLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth amputation of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93251","description":"Anesth amputation of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADD1","description":"ICD-JADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIE1","description":"ICD-JAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHF0","description":"ICD-IFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXD0","description":"ICD-NHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Octagam injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1568","description":"Octagam injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOB1","description":"ICD-GAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Phoenix wound matrix_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2015","description":"Phoenix wound matrix_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Primary closure sinus perf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7261","description":"Primary closure sinus perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Optic nerve head eval done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2027F","description":"Optic nerve head eval done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlh w/t/o uterus over 250 g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58573","description":"Tlh w/t/o uterus over 250 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD12B","description":"Clinically Complex _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAE1","description":"ICD-OFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMB0","description":"ICD-GGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47490","description":"Incision of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC106","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1410","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","description":"HCPCS-M1410","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC146","description":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablate bone tumor(s) perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20983","description":"Ablate bone tumor(s) perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hiv/aids measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8491","description":"Hiv/aids measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMA0","description":"ICD-MFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMA0","description":"ICD-MBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVF0","description":"ICD-FDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEB0","description":"ICD-GFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIA0","description":"ICD-JHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDE1","description":"ICD-NDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMB0","description":"ICD-GBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialysate conc sol add 10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4766","description":"Dialysate conc sol add 10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVE1","description":"ICD-ODVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Arthroscopy biceps tenodesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29828","description":"Arthroscopy biceps tenodesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dentures maxill part resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5211","description":"Dentures maxill part resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGF1","description":"ICD-JEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKC0","description":"ICD-FEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDF1","description":"ICD-MFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth cran surg hemotoma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21152","description":"Anesth cran surg hemotoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect thigh/knee tum < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27329","description":"Resect thigh/knee tum < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0530U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","description":"CPT-0530U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYF1","description":"ICD-PHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGA0","description":"ICD-NAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOE0","description":"ICD-PBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection_ percutaneous_ radiological supervision and interpretati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74480","description":"Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection_ percutaneous_ radiological supervision and interpretati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tick-borne relapsing fever Borrelia group_ antibody detection to 4 recombinant protein groups_ by immunoblot_ IgG","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0044U","description":"Tick-borne relapsing fever Borrelia group_ antibody detection to 4 recombinant protein groups_ by immunoblot_ IgG","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNC1","description":"ICD-OKNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9225","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9225","description":"CDT-D9225","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rimantadine hcl 100mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9020","description":"Rimantadine hcl 100mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIA1","description":"ICD-NAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYD1","description":"ICD-GIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Obstetric panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80055","description":"Obstetric panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23505","description":"Treat clavicle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ talimogene laherparepvec_ per 1 million plaque forming units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9325","description":"Injection_ talimogene laherparepvec_ per 1 million plaque forming units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBB1","description":"ICD-MBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC213","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDE0","description":"ICD-EDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQD0","description":"ICD-PGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx planar_ p-103","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2645","description":"Brachytx planar_ p-103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for prescribing or dispensing antibiotic (e.g._ intestinal infection_ pertussis_ bacterial infection_ lyme disease_ otitis media_ acute sinu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9712","description":"Documentation of medical reason(s) for prescribing or dispensing antibiotic (e.g._ intestinal infection_ pertussis_ bacterial infection_ lyme disease_ otitis media_ acute sinu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home visit prenatal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99500","description":"Home visit prenatal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILF1","description":"ICD-GILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35201","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8D","description":"Very High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOA1","description":"ICD-GIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrivalent (qIRV)_ mRNA; 30 mcg/0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90637","description":"Influenza virus vaccine_ quadrivalent (qIRV)_ mRNA; 30 mcg/0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITA1","description":"ICD-JITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES331","description":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIB1","description":"ICD-GGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect clavicle tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23200","description":"Resect clavicle tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVD1","description":"ICD-BIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIME0","description":"ICD-AIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACD0","description":"ICD-GACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coagulation time activated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85347","description":"Coagulation time activated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUB1","description":"ICD-FCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC226","description":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFA1","description":"ICD-CGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATF1","description":"ICD-AATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0903","description":"HCPCS-A0903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of leg at hip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27290","description":"Amputation of leg at hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients Age 66 And Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With A Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2081","description":"Patients Age 66 And Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With A Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTC1","description":"ICD-AGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEB1","description":"ICD-IHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Basic life disability exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99450","description":"Basic life disability exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEID0","description":"ICD-MEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVD1","description":"ICD-NBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9312","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9312","description":"HCPCS-C9312","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERB0","description":"ICD-GERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUE0","description":"ICD-JDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of haptoglobin quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83010","description":"Assay of haptoglobin quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28A","description":"Special Care Low _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMB0","description":"ICD-EAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWE1","description":"ICD-CHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood pressure measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2000F","description":"Blood pressure measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Child fostercare th per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5145","description":"Child fostercare th per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIA1","description":"ICD-KIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Closure ureter/bowel fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50930","description":"Closure ureter/bowel fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Palifermin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2425","description":"Palifermin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFE1","description":"ICD-FDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE130","description":"Clinically Complex _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPE1","description":"ICD-JBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28150","description":"Removal of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMC1","description":"ICD-MJMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Walker variable wheel resist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0147","description":"Walker variable wheel resist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXC1","description":"ICD-NLXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (congenital coagulation disorders)_ genomic sequence analysis of 20 genes_ blood_ buccal swab_ or amniotic fluid (Versitiā„¢ Coagulation Disorder Panel)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0270U","description":"Hematology (congenital coagulation disorders)_ genomic sequence analysis of 20 genes_ blood_ buccal swab_ or amniotic fluid (Versitiā„¢ Coagulation Disorder Panel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 3 vhd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0852","description":"Pwc gp 3 vhd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJE0","description":"ICD-OAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEB1","description":"ICD-OKEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSB1","description":"ICD-GBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect ovarian malignancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58951","description":"Resect ovarian malignancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair bladder neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51845","description":"Repair bladder neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX13","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILA0","description":"ICD-OILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLE0","description":"ICD-MFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLF0","description":"ICD-KHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFF1","description":"ICD-OHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXB1","description":"ICD-GAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHE1","description":"ICD-KGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antistreptolysin o screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86063","description":"Antistreptolysin o screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWA0","description":"ICD-HCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sebelipase alfa_ 1mg (Kanuma)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9478","description":"Injection_ sebelipase alfa_ 1mg (Kanuma)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81414","description":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55700","description":"Biopsy of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophgl motil w/stim/perfus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91013","description":"Esophgl motil w/stim/perfus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18B","description":"Special Care High _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Combination bilateral ho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1690","description":"Combination bilateral ho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIF0","description":"ICD-BHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA21B","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUF1","description":"ICD-GEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE10A","description":"Special Care High _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA43","description":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISC0","description":"ICD-KISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treprostinil_ non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7686","description":"Treprostinil_ non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCD1","description":"ICD-FCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ho abduction static plastic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1660","description":"Ho abduction static plastic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Xcell amnio matrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4280","description":"Xcell amnio matrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHE1","description":"ICD-EHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHA0","description":"ICD-ACHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX31","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERB0","description":"ICD-KERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9482","description":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTD0","description":"ICD-GGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of ileostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44312","description":"Revision of ileostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel drg >48 in w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6244","description":"Hydrogel drg >48 in w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiology port images(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77417","description":"Radiology port images(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUD0","description":"ICD-CGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVB1","description":"ICD-GGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVD1","description":"ICD-NGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFME0","description":"ICD-OFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALB0","description":"ICD-MALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJE0","description":"ICD-OBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ipratropium bromide non-comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7644","description":"Ipratropium bromide non-comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Med list docd in rcrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1159F","description":"Med list docd in rcrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKB0","description":"ICD-OIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJB1","description":"ICD-FBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49592","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEF1","description":"ICD-FBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIB1","description":"ICD-BDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC106","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72170","description":"X-ray exam of pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFC0","description":"ICD-JIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFE0","description":"ICD-KDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXB0","description":"ICD-OKXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise extra spine segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22226","description":"Revise extra spine segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGF1","description":"ICD-JHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IDH1 (isocitrate dehydrogenase 1 [NADP+]_ soluble) (eg_ glioma)_ common variants (eg_ R132H_ R132C)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81120","description":"IDH1 (isocitrate dehydrogenase 1 [NADP+]_ soluble) (eg_ glioma)_ common variants (eg_ R132H_ R132C)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Closure dev_ vasc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1760","description":"Closure dev_ vasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBA1","description":"ICD-IDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEA0","description":"ICD-FAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE13C","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSE0","description":"ICD-HGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPF0","description":"ICD-BGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wound filler gel/paste /oz","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6261","description":"Wound filler gel/paste /oz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWC1","description":"ICD-OKWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEA1","description":"ICD-GDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biofeedback peri/uro/rectal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90911","description":"Biofeedback peri/uro/rectal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ controlled by phone application","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0492","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ controlled by phone application","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIA1","description":"ICD-IGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXB0","description":"ICD-BCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOA0","description":"ICD-PBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE224","description":"Special Care High _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYA0","description":"ICD-CDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIB0","description":"ICD-BCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cam relese assem ftrst/lgrst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0051","description":"Cam relese assem ftrst/lgrst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral infus pump portab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9004","description":"Parenteral infus pump portab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth neck vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35251","description":"Anesth neck vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown porcelain/ceramic subs","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2740","description":"Crown porcelain/ceramic subs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Delay flap arms/legs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15610","description":"Delay flap arms/legs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31081","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High inten beh couns std 30m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0445","description":"High inten beh couns std 30m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat dental ridge fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21440","description":"Treat dental ridge fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLE0","description":"ICD-MGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKB0","description":"ICD-OEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADA1","description":"ICD-KADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHC0","description":"ICD-EAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excavation of a tooth resulting in the determination of non-restorability","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2989","description":"Excavation of a tooth resulting in the determination of non-restorability","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQB1","description":"ICD-PGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHA0","description":"ICD-MBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive (60 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiaryā€™s h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2004","description":"Comprehensive (60 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiaryā€™s h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHB0","description":"ICD-IFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGB1","description":"ICD-FGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX41","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMD0","description":"ICD-FAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIA0","description":"ICD-MEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disposable underpads","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4554","description":"Disposable underpads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCD0","description":"ICD-ODCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSC0","description":"ICD-GCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine urobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84583","description":"Assay of urine urobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYA1","description":"ICD-DIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB140","description":"Special Care Low _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYB0","description":"ICD-GHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup hip spica plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4025","description":"Cast sup hip spica plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4IB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IB11","description":"ICD-4IB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLC0","description":"ICD-AGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUB0","description":"ICD-BEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVC0","description":"ICD-OGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Demo-smoking cessation coun","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9016","description":"Demo-smoking cessation coun","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Provision of COVID-19 test_ nonprescription self-administered and self-collected use_ FDA approved_ authorized or cleared_ one test count","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1034","description":"Provision of COVID-19 test_ nonprescription self-administered and self-collected use_ FDA approved_ authorized or cleared_ one test count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of glucosidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82963","description":"Assay of glucosidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLA1","description":"ICD-GBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDD0","description":"ICD-CHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABB1","description":"ICD-CABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHE0","description":"ICD-CCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDA1","description":"ICD-MLDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWF1","description":"ICD-CGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"RAS (KRAS and NRAS) gene mutation testing not performed before initiation of anti-EGFR MoAb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9841","description":"RAS (KRAS and NRAS) gene mutation testing not performed before initiation of anti-EGFR MoAb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDB0","description":"ICD-JDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDE0","description":"ICD-IFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE211","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERB0","description":"ICD-OERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elbow arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29837","description":"Elbow arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEC1","description":"ICD-EAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mmrv vaccine sc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90710","description":"Mmrv vaccine sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cervical semi-rigid adjustab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0140","description":"Cervical semi-rigid adjustab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHC1","description":"ICD-CIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC260","description":"Special Care Low _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKD0","description":"ICD-GEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Family homecare train/sessio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5111","description":"Family homecare train/sessio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJF1","description":"ICD-GBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOE1","description":"ICD-DFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQD0","description":"ICD-KHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo partial nephrectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50543","description":"Laparo partial nephrectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81464","description":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27503","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSD0","description":"ICD-CFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B2001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2001","description":"HCPCS-B2001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWE0","description":"ICD-KAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1202","description":"HCPCS-C1202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct chest spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72129","description":"Ct chest spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56630","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19380","description":"Revise breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of fetal heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76826","description":"Echo exam of fetal heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIME1","description":"ICD-GIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELE0","description":"ICD-MELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBC1","description":"ICD-CEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MDPP session reported as a line-item on a claim for a payable MDPP Expanded Model (EM) HCPCS code for a session furnished by the billing supplier under the MDPP Expanded Model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9891","description":"MDPP session reported as a line-item on a claim for a payable MDPP Expanded Model (EM) HCPCS code for a session furnished by the billing supplier under the MDPP Expanded Model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Veritas collagen matrix_ cm2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9354","description":"Veritas collagen matrix_ cm2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLD1","description":"ICD-CDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3CA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CA21","description":"ICD-3CA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1401","description":"HCPCS-C1401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYD0","description":"ICD-LHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIE0","description":"ICD-FGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21087","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Meprobamate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6052","description":"Meprobamate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sodium nitrite 3 mg and sodium thiosulfate 125 mg (Nithiodote)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0211","description":"Injection_ sodium nitrite 3 mg and sodium thiosulfate 125 mg (Nithiodote)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of gonadotropin (lh)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83002","description":"Assay of gonadotropin (lh)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27284","description":"Fusion of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92851","description":"Anesth removal of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRD0","description":"ICD-PIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57105","description":"Biopsy of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIE1","description":"ICD-KEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1083T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1083T","description":"CPT-1083T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJC1","description":"ICD-FDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQD1","description":"ICD-HAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFME1","description":"ICD-AFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Not nsm lung ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9291","description":"Not nsm lung ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEC0","description":"ICD-IBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHA0","description":"ICD-GBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1KB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KB21","description":"ICD-1KB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB125","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rbc osmotic fragility","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85555","description":"Rbc osmotic fragility","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adj chem not pres rsn spec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8928","description":"Adj chem not pres rsn spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQC1","description":"ICD-GIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art pancreas ext receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1037","description":"Art pancreas ext receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1445","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","description":"HCPCS-M1445","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWA0","description":"ICD-OJWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISB0","description":"ICD-DISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWA1","description":"ICD-GDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECA0","description":"ICD-EECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0516U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","description":"CPT-0516U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJD0","description":"ICD-NCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Factor viii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7190","description":"Factor viii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXF1","description":"ICD-BBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace strap_ any orthosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4002","description":"Replace strap_ any orthosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No rev_ comm_ track biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8885","description":"No rev_ comm_ track biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLC0","description":"ICD-MJLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Influenza immunization administered or previously received","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1299","description":"Influenza immunization administered or previously received","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4CB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CB31","description":"ICD-4CB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE111","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64467","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","description":"CPT-64467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDE1","description":"ICD-ODDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert and remove bone pin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20650","description":"Insert and remove bone pin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc order cefazolin/cefurox","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4041F","description":"Doc order cefazolin/cefurox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61607","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA25A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC24B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL4C","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9713","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEC1","description":"ICD-OIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIF1","description":"ICD-CIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hdr rdncl ntrstl/icav brchtx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77771","description":"Hdr rdncl ntrstl/icav brchtx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEF1","description":"ICD-KHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21050","description":"Removal of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Breast Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1080","description":"Radiation Therapy For Breast Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKA1","description":"ICD-NCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo guide for biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76942","description":"Echo guide for biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sisi hearing test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92564","description":"Sisi hearing test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Probe nl duct w/balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68816","description":"Probe nl duct w/balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nonmed family planning ed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1010","description":"Nonmed family planning ed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1837","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","description":"HCPCS-J1837","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1050T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1050T","description":"CPT-1050T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAB1","description":"ICD-GEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC26","description":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVC0","description":"ICD-CDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB5C","description":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Recd cortico >=10mg/day >60d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9467","description":"Recd cortico >=10mg/day >60d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVA1","description":"ICD-NBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9382","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","description":"HCPCS-J9382","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJB1","description":"ICD-OBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPD0","description":"ICD-OHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of tongue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41130","description":"Partial removal of tongue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJC0","description":"ICD-OFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL05","description":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair wide w/ foot rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1093","description":"Wheelchair wide w/ foot rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Padding for comprssn bdg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8430","description":"Padding for comprssn bdg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64680","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc xdrl spine lesn thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63276","description":"Bx/exc xdrl spine lesn thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYE0","description":"ICD-PCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect hip tum incl acetabul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27076","description":"Resect hip tum incl acetabul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCA0","description":"ICD-AFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daratumumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9145","description":"Injection_ daratumumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemo ia infusion up to 1 hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96422","description":"Chemo ia infusion up to 1 hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHED1","description":"ICD-OHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospital discharge day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99239","description":"Hospital discharge day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the da","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0318","description":"Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anterior thoracic vertebral body tethering_ including thoracoscopy_ when performed; up to 7 vertebral segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22836","description":"Anterior thoracic vertebral body tethering_ including thoracoscopy_ when performed; up to 7 vertebral segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYA0","description":"ICD-OJYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Walker wheel attachment_pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0155","description":"Walker wheel attachment_pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABC1","description":"ICD-GABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUD1","description":"ICD-EIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB201","description":"Clinically Complex _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18F","description":"Clinically Complex _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUE1","description":"ICD-OJUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMF1","description":"ICD-FEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Msh6 gene dup/delete variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81300","description":"Msh6 gene dup/delete variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair stern/nuss w/o scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21742","description":"Repair stern/nuss w/o scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKD1","description":"ICD-JBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dimethyl sulfoxide 50% 50 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1212","description":"Dimethyl sulfoxide 50% 50 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA117","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSE1","description":"ICD-HDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAF0","description":"ICD-BGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ initial single antibody stain procedure (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0760T","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ initial single antibody stain procedure (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"O2 flow reg pos inspir press","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1352","description":"O2 flow reg pos inspir press","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0550","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","description":"HCPCS-G0550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMC0","description":"ICD-OKMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx ovarian stg3/4 noprog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9115","description":"Onc dx ovarian stg3/4 noprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transurethral destruction of prostate tissue; by radiofrequency generated water vapor thermotherapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53854","description":"Transurethral destruction of prostate tissue; by radiofrequency generated water vapor thermotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHD0","description":"ICD-MKHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0575","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0575","description":"HCPCS-G0575","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQB0","description":"ICD-DHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNF0","description":"ICD-OKNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTC0","description":"ICD-KGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMD1","description":"ICD-KFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB43","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFA0","description":"ICD-CIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHA0","description":"ICD-KBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNF0","description":"ICD-NHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQC1","description":"ICD-CGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bevacizumab-bvzr_ biosimilar_ (Zirabev)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5118","description":"Injection_ bevacizumab-bvzr_ biosimilar_ (Zirabev)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB155","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQF0","description":"ICD-DCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C7570","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7570","description":"HCPCS-C7570","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLE0","description":"ICD-GFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB51","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRF0","description":"ICD-PHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove implant of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65920","description":"Remove implant of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLB0","description":"ICD-NKLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYF1","description":"ICD-DFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC155","description":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOA0","description":"ICD-KHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB135","description":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1462","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","description":"HCPCS-M1462","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0598U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","description":"CPT-0598U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIED0","description":"ICD-JIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Part removal of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28111","description":"Part removal of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13131","description":"Cmplx rpr f/c/c/m/n/ax/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNF1","description":"ICD-NGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUE0","description":"ICD-EIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGME0","description":"ICD-FGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEC1","description":"ICD-NLEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB25","description":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Initial prenatal care visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0500F","description":"Initial prenatal care visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove wrist tendon lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25110","description":"Remove wrist tendon lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kafo plas doub free knee mol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2036","description":"Kafo plas doub free knee mol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEF0","description":"ICD-JEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPA1","description":"ICD-NDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX50","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Periph field stimul trial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0282T","description":"Periph field stimul trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGB0","description":"ICD-GBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Straight tip urine catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4351","description":"Straight tip urine catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prosthetic eye other type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2629","description":"Prosthetic eye other type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELC1","description":"ICD-AELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foot arch supp premold metat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3050","description":"Foot arch supp premold metat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXE1","description":"ICD-CIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLED0","description":"ICD-NLED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBF0","description":"ICD-NKBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis - periapical radiographic image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0374","description":"intraoral tomosynthesis - periapical radiographic image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUE1","description":"ICD-MBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA5B","description":"High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMD1","description":"ICD-OBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Phys review of motion tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96004","description":"Phys review of motion tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITC1","description":"ICD-EITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apply surf ldr radionuclide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77789","description":"Apply surf ldr radionuclide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLF1","description":"ICD-FFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADF1","description":"ICD-NADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp2 std sing pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0836","description":"Pwc gp2 std sing pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trcath replace aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33366","description":"Trcath replace aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB131","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient lift sling or seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0621","description":"Patient lift sling or seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient had only urgent care visits during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1021","description":"Patient had only urgent care visits during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl nstim apnea pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0428T","description":"Rmvl nstim apnea pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous vertebral augmentations_ first thoracic and any additional thoracic or lumbar vertebral bodies_ including cavity creations (fracture reductions and bone biopsies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7507","description":"Percutaneous vertebral augmentations_ first thoracic and any additional thoracic or lumbar vertebral bodies_ including cavity creations (fracture reductions and bone biopsies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLF1","description":"ICD-OBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBF0","description":"ICD-AGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFB1","description":"ICD-NCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGF1","description":"ICD-OLGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB254","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECC1","description":"ICD-GECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients With Moderate Or Severe Mitral Stenosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0044","description":"Patients With Moderate Or Severe Mitral Stenosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Carcinoembryonic antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82378","description":"Carcinoembryonic antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGF0","description":"ICD-BCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIA0","description":"ICD-BDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture ulnar styloid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25652","description":"Treat fracture ulnar styloid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQF1","description":"ICD-OLQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL3A","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blinded procedure for transcatheter implantation of coronary sinus reduction device or placebo control_ including vascular access and closure_ right heart catherization_ venou","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9783","description":"Blinded procedure for transcatheter implantation of coronary sinus reduction device or placebo control_ including vascular access and closure_ right heart catherization_ venou","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGF1","description":"ICD-BGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRF1","description":"ICD-GFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFA0","description":"ICD-OBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKC0","description":"ICD-BFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQD1","description":"ICD-PHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Genotype cytomegalovirus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87910","description":"Genotype cytomegalovirus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAC1","description":"ICD-IEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEB0","description":"ICD-JBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE12B","description":"Clinically Complex _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMA0","description":"ICD-GGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Liver image (3d) with flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78206","description":"Liver image (3d) with flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3392","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","description":"HCPCS-J3392","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUC1","description":"ICD-CEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"M.tuberculo dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87557","description":"M.tuberculo dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6069","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECB0","description":"ICD-KECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1001","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1001","description":"CDT-D1001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAA0","description":"ICD-FCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJE0","description":"ICD-GHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDB0","description":"ICD-NJDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKE1","description":"ICD-KEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cltx thigh fx w/mnpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27268","description":"Cltx thigh fx w/mnpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARA0","description":"ICD-PARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Ct Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33019","description":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Ct Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rep partial denture clasp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5630","description":"Rep partial denture clasp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ emicizumab-kxwh_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7170","description":"Injection_ emicizumab-kxwh_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOD0","description":"ICD-LCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous pulmonary artery revascularization by stent placement_ initial; abnormal connections_ bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33903","description":"Percutaneous pulmonary artery revascularization by stent placement_ initial; abnormal connections_ bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dacarbazine 100 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9130","description":"Dacarbazine 100 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bladder calculi irrig sol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2004","description":"Bladder calculi irrig sol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 9 genotyping (HPA-9w)_ ITGA2B (integrin_ alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex_ antigen CD41] [GPIIb]) (eg_ neonatal alloimmune thromb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81111","description":"Human Platelet Antigen 9 genotyping (HPA-9w)_ ITGA2B (integrin_ alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex_ antigen CD41] [GPIIb]) (eg_ neonatal alloimmune thromb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orchiectomy partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54522","description":"Orchiectomy partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis c probe&rvrs trnsc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87521","description":"Hepatitis c probe&rvrs trnsc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTB0","description":"ICD-CGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECA0","description":"ICD-JECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMF0","description":"ICD-OCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTA0","description":"ICD-CHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXB0","description":"ICD-GDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27501","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgimend_ fetal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9358","description":"Surgimend_ fetal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEC0","description":"ICD-BAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pulpal therapy posterior pri","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3240","description":"Pulpal therapy posterior pri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC2C","description":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tmj repair of joint disc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7852","description":"Tmj repair of joint disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOE0","description":"ICD-KFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIC1","description":"ICD-JIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTD1","description":"ICD-MCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBD1","description":"ICD-IEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXA0","description":"ICD-CBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNA0","description":"ICD-GBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUB1","description":"ICD-FEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBD0","description":"ICD-NJBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE110","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGA1","description":"ICD-GHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQB0","description":"ICD-DIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cerv flex n/adj foam pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0120","description":"Cerv flex n/adj foam pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAB1","description":"ICD-AHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKB1","description":"ICD-GGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of sialic acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84275","description":"Assay of sialic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYF0","description":"ICD-PJYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dx duod intub w/asp spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43756","description":"Dx duod intub w/asp spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29889","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKD1","description":"ICD-KEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31233","description":"Nasal/sinus endoscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Collagen imp urinary 2.5 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8603","description":"Collagen imp urinary 2.5 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0534U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","description":"CPT-0534U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Giardia ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87269","description":"Giardia ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc scr uter mal or us/samp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9618","description":"Doc scr uter mal or us/samp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9999","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9999","description":"HCPCS-A9999","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYE1","description":"ICD-DGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGB1","description":"ICD-JIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVE0","description":"ICD-NEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27602","description":"Decompression of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor liver lobe split","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47145","description":"Prep donor liver lobe split","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tmj aspiration joint fluid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7870","description":"Tmj aspiration joint fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lev 4 hosp type b ed visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0383","description":"Lev 4 hosp type b ed visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21615","description":"Removal of rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXC0","description":"ICD-FHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cad meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8498","description":"Cad meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC3D","description":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVC1","description":"ICD-NLVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr s/a/l addl 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13122","description":"Cmplx rpr s/a/l addl 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOD0","description":"ICD-CBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0683","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","description":"HCPCS-E0683","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIF1","description":"ICD-GCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRA0","description":"ICD-LGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5941","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5941","description":"CDT-D5941","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAA1","description":"ICD-KGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAA1","description":"ICD-AEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cryopreserve stem cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38207","description":"Cryopreserve stem cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Newborn metabolic screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3620","description":"Newborn metabolic screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA43","description":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29888","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3374","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","description":"HCPCS-J3374","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEC0","description":"ICD-NIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc abd tum 5 cm or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49203","description":"Exc abd tum 5 cm or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3373","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","description":"HCPCS-J3373","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXD0","description":"ICD-CGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRA1","description":"ICD-LHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB116","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGE0","description":"ICD-OIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exposure behavior treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0373T","description":"Exposure behavior treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEB0","description":"ICD-JIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medical home level 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9148","description":"Medical home level 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB22A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUA0","description":"ICD-AIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVF1","description":"ICD-NJVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECC1","description":"ICD-FECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJE1","description":"ICD-GEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35189","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pre-op service lvrs 10-15dos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0303","description":"Pre-op service lvrs 10-15dos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIF0","description":"ICD-OIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKA1","description":"ICD-BDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation)_ full sequence analysis_ including small sequence changes in exonic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0230U","description":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation)_ full sequence analysis_ including small sequence changes in exonic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"J-cell batt for glucose mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4234","description":"J-cell batt for glucose mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brief (20 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ domic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0076","description":"Brief (20 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ domic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vesiculobullous disease carr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5991","description":"Vesiculobullous disease carr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX13","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove coronoid process","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21070","description":"Remove coronoid process","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoe heel pad & depress for","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3480","description":"Shoe heel pad & depress for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heart rhythm pacing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93618","description":"Heart rhythm pacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNE0","description":"ICD-BHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQA0","description":"ICD-OHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A6614","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6614","description":"HCPCS-A6614","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC244","description":"Special Care High _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1190","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKF1","description":"ICD-GDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIB0","description":"ICD-AHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open femoral artery exposure for delivery of endovascular prosthesis_ by groin incision_ unilateral (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34812","description":"Open femoral artery exposure for delivery of endovascular prosthesis_ by groin incision_ unilateral (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVC0","description":"ICD-GBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lengthening of palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42227","description":"Lengthening of palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMD0","description":"ICD-CBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28H","description":"Special Care High _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","description":"HCPCS-M1404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5943","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5943","description":"CDT-D5943","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ subsequent treatment_ including noninvasive electroneurographic localizat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0768T","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ subsequent treatment_ including noninvasive electroneurographic localizat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKC1","description":"ICD-GGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDE0","description":"ICD-IIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXA0","description":"ICD-BBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"H pylori drug admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83014","description":"H pylori drug admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETD0","description":"ICD-NETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOF0","description":"ICD-HEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"So airplane w/wo joint cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3674","description":"So airplane w/wo joint cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg 0.6-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11421","description":"Exc h-f-nk-sp b9+marg 0.6-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUB1","description":"ICD-CHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47480","description":"Incision of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQD1","description":"ICD-CEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOC0","description":"ICD-HCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOD0","description":"ICD-DDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATB0","description":"ICD-JATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit hydra 1 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9374","description":"Hit hydra 1 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Grafting Of Autologous Soft Tissue_ Other_ Harvested By Direct Excision (Eg_ Fat_ Dermis_ Fascia)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15769","description":"Grafting Of Autologous Soft Tissue_ Other_ Harvested By Direct Excision (Eg_ Fat_ Dermis_ Fascia)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOC0","description":"ICD-KIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMF0","description":"ICD-ABMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hd shck absrbr for hd man wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1017","description":"Hd shck absrbr for hd man wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc taa repr w/o subcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33881","description":"Endovasc taa repr w/o subcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNF0","description":"ICD-KHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00842","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00842","description":"CPT-00842","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEB1","description":"ICD-NKEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home visit wound care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9097","description":"Home visit wound care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUA0","description":"ICD-IAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSF1","description":"ICD-OJSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ secukinumab_ IV_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3247","description":"Injection_ secukinumab_ IV_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRB0","description":"ICD-LIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Family training & counseling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1027","description":"Family training & counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC21A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRE0","description":"ICD-HBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psytx pt&/family 60 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90837","description":"Psytx pt&/family 60 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suicide risk based on their clinician_s evaluation or a clinician-rated tool","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1361","description":"Suicide risk based on their clinician_s evaluation or a clinician-rated tool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVD1","description":"ICD-FBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAD0","description":"ICD-IBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWB1","description":"ICD-CBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE136","description":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Quick disconn hook adapter o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6628","description":"Quick disconn hook adapter o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amoxicillin_ with or without clavulanate_ not prescribed as first line antibiotic at the time of diagnosis for documented reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9313","description":"Amoxicillin_ with or without clavulanate_ not prescribed as first line antibiotic at the time of diagnosis for documented reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHC0","description":"ICD-FCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVE0","description":"ICD-JCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE24D","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heavy metal screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83015","description":"Heavy metal screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Routine footcare pt w lops","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0247","description":"Routine footcare pt w lops","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL51","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMF1","description":"ICD-IAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct ulna/radioulnar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25337","description":"Reconstruct ulna/radioulnar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXD0","description":"ICD-JDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQF1","description":"ICD-LHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCE0","description":"ICD-NKCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE156","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX52","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Scr c/v cyto_thinlayer_rescr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0143","description":"Scr c/v cyto_thinlayer_rescr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31582","description":"Revision of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUC1","description":"ICD-NGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC54","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL51","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alprostadil urethral suppos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0275","description":"Alprostadil urethral suppos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECF1","description":"ICD-GECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITC1","description":"ICD-AITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18E","description":"Clinically Complex _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA22C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX12","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61524","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVD1","description":"ICD-NHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGE0","description":"ICD-NKGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epoprostenol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1325","description":"Epoprostenol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAA1","description":"ICD-AFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBB0","description":"ICD-FFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHA1","description":"ICD-FBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialys sol fld vol > 3999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4724","description":"Dialys sol fld vol > 3999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFB1","description":"ICD-BEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLC0","description":"ICD-CBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETA0","description":"ICD-KETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPD0","description":"ICD-CIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADC1","description":"ICD-BADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA105","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise/replace knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27487","description":"Revise/replace knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Path consult intraop 1 bloc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88331","description":"Path consult intraop 1 bloc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYD1","description":"ICD-LGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHC1","description":"ICD-ACHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDA0","description":"ICD-IBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54420","description":"Revision of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDND0","description":"ICD-FDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBC1","description":"ICD-JDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUE1","description":"ICD-NJUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair brake extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0961","description":"Wheelchair brake extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCC0","description":"ICD-KCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suction pump_ home model_ portable or stationary_ electric_ any type_ for use with external urine management system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1006","description":"Suction pump_ home model_ portable or stationary_ electric_ any type_ for use with external urine management system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADD1","description":"ICD-KADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUF1","description":"ICD-KIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAA0","description":"ICD-JBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLE1","description":"ICD-KFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBC0","description":"ICD-JCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure for pyelography (as nephrostogram_ pyelostogram_ antegrade pyeloureterograms) through nephrostomy or pyelostomy tube_ or indwelling ureteral c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50394","description":"Injection procedure for pyelography (as nephrostogram_ pyelostogram_ antegrade pyeloureterograms) through nephrostomy or pyelostomy tube_ or indwelling ureteral c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJE0","description":"ICD-CEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of calcium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82330","description":"Assay of calcium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abx reg prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9498","description":"Abx reg prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tumor imaging whole body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78802","description":"Tumor imaging whole body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBD0","description":"ICD-ADBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELE0","description":"ICD-IELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-rays transcath therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75894","description":"X-rays transcath therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKA1","description":"ICD-NBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVA0","description":"ICD-CCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSA0","description":"ICD-PBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOE1","description":"ICD-GCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMD1","description":"ICD-MFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPE1","description":"ICD-CFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAE1","description":"ICD-JGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPA0","description":"ICD-OEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUB0","description":"ICD-JIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQF1","description":"ICD-CIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWA1","description":"ICD-OEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dimethadione","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6048","description":"Dimethadione","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXA1","description":"ICD-CAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crotalidae poly immune fab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0840","description":"Crotalidae poly immune fab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Number of patients not screened for food insecurity_ housing instability_ transportation needs_ utility difficulties_ and interpersonal safety","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1208","description":"Number of patients not screened for food insecurity_ housing instability_ transportation needs_ utility difficulties_ and interpersonal safety","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMB0","description":"ICD-MLMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPA1","description":"ICD-NBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration Not Followed By Surgical Repair_ Artery; Lower Extremity (Eg_ Common Femoral_ Deep Femoral_ Superficial Femoral_ Popliteal_ Tibial_ Peroneal)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35703","description":"Exploration Not Followed By Surgical Repair_ Artery; Lower Extremity (Eg_ Common Femoral_ Deep Femoral_ Superficial Femoral_ Popliteal_ Tibial_ Peroneal)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylindr 7.25d/2.25-4d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2112","description":"Spherocylindr 7.25d/2.25-4d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICA0","description":"ICD-MICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRF0","description":"ICD-KDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj beta interferon sq 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q3028","description":"Inj beta interferon sq 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMA0","description":"ICD-KHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITC1","description":"ICD-JITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inpt/ed teleconsult70","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0427","description":"Inpt/ed teleconsult70","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1370","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","description":"HCPCS-J1370","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCD0","description":"ICD-MGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Optx medial ankle fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27766","description":"Optx medial ankle fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABF0","description":"ICD-BABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin protect wc cus wd>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2604","description":"Skin protect wc cus wd>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTC0","description":"ICD-MKTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXE1","description":"ICD-NAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj filgrastim excl biosimil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1442","description":"Inj filgrastim excl biosimil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laser surgery eye strands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67031","description":"Laser surgery eye strands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESF0","description":"ICD-GESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vestibular device implantation_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0725T","description":"Vestibular device implantation_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote real-time interactive video-conferenced critical care_ evaluation and management of the critically ill or critically injured patient; first 30-74 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0188T","description":"Remote real-time interactive video-conferenced critical care_ evaluation and management of the critically ill or critically injured patient; first 30-74 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIA0","description":"ICD-GIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUE1","description":"ICD-KGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISF0","description":"ICD-CISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal aneuploidy (trisomy 21_ and 18) DNA sequence analysis of selected reg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0112U","description":"Fetal aneuploidy (trisomy 21_ and 18) DNA sequence analysis of selected reg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQB0","description":"ICD-PIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL33","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEE1","description":"ICD-MCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent prenatal care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0502F","description":"Subsequent prenatal care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARD0","description":"ICD-HARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBC0","description":"ICD-NHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Singlay_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4329","description":"Singlay_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for reconstructive procedures of eyelid (eg_ blepharoplasty_ pto","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0114U","description":"Anesthesia for reconstructive procedures of eyelid (eg_ blepharoplasty_ pto","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGC1","description":"ICD-FAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removable unilateral partial denture - one piece cast metal_ maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5282","description":"Removable unilateral partial denture - one piece cast metal_ maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"F5 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81241","description":"F5 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVA1","description":"ICD-CFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNA1","description":"ICD-GBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ mon_ bte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5257","description":"Hearing aid_ digit_ mon_ bte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients Under Hospice Care In The Current Reporting Month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0051","description":"Patients Under Hospice Care In The Current Reporting Month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE14A","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXD0","description":"ICD-JIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFME0","description":"ICD-NFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0020","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stent_ non-cor_ tem w/del sy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2625","description":"Stent_ non-cor_ tem w/del sy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVE0","description":"ICD-NHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATD1","description":"ICD-BATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHA0","description":"ICD-MFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bartonella dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87472","description":"Bartonella dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDME0","description":"ICD-BDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28H","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49595","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N-et; encounter/trip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2003","description":"N-et; encounter/trip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXE0","description":"ICD-CCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Recording of fetal magnetic cardiac signal using at least 3 channels; review_ interpretation_ report by physician or other qualified health care professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0478T","description":"Recording of fetal magnetic cardiac signal using at least 3 channels; review_ interpretation_ report by physician or other qualified health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Includes Recording_ Scanning Analysis With Report_ Revie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93245","description":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Includes Recording_ Scanning Analysis With Report_ Revie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEA0","description":"ICD-JFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILB0","description":"ICD-IILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIE1","description":"ICD-KIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQD1","description":"ICD-OKQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Occlusal guard - soft appliance_ full arch","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9945","description":"Occlusal guard - soft appliance_ full arch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fabrication of a custom removable clear plastic temporary aesthetic appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9938","description":"Fabrication of a custom removable clear plastic temporary aesthetic appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPB0","description":"ICD-NGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Placement Of Intra-Socket Biological Dressing To Aid In Hemostasis Or Clot Stabiliization_ Per Site","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7922","description":"Placement Of Intra-Socket Biological Dressing To Aid In Hemostasis Or Clot Stabiliization_ Per Site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDB0","description":"ICD-KGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vitamin B-12 absorption studies combined_ with and without intrinsic factor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78272","description":"Vitamin B-12 absorption studies combined_ with and without intrinsic factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPF1","description":"ICD-OIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Instillation_ Bupivacaine And Meloxicam_ 1 Mg/0.03 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9088","description":"Instillation_ Bupivacaine And Meloxicam_ 1 Mg/0.03 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC246","description":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6012","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFF1","description":"ICD-OJFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQE1","description":"ICD-GHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRC1","description":"ICD-OIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOF1","description":"ICD-LHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8B","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKE0","description":"ICD-NKKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMB0","description":"ICD-BIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA30","description":"Default_ /30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Temp obturator prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5936","description":"Temp obturator prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLF0","description":"ICD-MBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Max MRI capture & interprete","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0369","description":"Max MRI capture & interprete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crisis interven waiver/diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2034","description":"Crisis interven waiver/diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPE1","description":"ICD-KBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGB0","description":"ICD-GEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIC1","description":"ICD-GBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mepolizumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2182","description":"Injection_ mepolizumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMC0","description":"ICD-BBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap sleeve gastrectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43775","description":"Lap sleeve gastrectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00864","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00864","description":"CPT-00864","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC216","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy implant stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52282","description":"Cystoscopy implant stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemophilus influenza b vaccine (hib)_ hboc conjugate (4 dose schedule)_for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90645","description":"Hemophilus influenza b vaccine (hib)_ hboc conjugate (4 dose schedule)_for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEA0","description":"ICD-BGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat hyoid bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21495","description":"Treat hyoid bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLA1","description":"ICD-BFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of Patient Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Patient Declined_ Other Patient Reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2094","description":"Documentation Of Patient Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Patient Declined_ Other Patient Reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens_ hydrophilic_ with blue-violet filter_ per lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2526","description":"Contact lens_ hydrophilic_ with blue-violet filter_ per lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVB1","description":"ICD-NBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic_ pectus carinatum orthosis_ sternal compression_ rigid circumferential frame with anterior and posterior rigid pads_ custom fabricated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1320","description":"Thoracic_ pectus carinatum orthosis_ sternal compression_ rigid circumferential frame with anterior and posterior rigid pads_ custom fabricated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBD1","description":"ICD-KFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAME0","description":"ICD-GAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMC1","description":"ICD-NJMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood typing serologic rh(d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86901","description":"Blood typing serologic rh(d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUE1","description":"ICD-ACUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"New eye exam & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92018","description":"New eye exam & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTE0","description":"ICD-BBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRB0","description":"ICD-PCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFA0","description":"ICD-OGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht leg splnt fbrgl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4046","description":"Cast sup sht leg splnt fbrgl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYA0","description":"ICD-CAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputate lower leg at knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27598","description":"Amputate lower leg at knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resuscitation bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8999","description":"Resuscitation bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Self-Measured Blood Pressure Using A Device Validated For Clinical Accuracy; Patient Education/Training And Device Calibration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99473","description":"Self-Measured Blood Pressure Using A Device Validated For Clinical Accuracy; Patient Education/Training And Device Calibration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cysto impl 4 or more","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9740","description":"Cysto impl 4 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy oocyte polar body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89290","description":"Biopsy oocyte polar body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert temp bladder cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51702","description":"Insert temp bladder cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEE1","description":"ICD-IBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLE0","description":"ICD-FCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFD0","description":"ICD-FDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct larynx & pharynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31395","description":"Reconstruct larynx & pharynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastrointestinal repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43360","description":"Gastrointestinal repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immed max part denture resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5221","description":"Immed max part denture resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37297","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","description":"CPT-37297","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0746T","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ONC SLD TUM ALYS BRCA1 BRCA2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0172U","description":"ONC SLD TUM ALYS BRCA1 BRCA2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28H","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTD0","description":"ICD-FFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJE1","description":"ICD-BFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLC0","description":"ICD-EGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTD0","description":"ICD-BBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pmp22 gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81325","description":"Pmp22 gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBD0","description":"ICD-NIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Twin zygosity_ genomic targeted sequence analysis of chromosome 2_ using circulating cell-free fetal DNA in maternal blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0060U","description":"Twin zygosity_ genomic targeted sequence analysis of chromosome 2_ using circulating cell-free fetal DNA in maternal blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFF1","description":"ICD-OKFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPC1","description":"ICD-FBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIB1","description":"ICD-NJIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMB1","description":"ICD-CFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTA0","description":"ICD-EHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDC0","description":"ICD-GIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ motixafortide_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2277","description":"Injection_ motixafortide_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARF1","description":"ICD-KARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18G","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSF1","description":"ICD-GFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOC1","description":"ICD-PEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL40","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLC1","description":"ICD-ODLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYD1","description":"ICD-PIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9734","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHB1","description":"ICD-BCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputate upper arm & implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24931","description":"Amputate upper arm & implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc t-pa admin considered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4077F","description":"Doc t-pa admin considered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0302","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0302","description":"CDT-D0302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27509","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation Medicine (Allograft Rejection_ Pediatric Liver And Small Bowel)_ Measurement Of Donor And Third-Party-Induced Cd154+T-Cytotoxic Memory Cells_ Utilizing Whole P","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81560","description":"Transplantation Medicine (Allograft Rejection_ Pediatric Liver And Small Bowel)_ Measurement Of Donor And Third-Party-Induced Cd154+T-Cytotoxic Memory Cells_ Utilizing Whole P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADA0","description":"ICD-JADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55831","description":"Removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTA0","description":"ICD-KBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQA1","description":"ICD-KDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0105","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0105","description":"HCPCS-B0105","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMD0","description":"ICD-EEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28A","description":"Special Care High _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICF1","description":"ICD-EICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKB0","description":"ICD-JEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAE0","description":"ICD-OCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1137","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFA0","description":"ICD-OKFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient is using hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9714","description":"Patient is using hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1261","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp pop-tibl-prl-other","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35571","description":"Art byp pop-tibl-prl-other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Motor speech d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9158","description":"Motor speech d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69661","description":"Revise middle ear bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1274","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFED1","description":"ICD-NFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/transpose nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64856","description":"Repair/transpose nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCB1","description":"ICD-OGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLA1","description":"ICD-KFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext b9+marg 0.6-1 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11401","description":"Exc tr-ext b9+marg 0.6-1 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBE1","description":"ICD-AGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAD0","description":"ICD-OJAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUA0","description":"ICD-IEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEF0","description":"ICD-CCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc cln cncr stage 2 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3386F","description":"Ajcc cln cncr stage 2 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBD0","description":"ICD-KGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rib gusset (elastic) each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1280","description":"Rib gusset (elastic) each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTC0","description":"ICD-IGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance cholangiopancreatography (QMRCP) including data preparation and transmission_ interpretation and report_ obtained with diagnostic magnetic reso","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0724T","description":"Quantitative magnetic resonance cholangiopancreatography (QMRCP) including data preparation and transmission_ interpretation and report_ obtained with diagnostic magnetic reso","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFID0","description":"ICD-OFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMF0","description":"ICD-BBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEF1","description":"ICD-NFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTD0","description":"ICD-MLTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of heel fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28406","description":"Treatment of heel fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown porcelain w/ noble met","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2752","description":"Crown porcelain w/ noble met","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28445","description":"Treat ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise parotid gland/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42426","description":"Excise parotid gland/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA121","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Serv asmnt/care plan waiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2024","description":"Serv asmnt/care plan waiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHD0","description":"ICD-OCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC45","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAD0","description":"ICD-EDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOB0","description":"ICD-CFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOC0","description":"ICD-DHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraabdominal pressure test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51797","description":"Intraabdominal pressure test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esrd srv 4 visits p mo 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90960","description":"Esrd srv 4 visits p mo 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nine total Medicare Diabetes Prevention Program (MDPP) core sessions were attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP servi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9875","description":"Nine total Medicare Diabetes Prevention Program (MDPP) core sessions were attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP servi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMD0","description":"ICD-BCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apply bone fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20692","description":"Apply bone fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYD0","description":"ICD-HCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2252","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","description":"HCPCS-J2252","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9174","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9174","description":"HCPCS-C9174","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61312","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Referred for an av fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4051F","description":"Referred for an av fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hsv dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87530","description":"Hsv dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA25","description":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBF1","description":"ICD-NHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming; transmitter component only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0863T","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming; transmitter component only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRF0","description":"ICD-GFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Volun service at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9476","description":"Volun service at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKB1","description":"ICD-NEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35236","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Collagen drsg>16<=48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6022","description":"Collagen drsg>16<=48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIE1","description":"ICD-KCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOD0","description":"ICD-KGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1110","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXA1","description":"ICD-GDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB43","description":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVA1","description":"ICD-GBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHF0","description":"ICD-OCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC05","description":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXE0","description":"ICD-BFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES32B","description":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dtap-ipv/hib vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90698","description":"Dtap-ipv/hib vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients admitted to a skilled nursing facility (snf)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1266","description":"Patients admitted to a skilled nursing facility (snf)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMB1","description":"ICD-IGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC46","description":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pros_ urinary sph_ imp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1815","description":"Pros_ urinary sph_ imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEF0","description":"ICD-KHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICE0","description":"ICD-IICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHF1","description":"ICD-GGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGA1","description":"ICD-OBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cranial prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5924","description":"Cranial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Histoplasma antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86698","description":"Histoplasma antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair tcat mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33418","description":"Repair tcat mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Restraints any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0710","description":"Restraints any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACA1","description":"ICD-CACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBC0","description":"ICD-MEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUD1","description":"ICD-AAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBF1","description":"ICD-MGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPE0","description":"ICD-NKPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPE1","description":"ICD-KHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAE1","description":"ICD-KHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOB1","description":"ICD-DIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUB0","description":"ICD-BIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILE0","description":"ICD-KILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPC1","description":"ICD-KFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc order anti-plat or p2y12","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9609","description":"Doc order anti-plat or p2y12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCED0","description":"ICD-OCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPB1","description":"ICD-NEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Z7610","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Z7610","description":"HCPCS-Z7610","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens fitting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92313","description":"Contact lens fitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27601","description":"Decompression of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Custom grad glove heavy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8426","description":"Custom grad glove heavy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of chin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21121","description":"Reconstruction of chin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leg strap each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0038","description":"Leg strap each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIC1","description":"ICD-KHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clin sig dep sym by dep tool","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3354F","description":"Clin sig dep sym by dep tool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ bin_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5250","description":"Hearing aid_ prog_ bin_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shdr fair lead cable molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6588","description":"Shdr fair lead cable molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDA1","description":"ICD-MHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPB1","description":"ICD-FAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILE1","description":"ICD-MILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGC0","description":"ICD-OKGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEC1","description":"ICD-CAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening oxycodone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80365","description":"Drug screening oxycodone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSD1","description":"ICD-PJSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27892","description":"Decompression of leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis B virus (HBV) status not assessed and results interpreted prior to initiating anti-TNF (tumor necrosis factor) therapy_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9913","description":"Hepatitis B virus (HBV) status not assessed and results interpreted prior to initiating anti-TNF (tumor necrosis factor) therapy_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Impr vis acuit w/in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9516","description":"Impr vis acuit w/in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUA0","description":"ICD-GHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQE1","description":"ICD-CEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADA1","description":"ICD-GADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYD1","description":"ICD-KDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMF1","description":"ICD-GAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release foot/toe nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64726","description":"Release foot/toe nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLF1","description":"ICD-NGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCA1","description":"ICD-BFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEF0","description":"ICD-IBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kafo femoral fx cast soft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2132","description":"Kafo femoral fx cast soft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQF0","description":"ICD-LGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHC1","description":"ICD-KAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATD0","description":"ICD-CATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPA1","description":"ICD-NCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj paravert f jnt l/s 1 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64493","description":"Inj paravert f jnt l/s 1 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXC0","description":"ICD-FGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLD0","description":"ICD-MHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ mRNA_ gene expression profiling by real-time RT-PCR of 17 genes (12 content and 5 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algori","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0047U","description":"Oncology (prostate)_ mRNA_ gene expression profiling by real-time RT-PCR of 17 genes (12 content and 5 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algori","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC134","description":"Special Care High _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Docetaxel injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9171","description":"Docetaxel injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng arm splint plst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4017","description":"Cast sup lng arm splint plst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat spinal cord lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62281","description":"Treat spinal cord lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECA1","description":"ICD-AECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDB0","description":"ICD-NCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEE0","description":"ICD-CEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; electrode only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0531T","description":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; electrode only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTA1","description":"ICD-EGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28B","description":"Clinically Complex _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneumococcal conjugate vaccine_ 15 valent (PCV15)_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90671","description":"Pneumococcal conjugate vaccine_ 15 valent (PCV15)_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX5D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eosinophil blood count","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3630","description":"Eosinophil blood count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultraviolet therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97028","description":"Ultraviolet therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cognition and functional assessment using standardized instruments with development of recorded care plan for the patient with cognitive impairment_ history obtained from pati","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0505","description":"Cognition and functional assessment using standardized instruments with development of recorded care plan for the patient with cognitive impairment_ history obtained from pati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE254","description":"Special Care High _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVD1","description":"ICD-CCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVC1","description":"ICD-OBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERE0","description":"ICD-GERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOB1","description":"ICD-OFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDC0","description":"ICD-IBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVD0","description":"ICD-JDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cebpa gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81218","description":"Cebpa gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIB1","description":"ICD-ABIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with thepower source and control electronics unit_ controlled by hardw","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0491","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with thepower source and control electronics unit_ controlled by hardw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0674","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0674","description":"HCPCS-G0674","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOE0","description":"ICD-KBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reimplant ureter in bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50785","description":"Reimplant ureter in bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tissue Transglutaminase_ Each Immunoglobulin (Ig) Class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86364","description":"Tissue Transglutaminase_ Each Immunoglobulin (Ig) Class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy & ureter catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52005","description":"Cystoscopy & ureter catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWC1","description":"ICD-OFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSB1","description":"ICD-CFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA14","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Us exam scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76870","description":"Us exam scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 81 Years And Older With A Diagnosis Of Frailty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2131","description":"Patients 81 Years And Older With A Diagnosis Of Frailty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1461","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","description":"HCPCS-M1461","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of support implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20680","description":"Removal of support implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNF1","description":"ICD-OCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFC1","description":"ICD-OFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOB0","description":"ICD-PDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nonpectin based ostomy paste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4405","description":"Nonpectin based ostomy paste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin sys stance flexion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5845","description":"Knee-shin sys stance flexion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct angio abd&pelv w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74174","description":"Ct angio abd&pelv w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1480","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","description":"HCPCS-M1480","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRD1","description":"ICD-GHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTD0","description":"ICD-JFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA15D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTA0","description":"ICD-FHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINE0","description":"ICD-JINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cltx medial ankle fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27760","description":"Cltx medial ankle fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADB1","description":"ICD-CADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUC0","description":"ICD-JHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFD1","description":"ICD-JAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDA0","description":"ICD-OBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ctlso a-p-l control molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0700","description":"Ctlso a-p-l control molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lso r post pnl sj-t9 pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0630","description":"Lso r post pnl sj-t9 pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Synthetic resorbable wound dressing_ sterile_ pad size more than 16 sq in but less than or equal to 48 sq in_ without adhesive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6461","description":"Synthetic resorbable wound dressing_ sterile_ pad size more than 16 sq in but less than or equal to 48 sq in_ without adhesive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0673U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673U","description":"CPT-0673U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJD1","description":"ICD-FAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAC0","description":"ICD-KIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGB1","description":"ICD-NIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB20A","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDID1","description":"ICD-JDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plastic eye prosth custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2623","description":"Plastic eye prosth custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJA0","description":"ICD-NIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES314","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJE1","description":"ICD-NEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise tear duct opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68440","description":"Incise tear duct opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPD1","description":"ICD-JEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOA0","description":"ICD-OBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUA0","description":"ICD-EFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNB0","description":"ICD-NGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove brain tumor w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62164","description":"Remove brain tumor w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-CDC SARS-CoV-2/2019-nCoV test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"U0002","description":"Non-CDC SARS-CoV-2/2019-nCoV test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home sleep test/type 4 porta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0400","description":"Home sleep test/type 4 porta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 14 targets (adenovirus_ coronavirus_ human metapneum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0098U","description":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 14 targets (adenovirus_ coronavirus_ human metapneum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDC0","description":"ICD-NCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDA0","description":"ICD-JIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISF1","description":"ICD-PISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL5D","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exam of vagina w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57420","description":"Exam of vagina w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very long chain acyl-coenzyme A (CoA) dehydrogenase (VLCAD)_ leukocyte enzyme activity_ whole blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0257U","description":"Very long chain acyl-coenzyme A (CoA) dehydrogenase (VLCAD)_ leukocyte enzyme activity_ whole blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAE0","description":"ICD-FFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYE1","description":"ICD-LCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam hips bi 5/> views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73523","description":"X-ray exam hips bi 5/> views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYA1","description":"ICD-LCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intro gastrointestinal tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44500","description":"Intro gastrointestinal tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Automated platelet count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85049","description":"Automated platelet count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCB0","description":"ICD-GDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABC1","description":"ICD-BABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDB0","description":"ICD-JHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDB1","description":"ICD-IFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNB1","description":"ICD-BHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt couns 4 txmnt opt prost","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4163F","description":"Pt couns 4 txmnt opt prost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICB1","description":"ICD-FICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGC0","description":"ICD-BEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace pretibial shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4130","description":"Replace pretibial shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD25B","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJE0","description":"ICD-FCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEC1","description":"ICD-JHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC20B","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Egd control bleeding any","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43255","description":"Egd control bleeding any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Add ue prost be/wd_ ultlite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7400","description":"Add ue prost be/wd_ ultlite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pentazocine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3070","description":"Pentazocine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Syst corticosteroids not rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4136F","description":"Syst corticosteroids not rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"B-amyloid (Abeta42) and total tau (tTau)_ electrochemiluminescent immunoassay (ECLIA)_ cerebral spinal fluid_ ratio reported as positive or negative for amyloid pathology","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0459U","description":"B-amyloid (Abeta42) and total tau (tTau)_ electrochemiluminescent immunoassay (ECLIA)_ cerebral spinal fluid_ ratio reported as positive or negative for amyloid pathology","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKE0","description":"ICD-NJKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urinary pouch w ex wear barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4391","description":"Urinary pouch w ex wear barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLE1","description":"ICD-JFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAE1","description":"ICD-MEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous Implantation Or Replacement Of Integrated Single Device Neurostimulation System Including Electrode Array And Receiver Or Pulse Generator_ Including Analysis_ Pro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0587T","description":"Percutaneous Implantation Or Replacement Of Integrated Single Device Neurostimulation System Including Electrode Array And Receiver Or Pulse Generator_ Including Analysis_ Pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC5C","description":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOE1","description":"ICD-HFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin splt grft t/a/l add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15101","description":"Skin splt grft t/a/l add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAD0","description":"ICD-GAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-76018","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","description":"CPT-76018","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKE0","description":"ICD-GBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lecanemab-irmb_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0174","description":"Injection_ lecanemab-irmb_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPD1","description":"ICD-JGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUC1","description":"ICD-OKUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4GA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GA31","description":"ICD-4GA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAME0","description":"ICD-EAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYF0","description":"ICD-GHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18C","description":"Special Care Low _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair pulmonary artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33917","description":"Repair pulmonary artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSF1","description":"ICD-PCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIC1","description":"ICD-FEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVF1","description":"ICD-JGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap jejunostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44186","description":"Lap jejunostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home modifications per serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5165","description":"Home modifications per serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBD1","description":"ICD-EFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0803","description":"HCPCS-A0803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEC0","description":"ICD-NBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB46","description":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHC0","description":"ICD-CFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEB1","description":"ICD-MDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGA1","description":"ICD-BFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPB0","description":"ICD-OEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28G","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59325","description":"Revision of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE25A","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ob us nuchal meas 1 gest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76813","description":"Ob us nuchal meas 1 gest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDF1","description":"ICD-FCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVC0","description":"ICD-CAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct scan for localization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77011","description":"Ct scan for localization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBE1","description":"ICD-CFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVC1","description":"ICD-BDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special reports or forms","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99080","description":"Special reports or forms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIED0","description":"ICD-CIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Miglustat_ oral_ 65 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1202","description":"Miglustat_ oral_ 65 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lymph nodes neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38720","description":"Removal of lymph nodes neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLB1","description":"ICD-ADLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fibrin degradj d-dimer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85380","description":"Fibrin degradj d-dimer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBF1","description":"ICD-BFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4GC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GC31","description":"ICD-4GC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB13A","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITE1","description":"ICD-KITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAF1","description":"ICD-BDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt reas no hcv infect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9453","description":"Pt reas no hcv infect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGC0","description":"ICD-JBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repeat control of nosebleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30906","description":"Repeat control of nosebleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Group (2 Or More Patients)_ Face-To-Face; Initial 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96164","description":"Health Behavior Intervention_ Group (2 Or More Patients)_ Face-To-Face; Initial 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALA0","description":"ICD-IALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt has resp insufficiency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1504F","description":"Pt has resp insufficiency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQF1","description":"ICD-OEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUB0","description":"ICD-NAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUB0","description":"ICD-BDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC5A","description":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEME0","description":"ICD-AEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0582","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","description":"HCPCS-J0582","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc medrsn no hist type rpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9288","description":"Doc medrsn no hist type rpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electronic sgd interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2351","description":"Electronic sgd interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBE0","description":"ICD-BFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHD1","description":"ICD-MAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth bladder tumor surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91251","description":"Anesth bladder tumor surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB41","description":"High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiofrequency Ablation_ Nerves Innervating The Sacroiliac Joint_ With Image Guidance (Ie_ Fluoroscopy Or Computed Tomography)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64625","description":"Radiofrequency Ablation_ Nerves Innervating The Sacroiliac Joint_ With Image Guidance (Ie_ Fluoroscopy Or Computed Tomography)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ige","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82785","description":"Assay of ige","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory setting substance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9475","description":"Ambulatory setting substance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home Adaptations (<$6_000)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0140","description":"Home Adaptations (<$6_000)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUD1","description":"ICD-KDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBE0","description":"ICD-FEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGE1","description":"ICD-OEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA13D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tis trnfr e/n/e/l10.1-30sqcm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14061","description":"Tis trnfr e/n/e/l10.1-30sqcm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXA1","description":"ICD-BAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Testosterone; bioavailable_ direct measurement (eg_ differential precipitation)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84410","description":"Testosterone; bioavailable_ direct measurement (eg_ differential precipitation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rv5 vacc 3 dose live oral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90680","description":"Rv5 vacc 3 dose live oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWF0","description":"ICD-PFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Afo sprng wir drsflx calf bd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1900","description":"Afo sprng wir drsflx calf bd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAD1","description":"ICD-MLAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB33","description":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0690U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690U","description":"CPT-0690U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHC1","description":"ICD-KFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLD0","description":"ICD-FHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of foot joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28050","description":"Biopsy of foot joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp fem-ant-post tib/prl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35566","description":"Art byp fem-ant-post tib/prl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUF0","description":"ICD-AHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWE0","description":"ICD-OJWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOC1","description":"ICD-KFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJB0","description":"ICD-NGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABE1","description":"ICD-MABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27558","description":"Treat knee dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65850","description":"Incision of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3FA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FA11","description":"ICD-3FA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHF0","description":"ICD-GBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRD1","description":"ICD-OCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aspirate pleura w/o imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32554","description":"Aspirate pleura w/o imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat spine fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22325","description":"Treat spine fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEA0","description":"ICD-BBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBA1","description":"ICD-IFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55877","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","description":"CPT-55877","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTF0","description":"ICD-MCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYD1","description":"ICD-GCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAME0","description":"ICD-MAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73070","description":"X-ray exam of elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compatibility test antiglob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86922","description":"Compatibility test antiglob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ptrsn no gc chl syp test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9229","description":"Ptrsn no gc chl syp test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEC0","description":"ICD-IIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAC1","description":"ICD-AEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0929T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","description":"CPT-0929T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRD0","description":"ICD-ODRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALC1","description":"ICD-IALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ elotuzumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9176","description":"Injection_ elotuzumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKC1","description":"ICD-FAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of chest wall lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19260","description":"Removal of chest wall lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMF0","description":"ICD-OHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILB1","description":"ICD-IILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHF0","description":"ICD-MEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; preparation_ screening and interpretation (List separately in addition to code for primary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0833T","description":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; preparation_ screening and interpretation (List separately in addition to code for primary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL0A","description":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology work-up evaluation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9050","description":"Oncology work-up evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHB0","description":"ICD-AAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunofix e-phoresis serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86334","description":"Immunofix e-phoresis serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breast gap flap reconst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2066","description":"Breast gap flap reconst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Arsenic trioxide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9017","description":"Arsenic trioxide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18D","description":"Special Care Low _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEF0","description":"ICD-KGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-linked intellectual dblt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81470","description":"X-linked intellectual dblt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE14D","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQF0","description":"ICD-GGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acyclovir injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0133","description":"Acyclovir injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYC1","description":"ICD-LBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABD0","description":"ICD-FABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0799T","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNB0","description":"ICD-OLNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISC1","description":"ICD-CISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTE0","description":"ICD-IGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antithromb no presc doc reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8697","description":"Antithromb no presc doc reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBB0","description":"ICD-BBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIC1","description":"ICD-FIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cabg vein three","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33512","description":"Cabg vein three","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUF1","description":"ICD-NHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE254","description":"Clinically Complex _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Igh@/Bcl2 (T(14;18)) (Eg_ Follicular Lymphoma) Translocation Analysis_ Major Breakpoint Region (Mbr) And Minor Cluster Region (Mcr) Breakpoints_ Qualitative Or Quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81278","description":"Igh@/Bcl2 (T(14;18)) (Eg_ Follicular Lymphoma) Translocation Analysis_ Major Breakpoint Region (Mbr) And Minor Cluster Region (Mcr) Breakpoints_ Qualitative Or Quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt surv results not avail","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9604","description":"Pt surv results not avail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLF0","description":"ICD-ACLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX45","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Egd balloon dil esoph30 mm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43233","description":"Egd balloon dil esoph30 mm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVD0","description":"ICD-JAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4EC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EC31","description":"ICD-4EC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Human papilloma virus (HPV)_ high-risk types (ie_ 16_ 18_ 31_ 33_ 45_ 52 and 58) qualitative mRNA expression of E6/E7 by quantitative polymerase chain reaction (qPCR)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0354U","description":"Human papilloma virus (HPV)_ high-risk types (ie_ 16_ 18_ 31_ 33_ 45_ 52 and 58) qualitative mRNA expression of E6/E7 by quantitative polymerase chain reaction (qPCR)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25000","description":"Incision of tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVF1","description":"ICD-OGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENE1","description":"ICD-CENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYC1","description":"ICD-HCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDB0","description":"ICD-IGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low density lipoprotein(ldl)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2120","description":"Low density lipoprotein(ldl)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNE0","description":"ICD-ODNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq plmt bile duct stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47539","description":"Perq plmt bile duct stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC225","description":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pediatrics Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4024","description":"Pediatrics Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFB1","description":"ICD-JGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0985T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","description":"CPT-0985T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ melphalan flufenamide hydrochloride_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9080","description":"Injection_ melphalan flufenamide hydrochloride_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Frame typ socket shoulder di","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6689","description":"Frame typ socket shoulder di","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHF1","description":"ICD-MGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ guselkumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9029","description":"Injection_ guselkumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPF0","description":"ICD-CBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sinus endo w/balloon dil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31297","description":"Sinus endo w/balloon dil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMA0","description":"ICD-BBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRF1","description":"ICD-LCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB25","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD12C","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD235","description":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSD1","description":"ICD-GGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0773T","description":"Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elbow mold sock suspension t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6110","description":"Elbow mold sock suspension t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDA1","description":"ICD-BHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"W/c acc_saf belt pelv strap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0978","description":"W/c acc_saf belt pelv strap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx cesium-131 chloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2644","description":"Brachytx cesium-131 chloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIC1","description":"ICD-EDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ko w/adj jt rot cntrl molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1844","description":"Ko w/adj jt rot cntrl molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nursing care_ in the home; b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9124","description":"Nursing care_ in the home; b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mr angiography head w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70544","description":"Mr angiography head w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWD1","description":"ICD-PKWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid dispensing fee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5110","description":"Hearing aid dispensing fee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBE1","description":"ICD-CDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAD0","description":"ICD-BHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foam filled caster tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2387","description":"Foam filled caster tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA25C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29450","description":"Application of leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg_ myotonic dystrophy type 2) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81187","description":"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg_ myotonic dystrophy type 2) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMF0","description":"ICD-JHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYE1","description":"ICD-CIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGE1","description":"ICD-JEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac Output Measurement(S)_ Thermodilution Or Other Indicator Dilution Method_ Performed During Cardiac Catheterization For The Evaluation Of Congenital Heart Defects (List","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93598","description":"Cardiac Output Measurement(S)_ Thermodilution Or Other Indicator Dilution Method_ Performed During Cardiac Catheterization For The Evaluation Of Congenital Heart Defects (List","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLE1","description":"ICD-BBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise/remove neuroreceiver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61888","description":"Revise/remove neuroreceiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTB0","description":"ICD-EGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aminolevulinic acid hcl top","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7308","description":"Aminolevulinic acid hcl top","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc abdl tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22900","description":"Exc abdl tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAF0","description":"ICD-GHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUC1","description":"ICD-MHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"External upper limb tremor stimulator of the peripheral nerves of the wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1018","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cyp2d6 gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81226","description":"Cyp2d6 gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Major vessel shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33766","description":"Major vessel shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy for bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45334","description":"Sigmoidoscopy for bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJA1","description":"ICD-CIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4EB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EB31","description":"ICD-4EB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Respite care_ in the home_ p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9125","description":"Respite care_ in the home_ p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAD0","description":"ICD-GIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXA0","description":"ICD-KBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not have a baseline pam score and/or a second score within 6 to 12 month of baseline pam score","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1344","description":"Patients who did not have a baseline pam score and/or a second score within 6 to 12 month of baseline pam score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXF1","description":"ICD-NAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENB1","description":"ICD-JENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plmt biliary drainage cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47533","description":"Plmt biliary drainage cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSB1","description":"ICD-HCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Management of a new patient with dementia_ low complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0522","description":"Management of a new patient with dementia_ low complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILE0","description":"ICD-FILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDC1","description":"ICD-FFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWF0","description":"ICD-CBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESA1","description":"ICD-LESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASB1","description":"ICD-HASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urinalysis test procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81099","description":"Urinalysis test procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDB1","description":"ICD-BFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB131","description":"Clinically Complex _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystometrogram w/up","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51727","description":"Cystometrogram w/up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLF0","description":"ICD-CHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation therapy planning","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77299","description":"Radiation therapy planning","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDC1","description":"ICD-NKDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDD1","description":"ICD-MHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGA1","description":"ICD-NGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adults currently taking pharmacotherapy for OUD","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1032","description":"Adults currently taking pharmacotherapy for OUD","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUB1","description":"ICD-AEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEC1","description":"ICD-OLEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUF1","description":"ICD-NDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFF0","description":"ICD-NAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"NFCT DS RNA 4 TARGETS UPPER RESPIRATORY SPECIMEN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0241U","description":"NFCT DS RNA 4 TARGETS UPPER RESPIRATORY SPECIMEN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Microvolt t-wave assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93025","description":"Microvolt t-wave assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHE1","description":"ICD-OGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILA0","description":"ICD-GILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQD0","description":"ICD-DCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cdifficile testing performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3520F","description":"Cdifficile testing performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAB0","description":"ICD-IBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOB1","description":"ICD-OIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEE0","description":"ICD-FEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSB0","description":"ICD-PCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute resp synd coronavirus 2 (SARS-CoV-2) ([COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preserv free_ 30 mcg/0.3 mL dosage_ tris-sucrose formula formula_ for intramus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91305","description":"Severe acute resp synd coronavirus 2 (SARS-CoV-2) ([COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preserv free_ 30 mcg/0.3 mL dosage_ tris-sucrose formula formula_ for intramus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abduct control hip semi-flex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1630","description":"Abduct control hip semi-flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen quantalcohols","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80320","description":"Drug screen quantalcohols","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCC1","description":"ICD-NDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIF1","description":"ICD-IIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1411","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","description":"HCPCS-M1411","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompress spine cord add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63057","description":"Decompress spine cord add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by bulk acoustic wave biosensor immunoassay_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19])","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0408U","description":"Infectious agent antigen detection by bulk acoustic wave biosensor immunoassay_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA07","description":"Very High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAC0","description":"ICD-BHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUA0","description":"ICD-OGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDB0","description":"ICD-OIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction maxilla total","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7946","description":"Reconstruction maxilla total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKD0","description":"ICD-KEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ko immob canvas long pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1830","description":"Ko immob canvas long pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLB0","description":"ICD-EHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQF1","description":"ICD-OHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQD0","description":"ICD-KAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25909","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"M.tuberculo dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87556","description":"M.tuberculo dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINA1","description":"ICD-FINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWE1","description":"ICD-PAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYD0","description":"ICD-OKYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAF1","description":"ICD-IHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDA1","description":"ICD-OIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"D/c hemo or perit dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9523","description":"D/c hemo or perit dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRE0","description":"ICD-CGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rezafungin_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0349","description":"Injection_ rezafungin_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKA1","description":"ICD-JEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rotary wing air mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0436","description":"Rotary wing air mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28D","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial hospitalization serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0201","description":"Partial hospitalization serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcv hedia outpt dyls fac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8956","description":"Pt rcv hedia outpt dyls fac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ustekinumab_ for intravenous injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3358","description":"Ustekinumab_ for intravenous injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq tx nasoethmoid fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21340","description":"Perq tx nasoethmoid fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQD1","description":"ICD-GIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHC0","description":"ICD-FBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOE0","description":"ICD-DIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEF0","description":"ICD-BIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ phenylephrine ketorolac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9447","description":"Inj_ phenylephrine ketorolac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGD0","description":"ICD-NKGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj w/fluor eval cv device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36598","description":"Inj w/fluor eval cv device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSA0","description":"ICD-KCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYC1","description":"ICD-KEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Norsn pt cath >=90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9266","description":"Norsn pt cath >=90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Combination oral/nasal mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7027","description":"Combination oral/nasal mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUB0","description":"ICD-EBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQC0","description":"ICD-DHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWC0","description":"ICD-HAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA05","description":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHC1","description":"ICD-OFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE231","description":"Special Care High _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1460","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","description":"HCPCS-M1460","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHND1","description":"ICD-JHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of bladder lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51720","description":"Treatment of bladder lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRC0","description":"ICD-OKRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0954T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","description":"CPT-0954T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp tibial-tib/peroneal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35570","description":"Art byp tibial-tib/peroneal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Create passage to kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52334","description":"Create passage to kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Draw blood off venous device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36591","description":"Draw blood off venous device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDF0","description":"ICD-IFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICE0","description":"ICD-FICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITC0","description":"ICD-NITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"C motor evoked uppr limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95928","description":"C motor evoked uppr limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove ureter stent percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50384","description":"Remove ureter stent percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6063","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0586U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","description":"CPT-0586U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYE1","description":"ICD-HCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL26","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise stomach-bowel fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43850","description":"Revise stomach-bowel fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC13D","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dermal filler inj px/suppl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9800","description":"Dermal filler inj px/suppl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heart first pass add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78496","description":"Heart first pass add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise vag graft via vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57295","description":"Revise vag graft via vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHC1","description":"ICD-OKHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENB1","description":"ICD-NENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc foot/toe tum sc 1.5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28039","description":"Exc foot/toe tum sc 1.5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTC1","description":"ICD-NFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gi protein loss exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78282","description":"Gi protein loss exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXF0","description":"ICD-JCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Family psytx w/patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90847","description":"Family psytx w/patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc shoulder les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23075","description":"Exc shoulder les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLD0","description":"ICD-CGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Community health integration services_ each additional 30 minutes per calendar month (list separately in addition to g0019)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0022","description":"Community health integration services_ each additional 30 minutes per calendar month (list separately in addition to g0019)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove aortic assist device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33968","description":"Remove aortic assist device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breast prosthesis bra & form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8001","description":"Breast prosthesis bra & form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCME0","description":"ICD-MCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove aorta constriction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33845","description":"Remove aorta constriction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCC1","description":"ICD-EHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of rectal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45160","description":"Excision of rectal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29822","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIA0","description":"ICD-AFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Larynx surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31599","description":"Larynx surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIC1","description":"ICD-MIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX01","description":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLC1","description":"ICD-FDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRA1","description":"ICD-PDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electronic positional obstructive sleep apnea treatment_ with sensor_ includes all components and accessories_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0530","description":"Electronic positional obstructive sleep apnea treatment_ with sensor_ includes all components and accessories_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPA1","description":"ICD-OEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAD1","description":"ICD-FEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEID0","description":"ICD-KEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXE0","description":"ICD-BDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGA0","description":"ICD-NKGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1114","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSC1","description":"ICD-PHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Denture tiss condtin mandbl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5851","description":"Denture tiss condtin mandbl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of tongue lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41112","description":"Excision of tongue lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHF0","description":"ICD-FCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHME1","description":"ICD-OHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise spine&cord 2 trx crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63196","description":"Incise spine&cord 2 trx crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCA0","description":"ICD-FBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGD0","description":"ICD-JDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAC1","description":"ICD-NIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCE1","description":"ICD-KFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIC0","description":"ICD-CHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFE1","description":"ICD-OBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINF0","description":"ICD-FINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJB0","description":"ICD-FIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Med reason for no ceph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9196","description":"Med reason for no ceph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKB0","description":"ICD-FBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE20C","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of hip bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27156","description":"Revision of hip bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0094A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUD0","description":"ICD-MFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKID0","description":"ICD-MKID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOC1","description":"ICD-CEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Completed epsdt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0302","description":"Completed epsdt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ann breast exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0613","description":"Ann breast exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0458","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0458","description":"HCPCS-J0458","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastroplasty w/o v-band","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43843","description":"Gastroplasty w/o v-band","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HC11","description":"ICD-2HC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBA0","description":"ICD-NBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHE0","description":"ICD-IGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Employment - Job Finding","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1735","description":"Employment - Job Finding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray strenoclavic jt 3/>vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71130","description":"X-ray strenoclavic jt 3/>vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt not rcvng esa thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4172F","description":"Pt not rcvng esa thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBE0","description":"ICD-JCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Participant-Directed Community Supports","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1900","description":"Participant-Directed Community Supports","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUD1","description":"ICD-GFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDD0","description":"ICD-IHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUB1","description":"ICD-EAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEA1","description":"ICD-ADEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIF1","description":"ICD-JHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home vent invasive interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0465","description":"Home vent invasive interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUC0","description":"ICD-ACUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSF0","description":"ICD-CGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLE1","description":"ICD-OKLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18A","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anes medscpy&thorscpy 1 lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52951","description":"Anes medscpy&thorscpy 1 lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of spleen total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38100","description":"Removal of spleen total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQD1","description":"ICD-PKQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduct compnd facial bone fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7780","description":"Reduct compnd facial bone fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPA0","description":"ICD-KCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gene test hippel-lindau","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3842","description":"Gene test hippel-lindau","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALA0","description":"ICD-AALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74000","description":"X-ray exam of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOB0","description":"ICD-LCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBF0","description":"ICD-BFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJE0","description":"ICD-NHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNF0","description":"ICD-CDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFF1","description":"ICD-JGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRE1","description":"ICD-HIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBA1","description":"ICD-AHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTD1","description":"ICD-IHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEE1","description":"ICD-BGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAC1","description":"ICD-MFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heparin-protamine tolerance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85530","description":"Heparin-protamine tolerance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove cva lumen obstruct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75902","description":"Remove cva lumen obstruct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISD1","description":"ICD-LISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23465","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam l-s spine 2/3 vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72100","description":"X-ray exam l-s spine 2/3 vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLF0","description":"ICD-GFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRF0","description":"ICD-PGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDED0","description":"ICD-KDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECE0","description":"ICD-JECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj ganirelix acetat 250 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0132","description":"Inj ganirelix acetat 250 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"SYPHILIS TST ANTB IA QUAN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0210U","description":"SYPHILIS TST ANTB IA QUAN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATF1","description":"ICD-JATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC24D","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYF0","description":"ICD-OEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38D","description":"Extensive Services _ ADL Index 2-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLB0","description":"ICD-CDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWD1","description":"ICD-LGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18I","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKND1","description":"ICD-OKND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAB0","description":"ICD-FBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA25C","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esrd home pt serv p mo 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90966","description":"Esrd home pt serv p mo 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHC0","description":"ICD-OGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment by protocol_ administered by technician under the direction of a physician or other qualified health care professional_ face-to-face with one patie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97153","description":"Adaptive behavior treatment by protocol_ administered by technician under the direction of a physician or other qualified health care professional_ face-to-face with one patie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLD1","description":"ICD-GBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assist living waiver/month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2030","description":"Assist living waiver/month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYF0","description":"ICD-GGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hc pro phone call 21-30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98968","description":"Hc pro phone call 21-30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQE0","description":"ICD-HDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC56","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap impl electrode antrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43647","description":"Lap impl electrode antrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0555","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","description":"HCPCS-G0555","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIB0","description":"ICD-BDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dtap vaccine < 7 yrs im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90700","description":"Dtap vaccine < 7 yrs im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct angio upr extrm w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73206","description":"Ct angio upr extrm w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urinalysis volume measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81050","description":"Urinalysis volume measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELC0","description":"ICD-GELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDA1","description":"ICD-IBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSF0","description":"ICD-PHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYC1","description":"ICD-GAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDB0","description":"ICD-EEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Basic life support mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0380","description":"Basic life support mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial vaginosis and vaginitis)_ multiplex amplified probe technique_ for detection of bacterial vaginosis-associated bacteria (BVAB-2_ Atopobium vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0352U","description":"Infectious disease (bacterial vaginosis and vaginitis)_ multiplex amplified probe technique_ for detection of bacterial vaginosis-associated bacteria (BVAB-2_ Atopobium vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAB1","description":"ICD-JFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAC1","description":"ICD-MGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lisocabtagene maraleucel_ up to 110 million autologous anti-cd19 car-positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9076","description":"Lisocabtagene maraleucel_ up to 110 million autologous anti-cd19 car-positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABB1","description":"ICD-FABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol renal-amirosy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B5000","description":"Parenteral sol renal-amirosy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hand tendon reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26500","description":"Hand tendon reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0923T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","description":"CPT-0923T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hip arthro acetabuloplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29915","description":"Hip arthro acetabuloplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGC0","description":"ICD-GDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIE0","description":"ICD-NJIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRD0","description":"ICD-HBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB215","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWC1","description":"ICD-OJWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLE1","description":"ICD-KHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUE0","description":"ICD-JIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee disart_ sach ft_ endo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5312","description":"Knee disart_ sach ft_ endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC126","description":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement (including removal of existing device)_ osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside the mastoid a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69730","description":"Replacement (including removal of existing device)_ osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside the mastoid a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA24D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBA0","description":"ICD-EHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC245","description":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01932","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01932","description":"CPT-01932","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQF0","description":"ICD-KBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRB1","description":"ICD-ODRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8F","description":"High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTB1","description":"ICD-MKTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraut copper contraceptive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7300","description":"Intraut copper contraceptive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPD0","description":"ICD-FGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical placement: zygomatic implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7994","description":"Surgical placement: zygomatic implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC21B","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPC1","description":"ICD-OLPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKF0","description":"ICD-NIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIA1","description":"ICD-ICIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bypass graft patency/patch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35685","description":"Bypass graft patency/patch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNA1","description":"ICD-OKNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGE0","description":"ICD-JGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1427","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","description":"HCPCS-M1427","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRD0","description":"ICD-PJRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of tonsil abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42700","description":"Drainage of tonsil abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oasis burn matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4103","description":"Oasis burn matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBB0","description":"ICD-NLBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHB0","description":"ICD-JFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJB1","description":"ICD-KCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPE1","description":"ICD-OKPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chorionic gonadotropin/1000u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0725","description":"Chorionic gonadotropin/1000u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thaw preserved stem cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38208","description":"Thaw preserved stem cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMB1","description":"ICD-NFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pancreatic elastase fecal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82656","description":"Pancreatic elastase fecal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPC1","description":"ICD-CAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Myomectomy abdom complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58146","description":"Myomectomy abdom complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNB1","description":"ICD-GGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23620","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tx l/r atrial fib addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93657","description":"Tx l/r atrial fib addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44146","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rh-immunoglobulin order","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8809","description":"Rh-immunoglobulin order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reclining back add ped w/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1014","description":"Reclining back add ped w/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIE1","description":"ICD-FEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Paclitaxel injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9267","description":"Paclitaxel injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPB0","description":"ICD-FDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUB1","description":"ICD-JGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cyclophosphamide (sandoz)_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9074","description":"Injection_ cyclophosphamide (sandoz)_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adult companioncare per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5136","description":"Adult companioncare per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYC1","description":"ICD-LCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABA1","description":"ICD-FABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fulvestrant (fresenius kabi) not therapeutically equivalent to j9395_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9394","description":"Injection_ fulvestrant (fresenius kabi) not therapeutically equivalent to j9395_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDC1","description":"ICD-FIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert ant drainage device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66183","description":"Insert ant drainage device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGB1","description":"ICD-GDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHC1","description":"ICD-CGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCA1","description":"ICD-EFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intermittent measurement of wheeze rate for bronchodilator or bronchial-challenge diagnostic evaluation(s)_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0243T","description":"Intermittent measurement of wheeze rate for bronchodilator or bronchial-challenge diagnostic evaluation(s)_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAC1","description":"ICD-GGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wrist endoscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29848","description":"Wrist endoscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWC1","description":"ICD-HIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBF0","description":"ICD-NHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDA1","description":"ICD-KDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8C","description":"High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSF1","description":"ICD-KHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRD0","description":"ICD-PBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intend rpt mult chr msr grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9669","description":"Intend rpt mult chr msr grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTA0","description":"ICD-CGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUA0","description":"ICD-KGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Organic acids qual each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83919","description":"Organic acids qual each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCE0","description":"ICD-BBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunoelectrophoresis assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86327","description":"Immunoelectrophoresis assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCED0","description":"ICD-FCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ftl cgen abnor five anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81512","description":"Ftl cgen abnor five anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYC1","description":"ICD-DIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of heel fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28405","description":"Treatment of heel fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone marrow imaging body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78104","description":"Bone marrow imaging body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMD1","description":"ICD-EFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"AmnioArmor_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4188","description":"AmnioArmor_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB15B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic custom molded shoe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5501","description":"Diabetic custom molded shoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVF0","description":"ICD-BAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urinalysis auto w/o scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81003","description":"Urinalysis auto w/o scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Xyntha inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7185","description":"Xyntha inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ocular reconst transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65781","description":"Ocular reconst transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYA1","description":"ICD-CDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOB1","description":"ICD-GCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28D","description":"Extensive Services _ ADL Index 2-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lungcx bx rpt docs class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9418","description":"Lungcx bx rpt docs class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Caster wheel excludes tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2225","description":"Caster wheel excludes tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUE0","description":"ICD-GDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRB0","description":"ICD-HHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUF1","description":"ICD-KBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Care after delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59430","description":"Care after delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anterior gait trainer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E8002","description":"Anterior gait trainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELF1","description":"ICD-EELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic appliance full leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0660","description":"Pneumatic appliance full leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ labetalol hydrochloride_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1920","description":"Injection_ labetalol hydrochloride_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHD0","description":"ICD-KFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dolasetron mesylate oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0180","description":"Dolasetron mesylate oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXF1","description":"ICD-GFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Custom shape cover ak","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5705","description":"Custom shape cover ak","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHD0","description":"ICD-CDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ intra echocardiography","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1759","description":"Cath_ intra echocardiography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEB0","description":"ICD-CBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0405","description":"HCPCS-B0405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace denture teeth complt","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5520","description":"Replace denture teeth complt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise stomach-bowel fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43865","description":"Revise stomach-bowel fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYF0","description":"ICD-CIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy flex biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43202","description":"Esophagoscopy flex biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cogenex Flowable Amnion_ per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4230","description":"Cogenex Flowable Amnion_ per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWF0","description":"ICD-OLWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardioversion electric int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92961","description":"Cardioversion electric int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ext breastprosthesis garment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8015","description":"Ext breastprosthesis garment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRA1","description":"ICD-KIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1JC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JC31","description":"ICD-1JC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDF1","description":"ICD-CHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKC1","description":"ICD-NKKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIA1","description":"ICD-GDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bile duct endoscopy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47550","description":"Bile duct endoscopy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKC0","description":"ICD-CGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC15D","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKC1","description":"ICD-KAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAED0","description":"ICD-MAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc iliac repr w/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34900","description":"Endovasc iliac repr w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Yersinia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86793","description":"Yersinia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUA1","description":"ICD-EBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX53","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45388","description":"Colonoscopy w/ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVB1","description":"ICD-BBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thrombolytic art therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37211","description":"Thrombolytic art therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOC1","description":"ICD-LAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYB0","description":"ICD-CHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34101","description":"Removal of artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASA1","description":"ICD-OASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neurofilament light chain_ digital immunoassay_ plasma_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0361U","description":"Neurofilament light chain_ digital immunoassay_ plasma_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDE0","description":"ICD-CHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXC1","description":"ICD-KBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOD1","description":"ICD-GGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of hip tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27000","description":"Incision of hip tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHC0","description":"ICD-KHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMA0","description":"ICD-NJMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIE0","description":"ICD-EIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCC0","description":"ICD-GHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCE1","description":"ICD-EHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSB1","description":"ICD-OKSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGB1","description":"ICD-OLGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCB1","description":"ICD-GBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL16","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUB1","description":"ICD-FBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Procure donor sperm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4026","description":"Procure donor sperm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNC0","description":"ICD-CCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC0A","description":"Very High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECE0","description":"ICD-FECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBE0","description":"ICD-NCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD10C","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRC0","description":"ICD-PHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Guide cathet fluid drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10030","description":"Guide cathet fluid drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVA1","description":"ICD-GIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) with iterative adjustment of the implantable mechano-electrical skin interface and/or external driver to test the function of the dev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0462T","description":"Programming device evaluation (in person) with iterative adjustment of the implantable mechano-electrical skin interface and/or external driver to test the function of the dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67413","description":"Explore/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRB1","description":"ICD-PLRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCB1","description":"ICD-GHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACA1","description":"ICD-FACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ casirivimab and imdevimab_ 2400 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0243","description":"Injection_ casirivimab and imdevimab_ 2400 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Jaw motion rehab system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1700","description":"Jaw motion rehab system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01272","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01272","description":"CPT-01272","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nerve pedicle transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64907","description":"Nerve pedicle transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMD0","description":"ICD-GFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB22B","description":"Reduced Physical Function _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE20C","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTD1","description":"ICD-AGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYB1","description":"ICD-PDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEF0","description":"ICD-MGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comp cont lens eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0592","description":"Comp cont lens eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAE0","description":"ICD-GIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0806","description":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEA1","description":"ICD-OJEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEB0","description":"ICD-JAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFF1","description":"ICD-KBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHD1","description":"ICD-BEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMD1","description":"ICD-NFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompress spine cord add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63066","description":"Decompress spine cord add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITF0","description":"ICD-IITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/o us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20600","description":"Drain/inj joint/bursa w/o us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilate urethra stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53605","description":"Dilate urethra stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL46","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26535","description":"Revise finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apply multlay comprs upr leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29582","description":"Apply multlay comprs upr leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tee w or w/o fol w/cont_ mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8927","description":"Tee w or w/o fol w/cont_ mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9980","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00120","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00120","description":"CPT-00120","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFD0","description":"ICD-GEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (lung)_ plasma analysis of 388 proteins_ using aptamer-based proteomics technology_ predictive algorithm reported as clinical benefit from immune checkpoint inhibitor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0436U","description":"Oncology (lung)_ plasma analysis of 388 proteins_ using aptamer-based proteomics technology_ predictive algorithm reported as clinical benefit from immune checkpoint inhibitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Surveillance Center Technical Support Including Data Transmission With Analysis_ With A Minimum Of 18 Training Hour","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0705T","description":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Surveillance Center Technical Support Including Data Transmission With Analysis_ With A Minimum Of 18 Training Hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUE0","description":"ICD-MIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prepare sperm duct x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55300","description":"Prepare sperm duct x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYA1","description":"ICD-OLYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCB0","description":"ICD-OJCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leptospira antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86720","description":"Leptospira antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBED0","description":"ICD-FBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUD0","description":"ICD-ODUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB155","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCND1","description":"ICD-CCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMD0","description":"ICD-GBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCF0","description":"ICD-MFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKE0","description":"ICD-NDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orthodontic retention","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8680","description":"Orthodontic retention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTC0","description":"ICD-FDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYE1","description":"ICD-OFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWB0","description":"ICD-CFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIA0","description":"ICD-MJIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJA1","description":"ICD-OAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRD0","description":"ICD-PGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAF0","description":"ICD-KGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Melan follow-up complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0015F","description":"Melan follow-up complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCB0","description":"ICD-CFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOC0","description":"ICD-DCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18I","description":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00160","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00160","description":"CPT-00160","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1051T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1051T","description":"CPT-1051T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIE1","description":"ICD-FHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair septal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33852","description":"Repair septal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA145","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eswl for gallstones","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9034","description":"Eswl for gallstones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUD1","description":"ICD-EEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPB1","description":"ICD-NAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No doc of dsm-iv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9213","description":"No doc of dsm-iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastro/jejuno tube_ std","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4087","description":"Gastro/jejuno tube_ std","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAE0","description":"ICD-MCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Preputial stretching","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54450","description":"Preputial stretching","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJA1","description":"ICD-FGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0573U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","description":"CPT-0573U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUF0","description":"ICD-GEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9818","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9818","description":"HCPCS-C9818","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPC0","description":"ICD-FGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit tpn 2 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9366","description":"Hit tpn 2 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGE1","description":"ICD-GHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBD1","description":"ICD-FEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Out-of-hosp on call service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99027","description":"Out-of-hosp on call service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB21A","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gemcitabine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9201","description":"Gemcitabine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCD0","description":"ICD-KBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0620U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","description":"CPT-0620U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (acute myelogenous leukemia)_ DNA_ genotyping of internal tandem d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0137U","description":"Oncology (acute myelogenous leukemia)_ DNA_ genotyping of internal tandem d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFE1","description":"ICD-KIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chiropract manj 1-2 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98940","description":"Chiropract manj 1-2 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Level of activity assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1003F","description":"Level of activity assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPE0","description":"ICD-GGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BA21","description":"ICD-2BA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGE0","description":"ICD-FCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENB1","description":"ICD-OENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLA0","description":"ICD-JBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHE0","description":"ICD-ABHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMA1","description":"ICD-MAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTD0","description":"ICD-JGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient not receiving a first course of anti-tnf therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8871","description":"Patient not receiving a first course of anti-tnf therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLF0","description":"ICD-BGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKA1","description":"ICD-GIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0201","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0201","description":"CDT-D0201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAA0","description":"ICD-IDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFE1","description":"ICD-KEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA42","description":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auditor evoke potent compre","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92585","description":"Auditor evoke potent compre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bridge resin w/noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6252","description":"Bridge resin w/noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism LogicNets_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1019","description":"Clinical decision support mechanism LogicNets_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHC1","description":"ICD-AIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQA0","description":"ICD-GCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCD0","description":"ICD-BBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQC0","description":"ICD-HBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tirofiban hcl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3246","description":"Tirofiban hcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pure tone hearing test air","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92551","description":"Pure tone hearing test air","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXE1","description":"ICD-OEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of b hexosaminidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83080","description":"Assay of b hexosaminidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA111","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWF0","description":"ICD-OFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRA1","description":"ICD-OHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDB1","description":"ICD-OBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFD0","description":"ICD-CAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acute venous thrombus image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78456","description":"Acute venous thrombus image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Misc sup/acc ext vad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0507","description":"Misc sup/acc ext vad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLD0","description":"ICD-NCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDC1","description":"ICD-BFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQD0","description":"ICD-OBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9308","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9308","description":"HCPCS-C9308","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bladder irrigation tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4355","description":"Bladder irrigation tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILE1","description":"ICD-AILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPE0","description":"ICD-GDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBB0","description":"ICD-GCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCF0","description":"ICD-BFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUD1","description":"ICD-NDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCE1","description":"ICD-IDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Truss single w/ standard pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8300","description":"Truss single w/ standard pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tumor immunohistochem/comput","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88361","description":"Tumor immunohistochem/comput","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADF1","description":"ICD-IADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCC1","description":"ICD-ABCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX1C","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"For diabetics only_ multiple density insert_ made by direct carving with CAM technology from a rectified CAD model created from","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5514","description":"For diabetics only_ multiple density insert_ made by direct carving with CAM technology from a rectified CAD model created from","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNC1","description":"ICD-JFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Computer-aided detection_ including computer algorithm analysis of breast MRI image data for lesion detection/characterization_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8937","description":"Computer-aided detection_ including computer algorithm analysis of breast MRI image data for lesion detection/characterization_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTA0","description":"ICD-MKTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1056T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1056T","description":"CPT-1056T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc arm/elbow les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24071","description":"Exc arm/elbow les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCD0","description":"ICD-ECCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC23C","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01742","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01742","description":"CPT-01742","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITB0","description":"ICD-NITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMD0","description":"ICD-EHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4BA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BA31","description":"ICD-4BA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation Device Evaluation (In-Person) With Analysis_ Review And Report By A Physician Or Other Qualified Health Care Professional_ Including Connection_ Recording And Di","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0685T","description":"Interrogation Device Evaluation (In-Person) With Analysis_ Review And Report By A Physician Or Other Qualified Health Care Professional_ Including Connection_ Recording And Di","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ethylene glycol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82693","description":"Assay of ethylene glycol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYD1","description":"ICD-LHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMA1","description":"ICD-OIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJD1","description":"ICD-OFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Matrl for vocal cord","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1878","description":"Matrl for vocal cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALA0","description":"ICD-KALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect fibula tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27646","description":"Resect fibula tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8I","description":"Medium Rehab _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of copper","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82525","description":"Assay of copper","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Htlv-i antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86687","description":"Htlv-i antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGD0","description":"ICD-OEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHED1","description":"ICD-AHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open tx compl front sinus fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21344","description":"Open tx compl front sinus fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove blood clot from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65930","description":"Remove blood clot from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHA1","description":"ICD-JDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANF1","description":"ICD-JANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADF1","description":"ICD-KADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVC1","description":"ICD-OAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Io anal gast n-stim init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95980","description":"Io anal gast n-stim init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHF0","description":"ICD-KFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBC1","description":"ICD-ECBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of heart veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33645","description":"Revision of heart veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0551","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","description":"HCPCS-G0551","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEA0","description":"ICD-OHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILC1","description":"ICD-IILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54440","description":"Repair of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam si joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72200","description":"X-ray exam si joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50365","description":"Transplantation of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHD0","description":"ICD-MHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJE0","description":"ICD-KAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDC1","description":"ICD-CEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit tocolysis diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9349","description":"Hit tocolysis diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33720","description":"Repair of heart defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDE0","description":"ICD-NCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCD1","description":"ICD-NHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9982","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCB1","description":"ICD-NFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA150","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTA1","description":"ICD-OBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYC1","description":"ICD-OGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKE0","description":"ICD-GGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUC1","description":"ICD-FHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemo anti-neopl sq/im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96401","description":"Chemo anti-neopl sq/im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUF1","description":"ICD-KDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEB1","description":"ICD-FIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breath tube kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2326","description":"Breath tube kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0802","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0802","description":"CDT-D0802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIA0","description":"ICD-BFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lipoprotein bld by nmr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83704","description":"Lipoprotein bld by nmr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD14C","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXC1","description":"ICD-CCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB130","description":"Reduced Physical Function _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc back tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21933","description":"Exc back tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOB0","description":"ICD-KEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIND0","description":"ICD-NIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial excision of lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40510","description":"Partial excision of lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Osteoarthritis assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1006F","description":"Osteoarthritis assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYD1","description":"ICD-DIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCE1","description":"ICD-CHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYF1","description":"ICD-HHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1417","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","description":"HCPCS-M1417","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hla class i high defin qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86832","description":"Hla class i high defin qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHC0","description":"ICD-NKHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1073","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","description":"HCPCS-J1073","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYB1","description":"ICD-HFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVB0","description":"ICD-OKVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inter limb compress dev nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0676","description":"Inter limb compress dev nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospital bed var ht w/ mattr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0255","description":"Hospital bed var ht w/ mattr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADB1","description":"ICD-GADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical boot each junior","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3211","description":"Surgical boot each junior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mcoln1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81290","description":"Mcoln1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJC0","description":"ICD-ODJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCC1","description":"ICD-MBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB156","description":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRB0","description":"ICD-DDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEE1","description":"ICD-ADEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEE1","description":"ICD-MIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX50","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHA1","description":"ICD-EDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo proc oviduct-ovary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58679","description":"Laparo proc oviduct-ovary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTB1","description":"ICD-NDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"U1 sealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2365","description":"U1 sealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup hip spica ped plstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4027","description":"Cast sup hip spica ped plstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEB0","description":"ICD-IDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Root amputation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3450","description":"Root amputation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4AB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AB11","description":"ICD-4AB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablate atria lmtd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33254","description":"Ablate atria lmtd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGF0","description":"ICD-OIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBB1","description":"ICD-FCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCB0","description":"ICD-AHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain chest lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21502","description":"Drain chest lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Occlusion analysis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9950","description":"Occlusion analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNF1","description":"ICD-CDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient had hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9691","description":"Patient had hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMA1","description":"ICD-JFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBE0","description":"ICD-FIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient not screened for unhealthy alcohol use using a systematic screening method or patient did not receive brief counseling if identified as an unhealthy alcohol user_ reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9624","description":"Patient not screened for unhealthy alcohol use using a systematic screening method or patient did not receive brief counseling if identified as an unhealthy alcohol user_ reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFB1","description":"ICD-BFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAA0","description":"ICD-OIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWB1","description":"ICD-PKWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQE0","description":"ICD-PCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDA1","description":"ICD-NGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML07","description":"Medium Rehab plus Extensive_ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implantation of intrastromal corneal ring segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0099T","description":"Implantation of intrastromal corneal ring segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMA0","description":"ICD-OKMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ argatroban (accord)_ not therapeutically equivalent to j0884_ 1 mg (for esrd on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0892","description":"Injection_ argatroban (accord)_ not therapeutically equivalent to j0884_ 1 mg (for esrd on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Appro rad ds dvcs techs docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6040F","description":"Appro rad ds dvcs techs docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES112","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGB1","description":"ICD-KEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33478","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMC1","description":"ICD-NGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Emergent Cases","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1142","description":"Emergent Cases","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cysto w/up stricture tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52342","description":"Cysto w/up stricture tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA10A","description":"Clinically Complex _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD131","description":"Special Care High _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQA0","description":"ICD-DFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAD1","description":"ICD-MKAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rebuild outer ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69320","description":"Rebuild outer ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytogen micrarray copy nmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81228","description":"Cytogen micrarray copy nmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC104","description":"Special Care Low _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of wrist prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25250","description":"Removal of wrist prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIB0","description":"ICD-NFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25670","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay myeloperoxidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83876","description":"Assay myeloperoxidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHD1","description":"ICD-FCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCA0","description":"ICD-OJCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABC0","description":"ICD-IABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSB1","description":"ICD-DGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTA1","description":"ICD-OHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHB1","description":"ICD-KEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0542U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","description":"CPT-0542U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAND0","description":"ICD-GAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01173","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01173","description":"CPT-01173","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNC0","description":"ICD-FHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAE0","description":"ICD-MBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB15B","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJB0","description":"ICD-KEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18D","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXC0","description":"ICD-FFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPD1","description":"ICD-JAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELE1","description":"ICD-IELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWB1","description":"ICD-PBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBA0","description":"ICD-NHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Receiver/transmitter_ neuro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1816","description":"Receiver/transmitter_ neuro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLF0","description":"ICD-AFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEF1","description":"ICD-BIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXD0","description":"ICD-GBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNB0","description":"ICD-FHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Frozen blood prep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86930","description":"Frozen blood prep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVC1","description":"ICD-BEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Initial Plmt Drug Eluting Ocular Insert Uni/Bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0444T","description":"Initial Plmt Drug Eluting Ocular Insert Uni/Bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acylcarnitines quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82017","description":"Acylcarnitines quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Peri-Procedural Device Evaluation (In-Person) And Programming Of Device System Parameters Before Or After A Surgery_ Procedure_ Or Test With Analysis_ Review_ And Report By A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0684T","description":"Peri-Procedural Device Evaluation (In-Person) And Programming Of Device System Parameters Before Or After A Surgery_ Procedure_ Or Test With Analysis_ Review_ And Report By A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUF0","description":"ICD-EIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noninterest escort in non er","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0080","description":"Noninterest escort in non er","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBED1","description":"ICD-IBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Postop dsg ak ea add cast ch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5430","description":"Postop dsg ak ea add cast ch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L8721","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8721","description":"HCPCS-L8721","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYE1","description":"ICD-HHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical_ total hysterectomy for resection of malignancy (tumor debulking)_ with omentectomy including salpingo-oophorectomy_ unilateral or bilateral_ when perfor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58575","description":"Laparoscopy_ surgical_ total hysterectomy for resection of malignancy (tumor debulking)_ with omentectomy including salpingo-oophorectomy_ unilateral or bilateral_ when perfor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDND0","description":"ICD-CDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBF1","description":"ICD-FHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endometrial cryoablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58356","description":"Endometrial cryoablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIA1","description":"ICD-MKIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrocardiogram report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93010","description":"Electrocardiogram report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFID0","description":"ICD-NFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELA0","description":"ICD-OELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNC1","description":"ICD-FBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of big toe joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28755","description":"Fusion of big toe joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of peripherally inserted central venous catheter (PICC)_ without subcutaneous port or pump_ including all imaging guidance_ image documentation_ and all associated r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36572","description":"Insertion of peripherally inserted central venous catheter (PICC)_ without subcutaneous port or pump_ including all imaging guidance_ image documentation_ and all associated r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Morphine 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0093","description":"Morphine 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore/irrigate tear ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68840","description":"Explore/irrigate tear ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB106","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputate metacarpal bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26910","description":"Amputate metacarpal bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETC1","description":"ICD-KETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJA0","description":"ICD-CFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPA1","description":"ICD-OKPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin full graft trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15200","description":"Skin full graft trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0515U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","description":"CPT-0515U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJB0","description":"ICD-CFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHA1","description":"ICD-OJHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOD1","description":"ICD-DBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBB0","description":"ICD-FBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Valvuloplasty_ aortic valve_ open_ with cardiopulmonary bypass; simple (ie_ valvotomy_ debridement_ debulking_ and/or simple commissural resuspension)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33390","description":"Valvuloplasty_ aortic valve_ open_ with cardiopulmonary bypass; simple (ie_ valvotomy_ debridement_ debulking_ and/or simple commissural resuspension)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB245","description":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tmj meniscectomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7850","description":"Tmj meniscectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFB0","description":"ICD-OGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQE1","description":"ICD-PFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYF0","description":"ICD-PFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTB0","description":"ICD-FBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYB1","description":"ICD-HDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKE0","description":"ICD-CCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTA1","description":"ICD-IFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLB1","description":"ICD-EBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22840","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE15D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glass/plastic slab off prism","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2710","description":"Glass/plastic slab off prism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIID1","description":"ICD-KIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medication admin visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1502","description":"Medication admin visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYF1","description":"ICD-LGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by groin incision_ unilateral (Li","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34714","description":"Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by groin incision_ unilateral (Li","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD106","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTD0","description":"ICD-CBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAC1","description":"ICD-AFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFE1","description":"ICD-KBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVD0","description":"ICD-NGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tonsils","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42825","description":"Removal of tonsils","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJC0","description":"ICD-BCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYB0","description":"ICD-OEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXB0","description":"ICD-CEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIE0","description":"ICD-FEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYB1","description":"ICD-OIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1901","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1901","description":"CDT-D1901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUB1","description":"ICD-EFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHB1","description":"ICD-FDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWE1","description":"ICD-KGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remv/replc penis pros compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54417","description":"Remv/replc penis pros compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit antibiotic q24h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9500","description":"Hit antibiotic q24h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC10C","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orthoptic/pleoptic training","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92065","description":"Orthoptic/pleoptic training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEA0","description":"ICD-AEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair lightwt fixed arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1087","description":"Wheelchair lightwt fixed arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDA0","description":"ICD-FEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch drain for barrier fl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4425","description":"Ost pch drain for barrier fl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUE1","description":"ICD-MCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Egd us exam duodenum/jejunum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43259","description":"Egd us exam duodenum/jejunum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adm Tocilizu COVID-19 2nd dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0250","description":"Adm Tocilizu COVID-19 2nd dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXB0","description":"ICD-GFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Irrigation tray","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4320","description":"Irrigation tray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ht care plan doc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4050F","description":"Ht care plan doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay three catecholamines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82384","description":"Assay three catecholamines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB10C","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1188","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKE1","description":"ICD-JBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQB1","description":"ICD-KCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNA1","description":"ICD-BBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit antibiotic q6h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9503","description":"Hit antibiotic q6h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0738","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","description":"HCPCS-J0738","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHED1","description":"ICD-IHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCA0","description":"ICD-FFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHF1","description":"ICD-GHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skilled services of a registered nurse (RN) for the observation and assessment of the patient_s condition_ each 15 minutes (the change in the patient_s condition requires skil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0493","description":"Skilled services of a registered nurse (RN) for the observation and assessment of the patient_s condition_ each 15 minutes (the change in the patient_s condition requires skil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJE1","description":"ICD-CIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRD1","description":"ICD-PLRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAC0","description":"ICD-OLAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLID0","description":"ICD-NLID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBF1","description":"ICD-NIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of corticosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82528","description":"Assay of corticosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No srch for ct in 12mo norsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9342","description":"No srch for ct in 12mo norsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPF1","description":"ICD-JCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTF0","description":"ICD-EBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp2 std mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0841","description":"Pwc gp2 std mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJB0","description":"ICD-NKJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKE1","description":"ICD-NIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEE0","description":"ICD-NJEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cryoprecipitate each unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9012","description":"Cryoprecipitate each unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroretinography (ERG)_ with interpretation and report; full field (ie_ ffERG_ flash ERG_ Ganzfeld ERG)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92273","description":"Electroretinography (ERG)_ with interpretation and report; full field (ie_ ffERG_ flash ERG_ Ganzfeld ERG)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVC0","description":"ICD-GAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial)_ strain typing by whole genome sequencing_ phylogenetic-based report of strain relatedness_ per submitted isolate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0010U","description":"Infectious disease (bacterial)_ strain typing by whole genome sequencing_ phylogenetic-based report of strain relatedness_ per submitted isolate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of neck muscle/rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21705","description":"Revision of neck muscle/rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEB0","description":"ICD-GAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"PuraPly_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4195","description":"PuraPly_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWF0","description":"ICD-LGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Talk re uv light pt/crgvr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4176F","description":"Talk re uv light pt/crgvr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lenticular lens_ trifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2321","description":"Lenticular lens_ trifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFE1","description":"ICD-KCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJD1","description":"ICD-CEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Supply allowance for therapeutic continuous glucose monitor (CGM)_ includes all supples and accessories_ 1 unit = 1 mo. supply","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0553","description":"Supply allowance for therapeutic continuous glucose monitor (CGM)_ includes all supples and accessories_ 1 unit = 1 mo. supply","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary rehab rec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4033F","description":"Pulmonary rehab rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2980","description":"Crown repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIA0","description":"ICD-FFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWF0","description":"ICD-CAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIID0","description":"ICD-AIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA51","description":"High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYC1","description":"ICD-OCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fuse/graft added joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26863","description":"Fuse/graft added joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score ue >=0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8667","description":"Fun stat score ue >=0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATA0","description":"ICD-BATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICE0","description":"ICD-JICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA INFLUENZA A/B EACH","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87400","description":"IAAD IA INFLUENZA A/B EACH","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUE0","description":"ICD-EHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair Of Fixed Retainer_ Includes Reattachment - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8701","description":"Repair Of Fixed Retainer_ Includes Reattachment - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB113","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPB1","description":"ICD-CDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXA1","description":"ICD-JFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without fusion_ including image guidance when performed_ with open decompression_ lumbar; sing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22867","description":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without fusion_ including image guidance when performed_ with open decompression_ lumbar; sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEC0","description":"ICD-GFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng leg cylinder fb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4034","description":"Cast sup lng leg cylinder fb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC35","description":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD11A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50080","description":"Removal of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXF0","description":"ICD-BAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBD0","description":"ICD-GIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1502","description":"HCPCS-A1502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGA0","description":"ICD-GDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Progenamatrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4222","description":"Progenamatrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHA1","description":"ICD-KCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBF1","description":"ICD-NEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCC0","description":"ICD-IDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUA0","description":"ICD-CHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair tcat mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33419","description":"Repair tcat mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETD0","description":"ICD-GETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0680U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680U","description":"CPT-0680U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRE1","description":"ICD-DBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; known familial variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81289","description":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; known familial variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXE1","description":"ICD-GCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLE0","description":"ICD-EHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUE0","description":"ICD-AIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFF0","description":"ICD-BGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEID0","description":"ICD-AEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQA0","description":"ICD-KCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr umbil hern reduc > 5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49585","description":"Rpr umbil hern reduc > 5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext b9+marg 1.1-2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11402","description":"Exc tr-ext b9+marg 1.1-2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHE1","description":"ICD-AHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA204","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVE1","description":"ICD-NAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDE1","description":"ICD-ABDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVD1","description":"ICD-CAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIF0","description":"ICD-OLIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC2A","description":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Candida dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87480","description":"Candida dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD140","description":"Special Care Low _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXE0","description":"ICD-BGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay thyroid stim hormone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84443","description":"Assay thyroid stim hormone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDB1","description":"ICD-MLDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coronary artery correction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33502","description":"Coronary artery correction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGME0","description":"ICD-AGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No pt cat and pt1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9431","description":"No pt cat and pt1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip socket fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27220","description":"Treat hip socket fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCD1","description":"ICD-BHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr f/e/e/n/l/m 7.6-12.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12015","description":"Rpr f/e/e/n/l/m 7.6-12.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nortriptyline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6037","description":"Nortriptyline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removable Unilateral Partial Denture - One Piece Flexible Base - Per Quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5284","description":"Removable Unilateral Partial Denture - One Piece Flexible Base - Per Quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAA0","description":"ICD-NBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNE0","description":"ICD-GHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKB1","description":"ICD-NIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0110","description":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0527U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","description":"CPT-0527U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGF1","description":"ICD-OKGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2516","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","description":"HCPCS-J2516","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICD0","description":"ICD-KICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVC1","description":"ICD-FEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECA1","description":"ICD-KECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78832","description":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implt brain chemotx add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61517","description":"Implt brain chemotx add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCC0","description":"ICD-NCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx dprsd zygomatic arch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21356","description":"Opn tx dprsd zygomatic arch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL41","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report_ unilateral or bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95919","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report_ unilateral or bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLC1","description":"ICD-NKLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of hydroceles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55041","description":"Removal of hydroceles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC124","description":"Special Care High _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADB0","description":"ICD-IADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Culture_ Typing; Identification Of Blood Pathogen And Resistance Typing_ When Performed_ By Nucleic Acid (Dna Or Rna) Probe_ Multiplexed Amplified Probe Technique Including Mu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87154","description":"Culture_ Typing; Identification Of Blood Pathogen And Resistance Typing_ When Performed_ By Nucleic Acid (Dna Or Rna) Probe_ Multiplexed Amplified Probe Technique Including Mu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJA0","description":"ICD-KIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4BC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BC31","description":"ICD-4BC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27540","description":"Treat knee fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTB0","description":"ICD-AFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAC1","description":"ICD-MJAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQA0","description":"ICD-LCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat elbow fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24620","description":"Treat elbow fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC160","description":"Clinically Complex _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYC0","description":"ICD-KAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral con def mod palat","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5959","description":"Intraoral con def mod palat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGA0","description":"ICD-OJGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD215","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rbc pretx incubatj w/chemicl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86970","description":"Rbc pretx incubatj w/chemicl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTE1","description":"ICD-OGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDED1","description":"ICD-KDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUB0","description":"ICD-GEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25622","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35241","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMF1","description":"ICD-NBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEND1","description":"ICD-NEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth anorectal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90251","description":"Anesth anorectal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC22B","description":"Special Care High _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27832","description":"Treat lower leg dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tte w or w/o fol w/cont_ f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8922","description":"Tte w or w/o fol w/cont_ f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC15A","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"5+ cc sterile syringe&needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4209","description":"5+ cc sterile syringe&needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFB1","description":"ICD-GAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1-Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66987","description":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1-Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vbac class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9439","description":"Vbac class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNF1","description":"ICD-BCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0281","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","description":"HCPCS-J0281","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAF1","description":"ICD-NEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOB0","description":"ICD-OJOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin splt grft trnk/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15100","description":"Skin splt grft trnk/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ talquetamab-tgvs_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9163","description":"Injection_ talquetamab-tgvs_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJE0","description":"ICD-NBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4CB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CB21","description":"ICD-4CB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mastoidectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69502","description":"Mastoidectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGID0","description":"ICD-OGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assess dyspnea not present","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1018F","description":"Assess dyspnea not present","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18D","description":"Extensive Services _ ADL Index 2-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOA0","description":"ICD-DIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hbot_ full body chamber_ 30m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0277","description":"Hbot_ full body chamber_ 30m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKD1","description":"ICD-NGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEB0","description":"ICD-ACEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enfuvirtide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1324","description":"Enfuvirtide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Add tooth to partial denture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5650","description":"Add tooth to partial denture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNB0","description":"ICD-OGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIE0","description":"ICD-JBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7530","description":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBE1","description":"ICD-ABBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUB0","description":"ICD-CAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraop cyst eval not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9608","description":"Intraop cyst eval not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA3A","description":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHB0","description":"ICD-EDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0607","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0607","description":"HCPCS-J0607","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHD0","description":"ICD-EEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUC1","description":"ICD-GFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUA0","description":"ICD-NBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release of big toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28240","description":"Release of big toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"NUDT15 (nudix hydrolase 15) and TPMT (thiopurine SCmethyltransferase) (eg drug metabolism) gene analysis common variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0169U","description":"NUDT15 (nudix hydrolase 15) and TPMT (thiopurine SCmethyltransferase) (eg drug metabolism) gene analysis common variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovas aaa repr w/3-p part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34803","description":"Endovas aaa repr w/3-p part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTB0","description":"ICD-JHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVB1","description":"ICD-NHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54500","description":"Biopsy of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"FlowerDerm_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4179","description":"FlowerDerm_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Initial hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99222","description":"Initial hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"I & d vaginal hematoma pp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57022","description":"I & d vaginal hematoma pp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXD1","description":"ICD-FIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial or viral)_ biochemical assays_ tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)_ interferon gamma-induced protein-10 (IP-10)_ and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0351U","description":"Infectious disease (bacterial or viral)_ biochemical assays_ tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)_ interferon gamma-induced protein-10 (IP-10)_ and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE24B","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29874","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASC0","description":"ICD-PASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq sacral augmt bilat inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0201T","description":"Perq sacral augmt bilat inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8E","description":"Very High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKB1","description":"ICD-BEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBC0","description":"ICD-JIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDE0","description":"ICD-AGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIED0","description":"ICD-NIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1BB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BB31","description":"ICD-1BB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSE0","description":"ICD-CGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Halo cervical into body jack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0820","description":"Halo cervical into body jack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JA31","description":"ICD-3JA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHD0","description":"ICD-NFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIF1","description":"ICD-JAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcervical ablation of uterine fibroid(s)_ including intraoperative ultrasound guidance and monitoring_ radiofrequency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58580","description":"Transcervical ablation of uterine fibroid(s)_ including intraoperative ultrasound guidance and monitoring_ radiofrequency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of homovanillic acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83150","description":"Assay of homovanillic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M0238","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","description":"HCPCS-M0238","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE24C","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQB1","description":"ICD-ODQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antepartum care only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59425","description":"Antepartum care only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEA1","description":"ICD-JAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHE1","description":"ICD-NAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGF0","description":"ICD-BBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLF1","description":"ICD-FHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1HC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HC31","description":"ICD-1HC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Naltrexone_ depot form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2315","description":"Naltrexone_ depot form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic anoscopy spx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46600","description":"Diagnostic anoscopy spx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMC1","description":"ICD-JIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vascular biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75970","description":"Vascular biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone marrow harvest autolog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38232","description":"Bone marrow harvest autolog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWB1","description":"ICD-LIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compres burn garment panty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6511","description":"Compres burn garment panty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEND0","description":"ICD-NEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apheresis plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36514","description":"Apheresis plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIA1","description":"ICD-GAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc of pain comfort 48hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9250","description":"Doc of pain comfort 48hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEF1","description":"ICD-JCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ny heart assoc class docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3118F","description":"Ny heart assoc class docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBA0","description":"ICD-MBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKB0","description":"ICD-KBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78831","description":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate cancer)_ image analysis of at least 128 histologic features and clinical factors_ prognostic algorithm determining the risk of distant metastases_ and prost","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0376U","description":"Oncology (prostate cancer)_ image analysis of at least 128 histologic features and clinical factors_ prognostic algorithm determining the risk of distant metastases_ and prost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Axolotl Graft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4331","description":"Axolotl Graft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRC0","description":"ICD-LHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDB1","description":"ICD-KIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tmj arthroscopy disc reposit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7874","description":"Tmj arthroscopy disc reposit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNA0","description":"ICD-JFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVC1","description":"ICD-CCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUB0","description":"ICD-GAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATF0","description":"ICD-FATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBED0","description":"ICD-EBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Asser com tx face-face/15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0039","description":"Asser com tx face-face/15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBA0","description":"ICD-KHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVE0","description":"ICD-GEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHA0","description":"ICD-CIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Free jejunum flap microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43496","description":"Free jejunum flap microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Genotype dna/rna hep c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87902","description":"Genotype dna/rna hep c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB21","description":"Medium Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ 3_ gene duplication/multiplication) (List s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0076U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ 3_ gene duplication/multiplication) (List s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGB1","description":"ICD-BFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disability examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99456","description":"Disability examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSD1","description":"ICD-GBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWF1","description":"ICD-PBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFA0","description":"ICD-CGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA1C","description":"Default_ /PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEA0","description":"ICD-KIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95721","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI lumbar spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72158","description":"MRI lumbar spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ limited_ joint or other nonvascular extremity structure(s) (eg_ joint space_ peri-articular tendon[s]_ muscle[s]_ nerve[s]_ other soft tissue structure[s]_ or soft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76882","description":"Ultrasound_ limited_ joint or other nonvascular extremity structure(s) (eg_ joint space_ peri-articular tendon[s]_ muscle[s]_ nerve[s]_ other soft tissue structure[s]_ or soft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immntx 3 sting insects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95132","description":"Immntx 3 sting insects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHD0","description":"ICD-BIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTB0","description":"ICD-KHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVD0","description":"ICD-NFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOA1","description":"ICD-GAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGA1","description":"ICD-JGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD240","description":"Special Care Low _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"R & l heart cath congenital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93531","description":"R & l heart cath congenital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Not >1 sinus ct w 90d dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9352","description":"Not >1 sinus ct w 90d dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUE0","description":"ICD-MLUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA15C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eeg coma or sleep only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95822","description":"Eeg coma or sleep only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7299","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","description":"HCPCS-J7299","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVA0","description":"ICD-JBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHC0","description":"ICD-JEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Term dev modifier wrist unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6805","description":"Term dev modifier wrist unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWB0","description":"ICD-CCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNC0","description":"ICD-GFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE236","description":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUE0","description":"ICD-MJUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hip joint adjustable flexion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2622","description":"Hip joint adjustable flexion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy dilate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45303","description":"Proctosigmoidoscopy dilate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients Who Receive Palliative Care Services Any Time During The Intake Period Through The End Of The Measurement Year","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0048","description":"Patients Who Receive Palliative Care Services Any Time During The Intake Period Through The End Of The Measurement Year","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUC0","description":"ICD-KDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRF1","description":"ICD-PGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA114","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc hip pelvis les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27043","description":"Exc hip pelvis les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens_ 1.54-1.65 p/1.60-1.79g","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2782","description":"Lens_ 1.54-1.65 p/1.60-1.79g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASA0","description":"ICD-PASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQB0","description":"ICD-DEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHC1","description":"ICD-MJHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDB1","description":"ICD-KEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1304","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1304","description":"HCPCS-A1304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOF1","description":"ICD-GDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE136","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLF1","description":"ICD-AHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy remove adnexa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58661","description":"Laparoscopy remove adnexa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rituximab-arrx_ biosimilar_ (riabni)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5123","description":"Injection_ rituximab-arrx_ biosimilar_ (riabni)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIF1","description":"ICD-AGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKD1","description":"ICD-GEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46750","description":"Repair of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALA1","description":"ICD-AALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscop ultrasound exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43231","description":"Esophagoscop ultrasound exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILD1","description":"ICD-EILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1133","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59136","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive assessment of blood oxygenation_ gas exchange efficiency_ and cardiorespiratory status_ with physician or other qualified health care professional interpretation a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0893T","description":"Noninvasive assessment of blood oxygenation_ gas exchange efficiency_ and cardiorespiratory status_ with physician or other qualified health care professional interpretation a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYC0","description":"ICD-GEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIE0","description":"ICD-NBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRF0","description":"ICD-PFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of forearm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25905","description":"Amputation of forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIA1","description":"ICD-JIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cine/video x-rays","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76120","description":"Cine/video x-rays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine phosphorus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84105","description":"Assay of urine phosphorus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKD0","description":"ICD-GIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVB1","description":"ICD-GCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1377","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","description":"HCPCS-M1377","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJF0","description":"ICD-OIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD230","description":"Special Care High _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJA1","description":"ICD-JBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQE1","description":"ICD-DHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLA0","description":"ICD-ACLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD101","description":"Special Care High _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hinge ext/flex wrist finger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3901","description":"Hinge ext/flex wrist finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETF0","description":"ICD-NETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Personal care ser per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1020","description":"Personal care ser per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUE1","description":"ICD-FIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQE1","description":"ICD-GAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMC0","description":"ICD-AEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx sclc/nsclc ext at dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9069","description":"Onc dx sclc/nsclc ext at dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOA0","description":"ICD-CHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlso r fram soft pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0467","description":"Tlso r fram soft pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB136","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPB1","description":"ICD-FEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKC0","description":"ICD-GDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXF0","description":"ICD-CAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUC0","description":"ICD-JCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drive wheel excludes tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2394","description":"Drive wheel excludes tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Impact tooth remov part bony","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7230","description":"Impact tooth remov part bony","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL07","description":"Very High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Outpt iv insulin tx any mea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9147","description":"Outpt iv insulin tx any mea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGE0","description":"ICD-CIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES15A","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVB1","description":"ICD-CCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of hip tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27005","description":"Incision of hip tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nondisposable nebulizer set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7005","description":"Nondisposable nebulizer set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALA0","description":"ICD-CALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL17","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Isolation- tooth w rubb dam","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3910","description":"Isolation- tooth w rubb dam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revita_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4180","description":"Revita_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC117","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchial brush biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31717","description":"Bronchial brush biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40801","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of skull tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61563","description":"Excision of skull tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSA1","description":"ICD-DGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFID0","description":"ICD-MFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytp dx eval fna 1st ea site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88172","description":"Cytp dx eval fna 1st ea site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAE0","description":"ICD-CDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lymph vessel x-ray arms/legs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75803","description":"Lymph vessel x-ray arms/legs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUF1","description":"ICD-IAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNB1","description":"ICD-NDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Xcm biologic tiss matrix 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4142","description":"Xcm biologic tiss matrix 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFB1","description":"ICD-GHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXB1","description":"ICD-JCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAC0","description":"ICD-OFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTA1","description":"ICD-ODTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHF1","description":"ICD-KFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adrenal cortex & medulla img","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78075","description":"Adrenal cortex & medulla img","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLF1","description":"ICD-CHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGC0","description":"ICD-NLGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXF0","description":"ICD-KEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Homedelivered prepared meal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5170","description":"Homedelivered prepared meal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Human Papillomavirus vaccine types 6_ 11_ 16_ 18_ 31_ 33_ 45_ 52_ 58_ nonavalent (9vHPV)_ 2 or 3 dose schedule_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90651","description":"Human Papillomavirus vaccine types 6_ 11_ 16_ 18_ 31_ 33_ 45_ 52_ 58_ nonavalent (9vHPV)_ 2 or 3 dose schedule_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHD1","description":"ICD-OHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSC1","description":"ICD-KHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug/substance nos 7/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80377","description":"Drug/substance nos 7/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYA0","description":"ICD-CBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAD0","description":"ICD-OBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGC1","description":"ICD-NLGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILD0","description":"ICD-AILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMD1","description":"ICD-BBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIA1","description":"ICD-BBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ delandistrogene moxeparvovec-rokl_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1413","description":"Injection_ delandistrogene moxeparvovec-rokl_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDC1","description":"ICD-KFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHB0","description":"ICD-KAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIB1","description":"ICD-NAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVD0","description":"ICD-OLVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1471","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","description":"HCPCS-M1471","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVB0","description":"ICD-BHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJF0","description":"ICD-NJJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj ceftazidime per 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0713","description":"Inj ceftazidime per 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB24A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNA0","description":"ICD-NLNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone graft repair perimplant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6103","description":"Bone graft repair perimplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTC1","description":"ICD-FCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wc van mileage per mi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0209","description":"Wc van mileage per mi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of finger splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29131","description":"Application of finger splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0703","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0703","description":"HCPCS-C0703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ikbkap gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81260","description":"Ikbkap gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Osteoarthritis composite","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0005F","description":"Osteoarthritis composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0926T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","description":"CPT-0926T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat fx distal radial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25606","description":"Treat fx distal radial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE154","description":"Special Care Low _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMA0","description":"ICD-CDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown full cast base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2791","description":"Crown full cast base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC51","description":"Very High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDB1","description":"ICD-OJDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINF0","description":"ICD-JINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interferon beta-1a inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1826","description":"Interferon beta-1a inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEC1","description":"ICD-ACEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Calcium glycer & lact/10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0620","description":"Calcium glycer & lact/10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKA0","description":"ICD-BGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUD0","description":"ICD-JCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METB0","description":"ICD-METB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES125","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"S bowel endoscope w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44379","description":"S bowel endoscope w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIE1","description":"ICD-IEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBC1","description":"ICD-MFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWA0","description":"ICD-GBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXA0","description":"ICD-GEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp aortoiliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35637","description":"Art byp aortoiliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-pneumatic sequential compression garment_ trunk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0677","description":"Non-pneumatic sequential compression garment_ trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ublituximab-xiiy_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2329","description":"Injection_ ublituximab-xiiy_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9183","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","description":"HCPCS-J9183","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAA1","description":"ICD-NDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Floxuridine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9200","description":"Floxuridine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPB0","description":"ICD-KAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOB0","description":"ICD-LAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy soft tissue of back","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21925","description":"Biopsy soft tissue of back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1233","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA230","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Occlusal guard - hard appliance_ partial arch","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9946","description":"Occlusal guard - hard appliance_ partial arch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHB0","description":"ICD-OAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Outer ear surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69399","description":"Outer ear surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYA0","description":"ICD-PIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rolapitant_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2797","description":"Injection_ rolapitant_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJD1","description":"ICD-CHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYD1","description":"ICD-DAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCD0","description":"ICD-OBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tongue and mouth surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41599","description":"Tongue and mouth surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAD0","description":"ICD-EIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQA0","description":"ICD-LGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce hip bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27187","description":"Reinforce hip bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDC1","description":"ICD-CCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMD0","description":"ICD-NDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15951","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert xdrl body crvcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63300","description":"Remove vert xdrl body crvcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEC0","description":"ICD-JCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCB1","description":"ICD-EBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous laser vein addon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36479","description":"Endovenous laser vein addon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJD1","description":"ICD-FDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTF0","description":"ICD-NKTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Screening of a patient","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0190","description":"Screening of a patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTE1","description":"ICD-GFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFB1","description":"ICD-FAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTD0","description":"ICD-NBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Corticotropin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0800","description":"Corticotropin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBID1","description":"ICD-GBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKC0","description":"ICD-BHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Levoleucovorin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0641","description":"Levoleucovorin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brachy_non-str_ytterbium-169","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2637","description":"Brachy_non-str_ytterbium-169","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSE1","description":"ICD-HFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEF0","description":"ICD-MHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOD0","description":"ICD-LGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"APC (APC regulator of WNT signaling pathway)(EG_familial adenomatosis polyposis [FAP] MRNA sequence analysis (list seperately in addition to code for primary procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0157U","description":"APC (APC regulator of WNT signaling pathway)(EG_familial adenomatosis polyposis [FAP] MRNA sequence analysis (list seperately in addition to code for primary procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone graft peri each addl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3429","description":"Bone graft peri each addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove eye/insert implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65103","description":"Remove eye/insert implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDA1","description":"ICD-FEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDID0","description":"ICD-GDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVA1","description":"ICD-JDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace implantable hrt syst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0053T","description":"Replace implantable hrt syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFC0","description":"ICD-JEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1609","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1609","description":"HCPCS-C1609","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1701","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1701","description":"HCPCS-A1701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Obstetric panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80081","description":"Obstetric panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHD1","description":"ICD-CEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of hammertoe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28286","description":"Repair of hammertoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDD1","description":"ICD-NGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Detach adjust armrst upper","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0018","description":"Detach adjust armrst upper","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nicotine patch nonlegend","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4991","description":"Nicotine patch nonlegend","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAB1","description":"ICD-KGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen concentrator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1390","description":"Oxygen concentrator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth electroshock","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10451","description":"Anesth electroshock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insulin long acting 5 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5553","description":"Insulin long acting 5 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup shoulder cast plstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4003","description":"Cast sup shoulder cast plstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHC1","description":"ICD-FHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIA0","description":"ICD-MKIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA50","description":"High Rehab _ ADL Index 0-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8E","description":"Low Rehab_ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMA0","description":"ICD-BFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGF0","description":"ICD-BIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLD0","description":"ICD-MCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of imperforated anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46742","description":"Repair of imperforated anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADB1","description":"ICD-FADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSD0","description":"ICD-OKSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bactericidal level serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87197","description":"Bactericidal level serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDD1","description":"ICD-BIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPD0","description":"ICD-OEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGE0","description":"ICD-NHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1455","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","description":"HCPCS-M1455","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8H","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICC1","description":"ICD-NICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Custom shape cvr knee disart","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5706","description":"Custom shape cvr knee disart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDD0","description":"ICD-NKDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYC0","description":"ICD-GIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISE1","description":"ICD-OISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIA1","description":"ICD-CDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPA0","description":"ICD-FAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQC0","description":"ICD-DDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUF0","description":"ICD-NGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAA1","description":"ICD-EDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPE1","description":"ICD-JFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCE1","description":"ICD-GDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc xdrl/idrl lsn any lvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63290","description":"Bx/exc xdrl/idrl lsn any lvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1CC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CC21","description":"ICD-1CC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronch w/balloon occlusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31634","description":"Bronch w/balloon occlusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGD0","description":"ICD-KGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam hip uni 1 view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73501","description":"X-ray exam hip uni 1 view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXC1","description":"ICD-JFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56800","description":"Repair of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dornase alfa non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7639","description":"Dornase alfa non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablate atria w/bypass add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33259","description":"Ablate atria w/bypass add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBA0","description":"ICD-CGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; download review_ interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0536T","description":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; download review_ interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Albumin ischemia modified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82045","description":"Albumin ischemia modified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXF1","description":"ICD-CAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKE0","description":"ICD-KDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKA0","description":"ICD-CHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Close tear system fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68770","description":"Close tear system fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endo ak ultra-light material","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5950","description":"Endo ak ultra-light material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Romiplostim injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2796","description":"Romiplostim injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXB0","description":"ICD-JEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHA1","description":"ICD-GCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33015","description":"Incision of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFD0","description":"ICD-CIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ evinacumab-dgnb_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1305","description":"Injection_ evinacumab-dgnb_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA141","description":"Clinically Complex _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADE0","description":"ICD-GADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative Magnetic Resonance For Analysis Of Tissue Composition (Eg_ Fat_ Iron_ Water Content)_ Including Multiparametric Data Acquisition_ Data Preparation And Transmissio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0698T","description":"Quantitative Magnetic Resonance For Analysis Of Tissue Composition (Eg_ Fat_ Iron_ Water Content)_ Including Multiparametric Data Acquisition_ Data Preparation And Transmissio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sternal pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1050","description":"Sternal pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWD0","description":"ICD-HCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMB0","description":"ICD-FIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA146","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; qualitative_ single stationary and mobile phase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82541","description":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; qualitative_ single stationary and mobile phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMC0","description":"ICD-MFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYE1","description":"ICD-PJYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHE0","description":"ICD-KFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEF0","description":"ICD-CFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMA1","description":"ICD-IAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1097T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1097T","description":"CPT-1097T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ doxercalciferol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1270","description":"Injection_ doxercalciferol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alkalin batt for glucose mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4233","description":"Alkalin batt for glucose mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA136","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVF1","description":"ICD-BBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHE1","description":"ICD-NBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"BRCA1_ BRCA2 (breast cancer 1 and 2) (eg_ hereditary breast and ovarian cancer) gene analysis; uncommon duplication/deletion variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81213","description":"BRCA1_ BRCA2 (breast cancer 1 and 2) (eg_ hereditary breast and ovarian cancer) gene analysis; uncommon duplication/deletion variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt hx act drain prev 90 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8560","description":"Pt hx act drain prev 90 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00796","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00796","description":"CPT-00796","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE126","description":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64901","description":"Nerve graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision malig lesion<=1.25c","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7413","description":"Excision malig lesion<=1.25c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPD1","description":"ICD-ODPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTF0","description":"ICD-JFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft subclav-vertbrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35515","description":"Art byp grft subclav-vertbrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFB0","description":"ICD-KBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLE0","description":"ICD-BBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTD1","description":"ICD-OLTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGB1","description":"ICD-ODGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tibial length sock fx or equ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2840","description":"Tibial length sock fx or equ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Malig tumor > 1.25 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7441","description":"Malig tumor > 1.25 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKC1","description":"ICD-BEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc prac mgmt disagree w/gui","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9058","description":"Onc prac mgmt disagree w/gui","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVC1","description":"ICD-JDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L5992","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","description":"HCPCS-L5992","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOD0","description":"ICD-PHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0658","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","description":"HCPCS-E0658","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATE0","description":"ICD-IATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Speech evaluation complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70371","description":"Speech evaluation complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC106","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mannitol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2150","description":"Mannitol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBC0","description":"ICD-BEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cst bse mtl inlay 2 surfaces","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6604","description":"Cst bse mtl inlay 2 surfaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJB0","description":"ICD-CHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTC0","description":"ICD-GBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAE0","description":"ICD-KEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVE0","description":"ICD-BAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESB1","description":"ICD-DESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHF0","description":"ICD-FFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive Full Body Computer-Based Markerless 3D Kinematic And Kinetic Motion Analysis And Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0693T","description":"Comprehensive Full Body Computer-Based Markerless 3D Kinematic And Kinetic Motion Analysis And Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8D","description":"Very High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFD0","description":"ICD-KBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92137","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","description":"CPT-92137","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGD0","description":"ICD-JEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNF1","description":"ICD-CCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services received by patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9692","description":"Hospice services received by patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise lower leg tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27690","description":"Revise lower leg tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAF1","description":"ICD-JCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ophthalmoscopy_ Extended; With Retinal Drawing And Scleral Depression Of Peripheral Retinal Disease (Eg_ For Retinal Tear_ Retinal Detachment_ Retinal Tumor) With Interpretati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92201","description":"Ophthalmoscopy_ Extended; With Retinal Drawing And Scleral Depression Of Peripheral Retinal Disease (Eg_ For Retinal Tear_ Retinal Detachment_ Retinal Tumor) With Interpretati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSF1","description":"ICD-OGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIF0","description":"ICD-GEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHID0","description":"ICD-KHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ argatroban","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9121","description":"Injection_ argatroban","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB251","description":"Clinically Complex _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIE0","description":"ICD-CBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Periph field stimul analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0285T","description":"Periph field stimul analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOB0","description":"ICD-OLOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWB1","description":"ICD-GDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIA0","description":"ICD-MDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXB0","description":"ICD-GBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBD1","description":"ICD-BGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iadna-dna/rna probe tq 6-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87506","description":"Iadna-dna/rna probe tq 6-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0582U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","description":"CPT-0582U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE245","description":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFID0","description":"ICD-AFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMB0","description":"ICD-FCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYA0","description":"ICD-PFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Topical prep rx aoe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4130F","description":"Topical prep rx aoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPB1","description":"ICD-BEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB0C","description":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB0B","description":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVA0","description":"ICD-BAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYF0","description":"ICD-OBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Melanomaajcc stage 0 or ia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3322F","description":"Melanomaajcc stage 0 or ia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA22A","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Woundfix_ BioWound_ Woundfix Plus_ BioWound Plus_ Woundfix Xplus or BioWound Xplus_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4217","description":"Woundfix_ BioWound_ Woundfix Plus_ BioWound Plus_ Woundfix Xplus or BioWound Xplus_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCA0","description":"ICD-BFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCD1","description":"ICD-CGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Measure blood oxygen level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94761","description":"Measure blood oxygen level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ bandage liner_ lower extremity_ any size or length_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6594","description":"Gradient compression bandaging supply_ bandage liner_ lower extremity_ any size or length_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-osseointegrated snd proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8692","description":"Non-osseointegrated snd proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQA0","description":"ICD-HGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBB1","description":"ICD-MIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65900","description":"Remove eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ag detect nos ia single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87450","description":"Ag detect nos ia single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bivalirudin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0583","description":"Bivalirudin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with single or multiple bronchial or endobronchial biopsy(ies)_ single or multiple sites_ with computer-assisted image-guided navigation_ incl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7511","description":"Bronchoscopy_ rigid or flexible_ with single or multiple bronchial or endobronchial biopsy(ies)_ single or multiple sites_ with computer-assisted image-guided navigation_ incl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXA1","description":"ICD-NJXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine lamina >2 lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63017","description":"Remove spine lamina >2 lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ambulance 02 life sustaining","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0422","description":"Ambulance 02 life sustaining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extraosseous joint stblztion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0335T","description":"Extraosseous joint stblztion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDE1","description":"ICD-FCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onlay cst hgh nbl mtl 2 srfc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6610","description":"Onlay cst hgh nbl mtl 2 srfc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr fe/e/en/l/m 12.6-20.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12016","description":"Rpr fe/e/en/l/m 12.6-20.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Upper Gi Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1103","description":"Radiation Therapy For Upper Gi Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wound prep addl 100 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15003","description":"Wound prep addl 100 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMF1","description":"ICD-IEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIC0","description":"ICD-KFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPD0","description":"ICD-NHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-META0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"META0","description":"ICD-META0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGA1","description":"ICD-FFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEF0","description":"ICD-EFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKE1","description":"ICD-GDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLB0","description":"ICD-CBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic apheresis; with extracorporeal immunoadsorption_ selective adsorption or selective filtration and plasma reinfusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36516","description":"Therapeutic apheresis; with extracorporeal immunoadsorption_ selective adsorption or selective filtration and plasma reinfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAID0","description":"ICD-IAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNA0","description":"ICD-OLNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBF1","description":"ICD-OBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOA0","description":"ICD-DEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAC0","description":"ICD-JAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOD1","description":"ICD-DAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesiology mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0061","description":"Anesthesiology mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTC1","description":"ICD-OJTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0175","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","description":"HCPCS-J0175","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQA0","description":"ICD-PEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOC0","description":"ICD-KFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX40","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOD1","description":"ICD-OCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGA0","description":"ICD-GIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRC0","description":"ICD-HBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tcd emboli detect w/inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93893","description":"Tcd emboli detect w/inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYE1","description":"ICD-OAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgigraft-dual_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4219","description":"Surgigraft-dual_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEF1","description":"ICD-IFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ epcoritamab-bysp_ 0.16 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9321","description":"Injection_ epcoritamab-bysp_ 0.16 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neck spine disk surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63020","description":"Neck spine disk surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of feces porphyrins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84126","description":"Assay of feces porphyrins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC151","description":"Clinically Complex _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ paliperidone palmitate extended release (invega hafyera_ or invega trinza)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2427","description":"Injection_ paliperidone palmitate extended release (invega hafyera_ or invega trinza)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLND0","description":"ICD-NLND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alpha-fetoprotein l3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82107","description":"Alpha-fetoprotein l3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCE0","description":"ICD-GCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJB0","description":"ICD-KGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEA1","description":"ICD-ICEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQE0","description":"ICD-OFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDA1","description":"ICD-NLDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neg press wound therapy pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2402","description":"Neg press wound therapy pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psytx pt&/fam w/e&m 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90833","description":"Psytx pt&/fam w/e&m 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUF1","description":"ICD-CGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGE1","description":"ICD-OBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFF1","description":"ICD-OBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNA0","description":"ICD-CGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVB1","description":"ICD-GIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTB0","description":"ICD-CBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rbc sickle cell test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85660","description":"Rbc sickle cell test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNB0","description":"ICD-KHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC25C","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQD0","description":"ICD-HEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75870","description":"Vein x-ray skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt asked/cnsld aed effects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6070F","description":"Pt asked/cnsld aed effects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETB1","description":"ICD-GETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pierce skull for biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61140","description":"Pierce skull for biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUB0","description":"ICD-BHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6088","description":"Implant Supported Crown - Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lsh uterus above 250 g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58543","description":"Lsh uterus above 250 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33414","description":"Repair of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJD0","description":"ICD-ODJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRC0","description":"ICD-LIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPF1","description":"ICD-FFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIF0","description":"ICD-CCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDE0","description":"ICD-BCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVA0","description":"ICD-BFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHA1","description":"ICD-FEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fas/dir ldl 70-189mg/dl mst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9666","description":"Fas/dir ldl 70-189mg/dl mst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGC1","description":"ICD-CAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES22C","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of lipoprotein(a)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83695","description":"Assay of lipoprotein(a)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEB1","description":"ICD-IEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ex arm/elbow tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24076","description":"Ex arm/elbow tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMC1","description":"ICD-OEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (non-small cell lung cancer)_ next-generation sequencing with identification of single nucleotide variants_ copy number variants_ insertions and deletions_ and struct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0388U","description":"Oncology (non-small cell lung cancer)_ next-generation sequencing with identification of single nucleotide variants_ copy number variants_ insertions and deletions_ and struct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWD0","description":"ICD-DBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVE0","description":"ICD-FHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54304","description":"Revision of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocortisone sodium ph inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1710","description":"Hydrocortisone sodium ph inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23020","description":"Release shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTB0","description":"ICD-CDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPE0","description":"ICD-GAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB216","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA1C","description":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap insert tunnel ip cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49324","description":"Lap insert tunnel ip cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICB1","description":"ICD-MICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB0D","description":"Ultra High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAD1","description":"ICD-CBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPF0","description":"ICD-OGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Improve visual funct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0913","description":"Improve visual funct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWD0","description":"ICD-HHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDD1","description":"ICD-CIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect leg/ankle tum < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27615","description":"Resect leg/ankle tum < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC13A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB3C","description":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair maxillofacial defects","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7955","description":"Repair maxillofacial defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDA1","description":"ICD-KEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of forearm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24495","description":"Decompression of forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","description":"HCPCS-J7601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXE1","description":"ICD-JCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOC1","description":"ICD-LGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYE0","description":"ICD-DIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXC1","description":"ICD-KAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDE1","description":"ICD-CEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home visit est pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99335","description":"Domicil/r-home visit est pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYA0","description":"ICD-LEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWF1","description":"ICD-OEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1BA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BA11","description":"ICD-1BA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDD0","description":"ICD-BFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronch ebus samplng 1/2 node","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31652","description":"Bronch ebus samplng 1/2 node","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHF0","description":"ICD-JAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0303","description":"HCPCS-A0303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol 52-73 gm prot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4193","description":"Parenteral sol 52-73 gm prot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laiv3 vaccine intranasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90660","description":"Laiv3 vaccine intranasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXD1","description":"ICD-NHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefazolin sodium (WG Critical Care)_ not therapeutically equivalent to J0690_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0687","description":"Injection_ cefazolin sodium (WG Critical Care)_ not therapeutically equivalent to J0690_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKD1","description":"ICD-KHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53415","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove digit nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64776","description":"Remove digit nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28D","description":"Clinically Complex _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILF0","description":"ICD-GILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAC0","description":"ICD-OHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPA1","description":"ICD-BHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Debride abdom wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11005","description":"Debride abdom wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXF1","description":"ICD-FDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEE1","description":"ICD-EDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCID0","description":"ICD-CCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPE1","description":"ICD-JHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Curette/treat cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65436","description":"Curette/treat cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXD0","description":"ICD-NCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNC0","description":"ICD-FCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOE1","description":"ICD-GEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biliary endoscopy thru skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47555","description":"Biliary endoscopy thru skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tension based scoliosis orth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1005","description":"Tension based scoliosis orth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYA1","description":"ICD-DHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59852","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIB0","description":"ICD-JAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit pain imp pump diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9328","description":"Hit pain imp pump diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNE1","description":"ICD-KDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDB0","description":"ICD-MHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular disease (acute coronary syndrome [ACS])_ IL-16_ FAS_ FASLigand_ HGF_ CTACK_ EOTAXIN_ and MCP-3 by immunoassay combined with age_ sex_ family history_ and person","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0415U","description":"Cardiovascular disease (acute coronary syndrome [ACS])_ IL-16_ FAS_ FASLigand_ HGF_ CTACK_ EOTAXIN_ and MCP-3 by immunoassay combined with age_ sex_ family history_ and person","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPB0","description":"ICD-GEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQA0","description":"ICD-OGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUC0","description":"ICD-ECUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hla i & ii type verify lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81371","description":"Hla i & ii type verify lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"W/c shoulder harness/straps","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0960","description":"W/c shoulder harness/straps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCE0","description":"ICD-BGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARC1","description":"ICD-GARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture radius/ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25600","description":"Treat fracture radius/ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGA0","description":"ICD-CCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJF1","description":"ICD-OJJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFID1","description":"ICD-NFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD23A","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXF1","description":"ICD-KCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCND1","description":"ICD-FCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAC1","description":"ICD-AIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dicom format image data availability not documented in final report due to medical reasons (eg_CT studies performed for radiation treatment planning or image-guided radiation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9328","description":"Dicom format image data availability not documented in final report due to medical reasons (eg_CT studies performed for radiation treatment planning or image-guided radiation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Max ultrasound capt & interp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0370","description":"Max ultrasound capt & interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVE0","description":"ICD-GDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-2 probe&revrse trnscripj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87538","description":"Hiv-2 probe&revrse trnscripj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCA1","description":"ICD-KFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPB1","description":"ICD-OHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB20B","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pos back post/lat wdth>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2616","description":"Pos back post/lat wdth>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPB0","description":"ICD-JGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBA0","description":"ICD-NFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYA0","description":"ICD-CCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAC0","description":"ICD-NLAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTE0","description":"ICD-NGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clsd reduct simpl maxilla fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7620","description":"Clsd reduct simpl maxilla fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVA0","description":"ICD-GGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHC0","description":"ICD-BIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of neck cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42815","description":"Excision of neck cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy/removal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38510","description":"Biopsy/removal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGA0","description":"ICD-GFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXC0","description":"ICD-FIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUB0","description":"ICD-KCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trach suction cath close sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4605","description":"Trach suction cath close sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Central dexa results docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3095F","description":"Central dexa results docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFA0","description":"ICD-BIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28234","description":"Incision of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3EB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EB11","description":"ICD-3EB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGC1","description":"ICD-KCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Zrsr2 (Zinc Finger Ccch-Type_ Rna Binding Motif And Serine/Arginine-Rich 2) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variant(S) (Eg_ E65Fs_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81360","description":"Zrsr2 (Zinc Finger Ccch-Type_ Rna Binding Motif And Serine/Arginine-Rich 2) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variant(S) (Eg_ E65Fs_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11462","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHE0","description":"ICD-IEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL0C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHC1","description":"ICD-GBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWD1","description":"ICD-PGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNC0","description":"ICD-GHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Attach ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65140","description":"Attach ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABF0","description":"ICD-AABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc esrd dia trans preg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9231","description":"Doc esrd dia trans preg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mast mod rad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19307","description":"Mast mod rad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBF0","description":"ICD-EIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comp periodontal evaluation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0180","description":"Comp periodontal evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24930","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBE1","description":"ICD-NGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amino acids quant 2-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82136","description":"Amino acids quant 2-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD154","description":"Special Care Low _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Us exam spinal canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76800","description":"Us exam spinal canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pp eval/edu perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9357","description":"Pp eval/edu perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUB1","description":"ICD-OKUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAME1","description":"ICD-BAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCC1","description":"ICD-GDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"KLF1 TARGETED SEQUENCING","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0195U","description":"KLF1 TARGETED SEQUENCING","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWF1","description":"ICD-LDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJE0","description":"ICD-KGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient safety and support of positive experiences with anesthesia mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0059","description":"Patient safety and support of positive experiences with anesthesia mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCB0","description":"ICD-JBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Frenulectomy/frenulotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7960","description":"Frenulectomy/frenulotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRE1","description":"ICD-KIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFA1","description":"ICD-OJFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBF1","description":"ICD-GEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLB0","description":"ICD-CGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9187","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9187","description":"HCPCS-J9187","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of facial bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70140","description":"X-ray exam of facial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWE1","description":"ICD-PIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPC1","description":"ICD-BBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Combined Perfusion With Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ W","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78432","description":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Combined Perfusion With Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ W","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVA0","description":"ICD-JEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWB1","description":"ICD-DHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0612U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","description":"CPT-0612U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDA0","description":"ICD-MFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pituitary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61546","description":"Removal of pituitary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYA1","description":"ICD-DEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0991T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","description":"CPT-0991T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1269","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJB1","description":"ICD-JBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVE1","description":"ICD-OAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES113","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLA1","description":"ICD-NCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of system reason(s) for not prescribing warfarin or another FDA-approved anticoagulation due to patient being currently enrolled in a clinical trial related to A","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9927","description":"Documentation of system reason(s) for not prescribing warfarin or another FDA-approved anticoagulation due to patient being currently enrolled in a clinical trial related to A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXA1","description":"ICD-KHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fixed appliance therapy habt","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8220","description":"Fixed appliance therapy habt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1000T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","description":"CPT-1000T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHND0","description":"ICD-OHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngeal function studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92520","description":"Laryngeal function studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCA1","description":"ICD-MFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOF0","description":"ICD-PIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMF1","description":"ICD-AGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ZZZZZ","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ZZZZZ","description":"ICD-ZZZZZ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJA0","description":"ICD-JDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of vip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84586","description":"Assay of vip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNC1","description":"ICD-OCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBD0","description":"ICD-NHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMF1","description":"ICD-OGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Post-operative body jacket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1310","description":"Post-operative body jacket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of new or replacement of permanent pacemaker with atrial transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for left ventricular pa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7537","description":"Insertion of new or replacement of permanent pacemaker with atrial transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for left ventricular pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJE1","description":"ICD-NCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LA11","description":"ICD-4LA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"PERIURETHRAL TRANSPERINEAL ADJUSTABLE BALLOON CONTINENCE DEVICE; UNILATERAL INSERTION_ INCLUDING CYSTOURETHROSCOPY AND IMAGING GUIDANCE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53452","description":"PERIURETHRAL TRANSPERINEAL ADJUSTABLE BALLOON CONTINENCE DEVICE; UNILATERAL INSERTION_ INCLUDING CYSTOURETHROSCOPY AND IMAGING GUIDANCE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63082","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWB0","description":"ICD-HEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOE0","description":"ICD-PLOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEE1","description":"ICD-JHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart vessel fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33500","description":"Repair heart vessel fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psytx pt&/fam w/e&m 45 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90836","description":"Psytx pt&/fam w/e&m 45 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILC1","description":"ICD-AILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYA1","description":"ICD-PBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYC1","description":"ICD-LHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASC1","description":"ICD-KASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHA1","description":"ICD-MEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sacituzumab govitecan-hziy_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9066","description":"Injection_ sacituzumab govitecan-hziy_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQA1","description":"ICD-PBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Specimen infect agnt concntj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87015","description":"Specimen infect agnt concntj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8D","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gated heart multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78473","description":"Gated heart multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair cleft lip/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40702","description":"Repair cleft lip/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEA0","description":"ICD-EDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKC0","description":"ICD-OKKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28E","description":"Clinically Complex _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Palate/uvula surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42299","description":"Palate/uvula surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular Stent Repair Of Coarctation Of The Ascending_ Transverse_ Or Descending Thoracic Or Abdominal Aorta_ Involving Stent Placement; Across Major Side Branches","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33894","description":"Endovascular Stent Repair Of Coarctation Of The Ascending_ Transverse_ Or Descending Thoracic Or Abdominal Aorta_ Involving Stent Placement; Across Major Side Branches","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No bone scn b/4 txmnt/aftrdx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3270F","description":"No bone scn b/4 txmnt/aftrdx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUB0","description":"ICD-IFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Encephaltis st louis antbody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86653","description":"Encephaltis st louis antbody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBC1","description":"ICD-MIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHB1","description":"ICD-ACHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18B","description":"Special Care High _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ak/knee disartic pelvic join","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5696","description":"Ak/knee disartic pelvic join","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Desipramine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6032","description":"Desipramine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB154","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inpt implant pros dev_no cov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9899","description":"Inpt implant pros dev_no cov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVC1","description":"ICD-FCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBC0","description":"ICD-CGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTD0","description":"ICD-AGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ glycopyrrolate (Glyrx-PF)_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1597","description":"Injection_ glycopyrrolate (Glyrx-PF)_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTC0","description":"ICD-KCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBE1","description":"ICD-OCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFC1","description":"ICD-KGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ocular function screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99172","description":"Ocular function screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Specimen handling office-lab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99000","description":"Specimen handling office-lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatry (eg_ depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ genomic analysis panel_ variant analysis of 15 genes_ including deletion/duplication ana","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0411U","description":"Psychiatry (eg_ depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ genomic analysis panel_ variant analysis of 15 genes_ including deletion/duplication ana","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glucose monitor platforms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4255","description":"Glucose monitor platforms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26412","description":"Repair/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAD0","description":"ICD-MBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth bladder surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91051","description":"Anesth bladder surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apheresis adsorp/reinfuse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36515","description":"Apheresis adsorp/reinfuse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFE1","description":"ICD-KAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES130","description":"Extensive Services _ ADL Index 2-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Who w/nontorsion jnt(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3905","description":"Who w/nontorsion jnt(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPC0","description":"ICD-OFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thyrotropin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3240","description":"Thyrotropin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCB1","description":"ICD-NDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLA0","description":"ICD-EBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVF1","description":"ICD-KGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA121","description":"Clinically Complex _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDF1","description":"ICD-EFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA23B","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESF1","description":"ICD-DESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transfer of embryo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58974","description":"Transfer of embryo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJC1","description":"ICD-OAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARB1","description":"ICD-LARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEE1","description":"ICD-IHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0607U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","description":"CPT-0607U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0684","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","description":"HCPCS-G0684","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOD1","description":"ICD-CDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMC0","description":"ICD-OHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFF0","description":"ICD-JBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMD1","description":"ICD-CGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31587","description":"Revision of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC14","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHA0","description":"ICD-BCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINB0","description":"ICD-GINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMF1","description":"ICD-KAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Upr/l xtremity art 2 levels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93922","description":"Upr/l xtremity art 2 levels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBME0","description":"ICD-BBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy with injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9742","description":"Laryngoscopy with injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE22D","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBA0","description":"ICD-AHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brca2 gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81216","description":"Brca2 gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIA1","description":"ICD-JBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of neck muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21720","description":"Revision of neck muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPC1","description":"ICD-GIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36815","description":"Insertion of cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQD0","description":"ICD-HCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE25D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHF1","description":"ICD-OIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUE1","description":"ICD-KFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including MR guidance; each additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10012","description":"Fine needle aspiration biopsy_ including MR guidance; each additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIE1","description":"ICD-NDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0029","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oxytetracycline injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2460","description":"Oxytetracycline injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC4B","description":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ mRNA_ gene expression profiling of 18 genes_ first-catch post-digital rectal examination urine (or processed first-catch urine)_ algorithm reported as per","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0403U","description":"Oncology (prostate)_ mRNA_ gene expression profiling of 18 genes_ first-catch post-digital rectal examination urine (or processed first-catch urine)_ algorithm reported as per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lanreotide_ (Cipla)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1932","description":"Injection_ lanreotide_ (Cipla)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXF1","description":"ICD-NLXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dopamine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1265","description":"Dopamine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1134","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis B Vaccine (Hepb)_ 3-Antigen (S_ Pre-S1_ Pre-S2)_ 10 Mcg Dosage_ 3 Dose Schedule_ For Intramuscular Use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90759","description":"Hepatitis B Vaccine (Hepb)_ 3-Antigen (S_ Pre-S1_ Pre-S2)_ 10 Mcg Dosage_ 3 Dose Schedule_ For Intramuscular Use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEB0","description":"ICD-NFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNC0","description":"ICD-OBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of lap enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83670","description":"Assay of lap enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEID0","description":"ICD-CEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJC0","description":"ICD-JFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Folding ped wc adjustable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1236","description":"Folding ped wc adjustable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hysteroscope procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58579","description":"Hysteroscope procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hair trnspl 1-15 punch grfts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15775","description":"Hair trnspl 1-15 punch grfts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRA1","description":"ICD-OJRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rem oct rta phys/qhp ea 30d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0606T","description":"Rem oct rta phys/qhp ea 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude_ pulse duration_ configuration of wave form_ battery status_ electrode selec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95974","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude_ pulse duration_ configuration of wave form_ battery status_ electrode selec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepc gn tstng docd b/4txmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3266F","description":"Hepc gn tstng docd b/4txmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHA1","description":"ICD-OBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ waist length_ 18-30 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6562","description":"Gradient compression stocking_ waist length_ 18-30 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace molded thigh lacer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4040","description":"Replace molded thigh lacer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 1","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA26","description":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLB0","description":"ICD-MBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLD1","description":"ICD-NJLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"deep sedation/general anesthesia each subsequent 15 minute increment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9223","description":"deep sedation/general anesthesia each subsequent 15 minute increment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDA1","description":"ICD-KHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anterior colporrhaphy_ repair of cystocele with or without repair of urethrocele_ including cystourethroscopy_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57240","description":"Anterior colporrhaphy_ repair of cystocele with or without repair of urethrocele_ including cystourethroscopy_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIC1","description":"ICD-OHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Breast)_ Mrna_ Gene Expression Profiling By Rt-Pcr Of 12 Genes (8 Content And 4 Housekeeping)_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_ Algorithm Reported","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81522","description":"Oncology (Breast)_ Mrna_ Gene Expression Profiling By Rt-Pcr Of 12 Genes (8 Content And 4 Housekeeping)_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_ Algorithm Reported","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGF0","description":"ICD-JEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIF1","description":"ICD-MDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWE0","description":"ICD-DBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEA0","description":"ICD-JIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNB1","description":"ICD-KGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Declot vascular device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36593","description":"Declot vascular device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKB1","description":"ICD-OIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25126","description":"Remove/graft forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPC1","description":"ICD-NKPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Battery cables","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4612","description":"Battery cables","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC14C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colorectal cancer screening results documented and reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1277","description":"Colorectal cancer screening results documented and reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBD0","description":"ICD-OGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Telehealth transmit_ per min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1014","description":"Telehealth transmit_ per min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNA0","description":"ICD-BCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chorion biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59015","description":"Chorion biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore adrenal gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60540","description":"Explore adrenal gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTD1","description":"ICD-ODTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC140","description":"Special Care Low _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27250","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth procedures on eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14051","description":"Anesth procedures on eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tmj cutting of a muscle","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7856","description":"Tmj cutting of a muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJF1","description":"ICD-FCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUD0","description":"ICD-IFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKA0","description":"ICD-NEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1420","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","description":"HCPCS-M1420","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18C","description":"Clinically Complex _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMA1","description":"ICD-MGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEED1","description":"ICD-MEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of urinary leakage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53080","description":"Drainage of urinary leakage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFC0","description":"ICD-BCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIA0","description":"ICD-NHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTE0","description":"ICD-KBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBE1","description":"ICD-CBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDD1","description":"ICD-JFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEB0","description":"ICD-EHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Co57 cyano","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9559","description":"Co57 cyano","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJA1","description":"ICD-JHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Preventive counseling indiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99404","description":"Preventive counseling indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLB1","description":"ICD-OKLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUF0","description":"ICD-BAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMB1","description":"ICD-EDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1425","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","description":"HCPCS-M1425","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQB0","description":"ICD-LAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEA1","description":"ICD-CDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAA0","description":"ICD-FFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEA1","description":"ICD-NJEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPD1","description":"ICD-GGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electric heat pad moist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0215","description":"Electric heat pad moist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUF0","description":"ICD-CFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPE0","description":"ICD-GBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATB1","description":"ICD-OATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Preperitoneal Pelvic Packing For Hemorrhage Associated With Pelvic Trauma_ Including Local Exploration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49013","description":"Preperitoneal Pelvic Packing For Hemorrhage Associated With Pelvic Trauma_ Including Local Exploration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHA1","description":"ICD-ICHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLD1","description":"ICD-OJLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKD0","description":"ICD-GGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKD0","description":"ICD-NCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Duodenal exclusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48547","description":"Duodenal exclusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENB0","description":"ICD-JENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Imm admin by intramusc injection of (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimp adenovirus Oxford 1 preserv free_ 0.5 ml dose_ 1st dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0021A","description":"Imm admin by intramusc injection of (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimp adenovirus Oxford 1 preserv free_ 0.5 ml dose_ 1st dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAC0","description":"ICD-EBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJD1","description":"ICD-NGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL26","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBF1","description":"ICD-EIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMA1","description":"ICD-IGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comp multiplane ext fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20696","description":"Comp multiplane ext fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hyperthermia treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77610","description":"Hyperthermia treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ with definitive confirmation of positive results_ any number of drug classes_ urine_ with specimen verification including DNA authentication in comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0020U","description":"Drug test(s)_ presumptive_ with definitive confirmation of positive results_ any number of drug classes_ urine_ with specimen verification including DNA authentication in comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dengue vaccine_ quadrivalent_ live_ 2 dose schedule_ for subcutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90584","description":"Dengue vaccine_ quadrivalent_ live_ 2 dose schedule_ for subcutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5274","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWD1","description":"ICD-PCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATC0","description":"ICD-NATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYC0","description":"ICD-KGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAB1","description":"ICD-NCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMC1","description":"ICD-JHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilated macular exam was not performed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9893","description":"Dilated macular exam was not performed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Probe_ Image-Guided_ Robotic_ Waterjet Ablation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2596","description":"Probe_ Image-Guided_ Robotic_ Waterjet Ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEB0","description":"ICD-OEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUF1","description":"ICD-OAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOB1","description":"ICD-PHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amitriptyline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6030","description":"Amitriptyline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXB1","description":"ICD-BCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRF1","description":"ICD-CHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEE0","description":"ICD-MBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA4B","description":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28E","description":"Clinically Complex _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLD1","description":"ICD-BGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBD1","description":"ICD-KDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTB1","description":"ICD-KCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemolysin acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85475","description":"Hemolysin acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tract equip cervical tract","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0860","description":"Tract equip cervical tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28I","description":"Special Care High _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC150","description":"Reduced Physical Function _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAA0","description":"ICD-BEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spec site no cutaneous","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9430","description":"Spec site no cutaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEB1","description":"ICD-ABEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ copanlisib_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9057","description":"Injection_ copanlisib_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUF1","description":"ICD-OLUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACF0","description":"ICD-OACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLA0","description":"ICD-GGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPA0","description":"ICD-GAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUB0","description":"ICD-OGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLA0","description":"ICD-MKLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAF0","description":"ICD-IEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQA0","description":"ICD-KEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBE0","description":"ICD-KCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICE0","description":"ICD-KICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Com wrap-around sv_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2022","description":"Com wrap-around sv_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB224","description":"Special Care High _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast noble metal inlay 2 sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6606","description":"Cast noble metal inlay 2 sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Peri-px pacemaker device evl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93286","description":"Peri-px pacemaker device evl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spiro no perf or doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8926","description":"Spiro no perf or doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ avacincaptad pegol_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2782","description":"Injection_ avacincaptad pegol_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42660","description":"Dilation of salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chromatography_ qualitative; thin layer_ analyte not elsewhere specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82489","description":"Chromatography_ qualitative; thin layer_ analyte not elsewhere specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Atropine sulfate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0461","description":"Atropine sulfate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBME1","description":"ICD-EBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reticulated platelet assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85055","description":"Reticulated platelet assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPA1","description":"ICD-FAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMC0","description":"ICD-CCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKC0","description":"ICD-GEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45379","description":"Colonoscopy w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of collar bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73000","description":"X-ray exam of collar bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21454","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-rays bone length studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77073","description":"X-rays bone length studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66172","description":"Incision of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abdom aneurysm endovas rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75953","description":"Abdom aneurysm endovas rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCME1","description":"ICD-CCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEE0","description":"ICD-KDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCC1","description":"ICD-JDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRF1","description":"ICD-OLRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Smoking & 2nd hand assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1031F","description":"Smoking & 2nd hand assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision or removal of integrated neurostimulation system for bladder dysfunction_ including analysis_ programming_ and imaging_ when performed_ posterior tibial nerve; subcut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0818T","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction_ including analysis_ programming_ and imaging_ when performed_ posterior tibial nerve; subcut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ep & ablate supravent arrhyt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93653","description":"Ep & ablate supravent arrhyt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBND1","description":"ICD-BBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYF0","description":"ICD-HGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFF0","description":"ICD-GCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE212","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA14B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neck spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22548","description":"Neck spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ligate/staple esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43405","description":"Ligate/staple esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNF1","description":"ICD-NBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCE1","description":"ICD-BFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAB1","description":"ICD-NBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove hip pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15940","description":"Remove hip pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37276","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","description":"CPT-37276","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEF0","description":"ICD-IHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIE1","description":"ICD-JEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIF0","description":"ICD-KCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine lamina 1/2 crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63001","description":"Remove spine lamina 1/2 crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of somatostatin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84307","description":"Assay of somatostatin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion Or Replacement Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ With Connection To","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0680T","description":"Insertion Or Replacement Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ With Connection To","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Air pressure mattress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0186","description":"Air pressure mattress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD112","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA NOT OTHERWISE SPECIFIED EACH ORGANISM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87449","description":"IAAD IA NOT OTHERWISE SPECIFIED EACH ORGANISM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/pericard exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32661","description":"Thoracoscopy w/pericard exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Right ventricular recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93603","description":"Right ventricular recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1LA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LA21","description":"ICD-1LA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin full graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15261","description":"Skin full graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE24D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bypass graft/av fist patency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35686","description":"Bypass graft/av fist patency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repl tip cane/crutch/walker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4637","description":"Repl tip cane/crutch/walker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin full graft trunk add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15201","description":"Skin full graft trunk add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGB1","description":"ICD-OIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAB0","description":"ICD-EHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLE1","description":"ICD-EGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEF1","description":"ICD-MCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ elotuzumab_ 1mg (Empliciti)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9477","description":"Injection_ elotuzumab_ 1mg (Empliciti)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC07","description":"High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBE0","description":"ICD-ODBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECA0","description":"ICD-CECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA5A","description":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43124","description":"Removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Washed red blood cells unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9022","description":"Washed red blood cells unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Visual funct status assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1055F","description":"Visual funct status assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKF0","description":"ICD-FDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGF0","description":"ICD-NKGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESB0","description":"ICD-DESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Miroderm_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4175","description":"Miroderm_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-1/hiv-2 1 result antbdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86703","description":"Hiv-1/hiv-2 1 result antbdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23802","description":"Fusion of shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eye muscle evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92265","description":"Eye muscle evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastroenterology (Barrett esophagus)_ P16_ RUNX3_ HPP1_ and FBN1 DNA methylation analysis using PCR_ formalin-fixed paraffin-embedded (FFPE) tissue_ algorithm reported as risk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0398U","description":"Gastroenterology (Barrett esophagus)_ P16_ RUNX3_ HPP1_ and FBN1 DNA methylation analysis using PCR_ formalin-fixed paraffin-embedded (FFPE) tissue_ algorithm reported as risk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIB0","description":"ICD-BGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Benesch boot pair junior","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3214","description":"Benesch boot pair junior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj perflutren lip micros_ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9957","description":"Inj perflutren lip micros_ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSE0","description":"ICD-HHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Limited dental tx transition","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8020","description":"Limited dental tx transition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suspension of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57280","description":"Suspension of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXD1","description":"ICD-NAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt w iv ab given on time","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8916","description":"Pt w iv ab given on time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient lift hydraulic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0630","description":"Patient lift hydraulic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKF0","description":"ICD-GDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKC0","description":"ICD-NKKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cabg vein two","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33511","description":"Cabg vein two","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLC1","description":"ICD-JFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWA0","description":"ICD-GDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA40","description":"Low Rehab_ ADL Index 0-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tract frame attach headboard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0840","description":"Tract frame attach headboard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electric breast pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0603","description":"Electric breast pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIE0","description":"ICD-AAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUD1","description":"ICD-NBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0842T","description":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Npo (nothing-mouth) ordered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6020F","description":"Npo (nothing-mouth) ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKE0","description":"ICD-OGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Photochemotherapy with uv-a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96912","description":"Photochemotherapy with uv-a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSB0","description":"ICD-GFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision and drainage of soft tissue abscess_ subfascial (ie_ involves the soft tissue below the deep fascia)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20005","description":"Incision and drainage of soft tissue abscess_ subfascial (ie_ involves the soft tissue below the deep fascia)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5942","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5942","description":"CDT-D5942","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rib cartilage graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21230","description":"Rib cartilage graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Verteporfin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3396","description":"Verteporfin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood Component Or Product Not Otherwise Classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9099","description":"Blood Component Or Product Not Otherwise Classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLB1","description":"ICD-FHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRA0","description":"ICD-GGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAE1","description":"ICD-OEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIF1","description":"ICD-MGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQB1","description":"ICD-DCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9483","description":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Optical coherence tomography (OCT) for microstructural and morphological imaging of skin_ image acq_ interpretation_ and report; each additional lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0471T","description":"Optical coherence tomography (OCT) for microstructural and morphological imaging of skin_ image acq_ interpretation_ and report; each additional lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHE1","description":"ICD-NFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Quant results activity &symp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3115F","description":"Quant results activity &symp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC60","description":"Very High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLA1","description":"ICD-ADLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYE0","description":"ICD-KEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTB0","description":"ICD-BFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of needle or intracatheter_ upper or lower extremity artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36140","description":"Introduction of needle or intracatheter_ upper or lower extremity artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUD1","description":"ICD-IHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC5B","description":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ genital region_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6570","description":"Gradient compression garment_ genital region_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50557","description":"Kidney endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy/lung bx addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31632","description":"Bronchoscopy/lung bx addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31291","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQF1","description":"ICD-DGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore chest vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35820","description":"Explore chest vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice general care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2045","description":"Hospice general care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx chron care w/o pt vsit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99487","description":"Cmplx chron care w/o pt vsit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIB0","description":"ICD-ADIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder joint surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23101","description":"Shoulder joint surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Novafix dl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4254","description":"Novafix dl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDD1","description":"ICD-OGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray liver w/hemodynam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75885","description":"Vein x-ray liver w/hemodynam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB125","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBME1","description":"ICD-CBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUF0","description":"ICD-FAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1303","description":"HCPCS-A1303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dermabind dl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4287","description":"Dermabind dl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUA1","description":"ICD-IBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLE0","description":"ICD-IFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSC0","description":"ICD-KHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8G","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0667","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","description":"HCPCS-G0667","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reproductive Medicine (Preimplantation Genetic Assessment)_ Analysis Of 24 Chromosomes Using Embryonic Dna Genomic Sequence Analysis For Aneuploidy_ And A Mitochondrial Dna Sc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0254U","description":"Reproductive Medicine (Preimplantation Genetic Assessment)_ Analysis Of 24 Chromosomes Using Embryonic Dna Genomic Sequence Analysis For Aneuploidy_ And A Mitochondrial Dna Sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Collect blood from picc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36592","description":"Collect blood from picc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient lift bathroom or toi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0625","description":"Patient lift bathroom or toi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJD0","description":"ICD-NHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA13C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic Insertion Of New Or Replacement Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0675T","description":"Laparoscopic Insertion Of New Or Replacement Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJD1","description":"ICD-CDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB205","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDC0","description":"ICD-FFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB5A","description":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL41","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc first line amox","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9315","description":"Doc first line amox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXD0","description":"ICD-CDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTC0","description":"ICD-NKTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Powered air flotation bed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0193","description":"Powered air flotation bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJA1","description":"ICD-NCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient identified as a tobacco user received tobacco cessation intervention (counseling and/or pharmacotherapy)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9906","description":"Patient identified as a tobacco user received tobacco cessation intervention (counseling and/or pharmacotherapy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX0C","description":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLB1","description":"ICD-NLLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEA0","description":"ICD-NAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28G","description":"Special Care Low _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMC0","description":"ICD-AAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pca3/klk3 antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81313","description":"Pca3/klk3 antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gamunex-c/gammaked","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1561","description":"Gamunex-c/gammaked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIE1","description":"ICD-IGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE220","description":"Reduced Physical Function _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFC0","description":"ICD-CIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61314","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDB1","description":"ICD-BIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCE0","description":"ICD-MJCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOA0","description":"ICD-LEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mammo assess cat in dbase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"7020F","description":"Mammo assess cat in dbase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPE1","description":"ICD-JCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ bupivacaine liposome","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9290","description":"Inj_ bupivacaine liposome","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHC0","description":"ICD-MCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBC0","description":"ICD-MDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML2D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43118","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Search for prior patient completed dicom format images not completed due to medical reasons(eg_CT studies performed for radiation treatment planning or image-guided radiation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9343","description":"Search for prior patient completed dicom format images not completed due to medical reasons(eg_CT studies performed for radiation treatment planning or image-guided radiation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No doc cur funct assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8541","description":"No doc cur funct assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0939T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","description":"CPT-0939T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKB1","description":"ICD-CBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4395","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","description":"HCPCS-Q4395","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx nhl trans to lg bcell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9136","description":"Onc dx nhl trans to lg bcell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Speech volume modulation system_ any type_ including all components and accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E3000","description":"Speech volume modulation system_ any type_ including all components and accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD231","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hook/hand_ hvy dty_ vol clos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6722","description":"Hook/hand_ hvy dty_ vol clos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIF1","description":"ICD-BGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Camp day waiver/session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2037","description":"Camp day waiver/session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMB1","description":"ICD-NCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGID1","description":"ICD-OGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYD0","description":"ICD-DDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPE1","description":"ICD-OEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTE1","description":"ICD-JGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cell enumeration & id","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86152","description":"Cell enumeration & id","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote retinal imaging mgmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92228","description":"Remote retinal imaging mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDF1","description":"ICD-CDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAB1","description":"ICD-NIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prq card stent w/angio addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92929","description":"Prq card stent w/angio addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC24A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTF0","description":"ICD-KCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMB1","description":"ICD-GFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0571U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","description":"CPT-0571U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7526","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reverse osmosis h2o puri sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1610","description":"Reverse osmosis h2o puri sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGB1","description":"ICD-JHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLE0","description":"ICD-MDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25450","description":"Revision of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHA0","description":"ICD-OBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALF1","description":"ICD-GALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCB0","description":"ICD-EHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCF1","description":"ICD-KFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOA1","description":"ICD-KIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystourethroscopy with adjunctive blue light cystoscopy with fluorescent imaging agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7554","description":"Cystourethroscopy with adjunctive blue light cystoscopy with fluorescent imaging agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig rna no antvir tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8460","description":"Pt inelig rna no antvir tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intend rpt card prev msr grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9673","description":"Intend rpt card prev msr grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mycophenolic acid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7518","description":"Mycophenolic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27818","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLB1","description":"ICD-OJLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; assessment of bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0556T","description":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; assessment of bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILB1","description":"ICD-CILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1010","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBF0","description":"ICD-NFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFE1","description":"ICD-JEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB51","description":"Very High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWA1","description":"ICD-PKWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIC1","description":"ICD-JHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDD0","description":"ICD-JCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA2A","description":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sgmdsc w/band ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45350","description":"Sgmdsc w/band ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove cervix/repair vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57555","description":"Remove cervix/repair vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contact layer <= 16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6206","description":"Contact layer <= 16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHF0","description":"ICD-OKHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason for not screening for TB or interpreting results (i.e._ patient positive for TB and documentati","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1004","description":"Documentation of medical reason for not screening for TB or interpreting results (i.e._ patient positive for TB and documentati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFF1","description":"ICD-JFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGA0","description":"ICD-JCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trtmnt simulation 3d image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0393","description":"Trtmnt simulation 3d image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYF0","description":"ICD-KBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hypnotherapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90880","description":"Hypnotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVC0","description":"ICD-FEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKF0","description":"ICD-GCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLA0","description":"ICD-KHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nonemergency transport taxi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0100","description":"Nonemergency transport taxi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAA0","description":"ICD-OHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ant fusion 2-3 vert seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22808","description":"Ant fusion 2-3 vert seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAD1","description":"ICD-FBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGC0","description":"ICD-NGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPB1","description":"ICD-NBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Macul result phy/qhp mng dm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5010F","description":"Macul result phy/qhp mng dm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX42","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMD1","description":"ICD-IBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cst hgh nble mtl inlay >=3sr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6603","description":"Cst hgh nble mtl inlay >=3sr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft aortofemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35539","description":"Art byp grft aortofemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQB1","description":"ICD-DEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LC21","description":"ICD-4LC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinician documented that patient had medical reason for not performing lower extremity neurological exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2179","description":"Clinician documented that patient had medical reason for not performing lower extremity neurological exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCF1","description":"ICD-GCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDC1","description":"ICD-EHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mobility cart pneum vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0502","description":"Mobility cart pneum vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSC0","description":"ICD-PLSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQC1","description":"ICD-GAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA14B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSD0","description":"ICD-HGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCF1","description":"ICD-MFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCID1","description":"ICD-KCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIA1","description":"ICD-FIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diphtheria_ tetanus toxoids_ and whole cell pertussis vaccine and hemophilus influenza b vaccine (dtp-hib)_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90720","description":"Diphtheria_ tetanus toxoids_ and whole cell pertussis vaccine and hemophilus influenza b vaccine (dtp-hib)_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTB1","description":"ICD-MBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert cath pleura w/o image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32556","description":"Insert cath pleura w/o image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDB0","description":"ICD-MFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEE0","description":"ICD-BCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digital sub 2 or more images","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0394","description":"Digital sub 2 or more images","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup long arm adult fbrg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4006","description":"Cast sup long arm adult fbrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull for treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61770","description":"Incise skull for treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1171","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","description":"HCPCS-J1171","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ abdomen; 3 or more views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74021","description":"Radiologic examination_ abdomen; 3 or more views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Toilet seat raised","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0244","description":"Toilet seat raised","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQC1","description":"ICD-DHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pulpal regeneration complete","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3357","description":"Pulpal regeneration complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35452","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76140","description":"X-ray consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPA1","description":"ICD-GBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOA1","description":"ICD-DIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB40","description":"Very High Rehab _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of eye fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67005","description":"Partial removal of eye fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPF0","description":"ICD-BCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUC1","description":"ICD-AHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFC0","description":"ICD-OBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Systemic corticosteroids rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4135F","description":"Systemic corticosteroids rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tobramycin comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7685","description":"Tobramycin comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAF1","description":"ICD-IEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEF1","description":"ICD-OEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHA0","description":"ICD-ICHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOD1","description":"ICD-KDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVD1","description":"ICD-NIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gene expression profiling panel for use in the management of breast cancer treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3854","description":"Gene expression profiling panel for use in the management of breast cancer treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rna tstng hepc vir ord/docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3265F","description":"Rna tstng hepc vir ord/docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKB0","description":"ICD-KIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMD1","description":"ICD-AAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thawing cryopresrved oocyte","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89356","description":"Thawing cryopresrved oocyte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGD0","description":"ICD-BEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKA0","description":"ICD-BHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC216","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55862","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC03","description":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWB1","description":"ICD-KHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBID1","description":"ICD-KBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEB1","description":"ICD-NHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA CHLAMYDIA TRACHOMATIS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87320","description":"IAAD IA CHLAMYDIA TRACHOMATIS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITB1","description":"ICD-BITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUF1","description":"ICD-GIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPA0","description":"ICD-FGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAE0","description":"ICD-CIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB216","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETB1","description":"ICD-OETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIA1","description":"ICD-MIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSB0","description":"ICD-CHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18X","description":"Special Care High _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARE1","description":"ICD-OARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23140","description":"Removal of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE13C","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXA0","description":"ICD-FFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTF0","description":"ICD-CCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACD0","description":"ICD-CACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Restrata_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2007","description":"Restrata_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALD1","description":"ICD-FALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDB1","description":"ICD-NHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61570","description":"Remove foreign body brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLA0","description":"ICD-OFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Install spinal shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63741","description":"Install spinal shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYA1","description":"ICD-GIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Architect ecm px fx 1 sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4147","description":"Architect ecm px fx 1 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYF0","description":"ICD-DFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWC0","description":"ICD-PAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction anal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46900","description":"Destruction anal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASF1","description":"ICD-GASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD136","description":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDND1","description":"ICD-NDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUC0","description":"ICD-GFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYF1","description":"ICD-HIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUD0","description":"ICD-BDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair major blood vessel(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33320","description":"Repair major blood vessel(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA224","description":"Clinically Complex _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIB0","description":"ICD-CDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLE0","description":"ICD-BGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic laryngoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31575","description":"Diagnostic laryngoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEF0","description":"ICD-FBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc stage docd b/4 thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3300F","description":"Ajcc stage docd b/4 thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychia interven order","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4525F","description":"Neuropsychia interven order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anal stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46700","description":"Repair of anal stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES320","description":"Extensive Services _ ADL Index 2-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDE1","description":"ICD-FEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNC1","description":"ICD-NFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21081","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompress fingers/hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26035","description":"Decompress fingers/hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent psychiatric collaborative care management_ first 60 minutes in a subsequent month of behavioral health care manager activities_ in consultation with a psychiatric c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99493","description":"Subsequent psychiatric collaborative care management_ first 60 minutes in a subsequent month of behavioral health care manager activities_ in consultation with a psychiatric c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Custom mold shoe remov prost","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3250","description":"Custom mold shoe remov prost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMA1","description":"ICD-FHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kyphectomy 3 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22819","description":"Kyphectomy 3 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBD1","description":"ICD-IGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection for ureter x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50684","description":"Injection for ureter x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHF1","description":"ICD-NKHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aed garment w elec analysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0606","description":"Aed garment w elec analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of anorectal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45108","description":"Removal of anorectal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEC1","description":"ICD-EIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMD1","description":"ICD-NCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ tubular protective absorption layer_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6607","description":"Gradient compression bandaging supply_ tubular protective absorption layer_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB13B","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resin two surfaces-anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2331","description":"Resin two surfaces-anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECC1","description":"ICD-BECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIA1","description":"ICD-MGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Integrated keratoprosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1818","description":"Integrated keratoprosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemorrhoidectomy_ Internal_ By Transanal Hemorrhoidal Dearterialization_ 2 Or More Hemorrhoid Columns/Groups_ Including Ultrasound Guidance_ With Mucopexy_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46948","description":"Hemorrhoidectomy_ Internal_ By Transanal Hemorrhoidal Dearterialization_ 2 Or More Hemorrhoid Columns/Groups_ Including Ultrasound Guidance_ With Mucopexy_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIE0","description":"ICD-OFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal hemoglobin chemical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83030","description":"Fetal hemoglobin chemical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amnio Wound_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4181","description":"Amnio Wound_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ketogenic steroids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83582","description":"Assay of ketogenic steroids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKF0","description":"ICD-KAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA13C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Evaluation of wheezing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94060","description":"Evaluation of wheezing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAC1","description":"ICD-GEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATD1","description":"ICD-NATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High risk recurrence pro ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8465","description":"High risk recurrence pro ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB17","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antipsychotic rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4065F","description":"Antipsychotic rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0688U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688U","description":"CPT-0688U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC31","description":"Medium Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENB0","description":"ICD-GENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Attendant care service /15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5125","description":"Attendant care service /15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAD0","description":"ICD-CDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNA0","description":"ICD-JDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVE0","description":"ICD-JFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wound closure by adhesive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0168","description":"Wound closure by adhesive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEND0","description":"ICD-GEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; Without Contrast_ Followed By Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0635T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; Without Contrast_ Followed By Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX02","description":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFB1","description":"ICD-CBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILB1","description":"ICD-BILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBID0","description":"ICD-KBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUC1","description":"ICD-FAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATC1","description":"ICD-JATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESA0","description":"ICD-KESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove sciatic nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64786","description":"Remove sciatic nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26432","description":"Repair finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exchange nephrostomy cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50435","description":"Exchange nephrostomy cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJB0","description":"ICD-NHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITF1","description":"ICD-MITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGC1","description":"ICD-FDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHD1","description":"ICD-BBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAB0","description":"ICD-FGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0652U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0652U","description":"CPT-0652U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ full length/chap style_ 18-30 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6559","description":"Gradient compression stocking_ full length/chap style_ 18-30 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay everolimus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80169","description":"Drug assay everolimus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9732","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXE0","description":"ICD-NLXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; each multiplex probe stain procedure (List separately in addition to code for prima","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0850T","description":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; each multiplex probe stain procedure (List separately in addition to code for prima","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy bifo 7.25-12/.25-","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2211","description":"Lens sphcy bifo 7.25-12/.25-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not having a follow up exam (e.g._ inadequate time for follow up)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1330","description":"Documentation of patient reason(s) for not having a follow up exam (e.g._ inadequate time for follow up)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHC0","description":"ICD-KIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Choline c-11_ diagnostic_ per study dose up to 20 millicuries","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9515","description":"Choline c-11_ diagnostic_ per study dose up to 20 millicuries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCB1","description":"ICD-IGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Derm autograft face/nck/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15135","description":"Derm autograft face/nck/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise spermatic cord veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55535","description":"Revise spermatic cord veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHID0","description":"ICD-BHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIE1","description":"ICD-OHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJE1","description":"ICD-CGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYB0","description":"ICD-DDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCB0","description":"ICD-NLCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETA0","description":"ICD-EETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompress fingers/hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26037","description":"Decompress fingers/hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASC0","description":"ICD-CASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bio imm resp mod presc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9506","description":"Bio imm resp mod presc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUA0","description":"ICD-KCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abd paracentesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49082","description":"Abd paracentesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement air bubble detec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1530","description":"Replacement air bubble detec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospital bed var ht w/o matt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0256","description":"Hospital bed var ht w/o matt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lipid profile not perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8728","description":"Lipid profile not perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient alive as of the last day of the measurement year","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9787","description":"Patient alive as of the last day of the measurement year","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mlh1 gene full seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81292","description":"Mlh1 gene full seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWB1","description":"ICD-CFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIF1","description":"ICD-CGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAE1","description":"ICD-MGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUF0","description":"ICD-EDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD230","description":"Clinically Complex _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheterize for urine spec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9612","description":"Catheterize for urine spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHF1","description":"ICD-JHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXA1","description":"ICD-OIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTA1","description":"ICD-BHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXC0","description":"ICD-OAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADD1","description":"ICD-NADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGF0","description":"ICD-GDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90639","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90639","description":"CPT-90639","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0454T","description":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parathyrd planar w/wo subtrj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78071","description":"Parathyrd planar w/wo subtrj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise hip/thigh nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64763","description":"Incise hip/thigh nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAND1","description":"ICD-GAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gallium Ga-68 gozetotide_ diagnostic_ (Locametz)_1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9800","description":"Gallium Ga-68 gozetotide_ diagnostic_ (Locametz)_1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL46","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX5C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7173","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","description":"HCPCS-J7173","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLND0","description":"ICD-OLND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Grafix plus_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4304","description":"Grafix plus_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of arm muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24331","description":"Revision of arm muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKD1","description":"ICD-OKKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHB0","description":"ICD-JAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHD0","description":"ICD-GFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKE1","description":"ICD-NFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAF1","description":"ICD-MDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rural health clinic or federally qualified health center (RHC/FQHC) only_ psychiatric collaborative care model (psychiatric COCM)_ 60 minutes or more of clinical staff time fo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0512","description":"Rural health clinic or federally qualified health center (RHC/FQHC) only_ psychiatric collaborative care model (psychiatric COCM)_ 60 minutes or more of clinical staff time fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD146","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auto test panel pricing code_ 17-18 test","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP18","description":"Auto test panel pricing code_ 17-18 test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transfer care checklist used","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0583F","description":"Transfer care checklist used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Muscle-specific kinase (MuSK) antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86366","description":"Muscle-specific kinase (MuSK) antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSE1","description":"ICD-CFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Solid drive wheel tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2390","description":"Solid drive wheel tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-81524","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","description":"CPT-81524","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKE0","description":"ICD-OBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAF1","description":"ICD-ADAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36012","description":"Place catheter in vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"SLCO1B1 (solute carrier organic anion transporter family_ member 1B1) (eg_ adverse drug reaction)_ gene analysis_ common variant(s) (eg_ *5)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81328","description":"SLCO1B1 (solute carrier organic anion transporter family_ member 1B1) (eg_ adverse drug reaction)_ gene analysis_ common variant(s) (eg_ *5)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE216","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18B","description":"Special Care High _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLC1","description":"ICD-FFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCD0","description":"ICD-KCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCC0","description":"ICD-MFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acylcarnitines qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82016","description":"Acylcarnitines qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXA1","description":"ICD-GBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laser surgery anal lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46917","description":"Laser surgery anal lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMF0","description":"ICD-OIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBB0","description":"ICD-GHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHE1","description":"ICD-FDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth sternal debridement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55051","description":"Anesth sternal debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urea nitrogen semi-quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84525","description":"Urea nitrogen semi-quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALD1","description":"ICD-KALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L1007","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1007","description":"HCPCS-L1007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDD0","description":"ICD-CDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v index add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88155","description":"Cytopath c/v index add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMC1","description":"ICD-EDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMD0","description":"ICD-MGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHF0","description":"ICD-OLHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1EC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EC31","description":"ICD-1EC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHC0","description":"ICD-OBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTF0","description":"ICD-GDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKA0","description":"ICD-KAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Denture interm part mandbl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5821","description":"Denture interm part mandbl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD22C","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cataract mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8765","description":"Cataract mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUC0","description":"ICD-MFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fluoroscopy_ physician or other qualified health care professional time more than 1 hour_ assisting a nonradiologic physician or other qualified health care professional (eg_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76001","description":"Fluoroscopy_ physician or other qualified health care professional time more than 1 hour_ assisting a nonradiologic physician or other qualified health care professional (eg_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC141","description":"Clinically Complex _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMA1","description":"ICD-BIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVC0","description":"ICD-BCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Polycentric hinge pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6600","description":"Polycentric hinge pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB23B","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion 1.1-2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11302","description":"Shave skin lesion 1.1-2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Osseous surgery per quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4260","description":"Osseous surgery per quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg_ array or leadless)_ and pulse generator or receiver_ in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0817T","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg_ array or leadless)_ and pulse generator or receiver_ in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHC1","description":"ICD-JBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXE1","description":"ICD-OKXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXC0","description":"ICD-JBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFD1","description":"ICD-GDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; partial (anterior)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31254","description":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; partial (anterior)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTF1","description":"ICD-BFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGD0","description":"ICD-CEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYD1","description":"ICD-LCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQF0","description":"ICD-PCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Propranolol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1800","description":"Propranolol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTA1","description":"ICD-EHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac rehabilitation progr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9472","description":"Cardiac rehabilitation progr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Delivery/set up/dispensing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9901","description":"Delivery/set up/dispensing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens trifocal add over 3.25d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2320","description":"Lens trifocal add over 3.25d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBC1","description":"ICD-FDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of hip socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27120","description":"Reconstruction of hip socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB21A","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKA1","description":"ICD-OGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFD0","description":"ICD-FBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYA0","description":"ICD-OAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mr angiograph neck w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70549","description":"Mr angiograph neck w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCA0","description":"ICD-EGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKA0","description":"ICD-JCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct urethra/bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53431","description":"Reconstruct urethra/bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITF0","description":"ICD-CITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIE1","description":"ICD-GBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of custom sleep apnea appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9949","description":"Repair of custom sleep apnea appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73110","description":"X-ray exam of wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMC0","description":"ICD-GIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC36","description":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA15","description":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aflibercept hd_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0177","description":"Injection_ aflibercept hd_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mumps virus vaccine_ live_ for subcutaneous or jet injection use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90704","description":"Mumps virus vaccine_ live_ for subcutaneous or jet injection use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy/biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44377","description":"Small bowel endoscopy/biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBC0","description":"ICD-AGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOF1","description":"ICD-CDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFE0","description":"ICD-NDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ (Afstyla)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7210","description":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ (Afstyla)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFC1","description":"ICD-OBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Safety concerns screening positive screen is without provision of mitigation recommendations_ including but not limited to referral to other resources","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9926","description":"Safety concerns screening positive screen is without provision of mitigation recommendations_ including but not limited to referral to other resources","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEE0","description":"ICD-GAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJF1","description":"ICD-NIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYF1","description":"ICD-DIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRA0","description":"ICD-CIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01190","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01190","description":"CPT-01190","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLF0","description":"ICD-ODLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWC1","description":"ICD-PJWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch for bar w flange/flt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4419","description":"Ost pch for bar w flange/flt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANB0","description":"ICD-FANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0403","description":"HCPCS-C0403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1435","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","description":"HCPCS-M1435","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Safety concerns screen provided and if positive then documented mitigation recommendations","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9922","description":"Safety concerns screen provided and if positive then documented mitigation recommendations","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ ep_ 19 or few elect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1730","description":"Cath_ ep_ 19 or few elect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth heart surg w/o pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56051","description":"Anesth heart surg w/o pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9777","description":"Patient did not receive at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVB1","description":"ICD-JHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPC0","description":"ICD-NBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Period O","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2132","description":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Period O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE224","description":"Special Care Low _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abltj Perc Cryoabltj Img Gdn Nrv Plex/Trncl Nrv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0442T","description":"Abltj Perc Cryoabltj Img Gdn Nrv Plex/Trncl Nrv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transluminal coronary angioplasty_ single major coronary artery or branch with transcatheter placement of radiation delivery device for subsequent coronary intrav","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7533","description":"Percutaneous transluminal coronary angioplasty_ single major coronary artery or branch with transcatheter placement of radiation delivery device for subsequent coronary intrav","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEE1","description":"ICD-BIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUF1","description":"ICD-KCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLF0","description":"ICD-NBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q0521","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","description":"HCPCS-Q0521","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCA0","description":"ICD-IBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTC1","description":"ICD-CHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr s/tr/ext >30.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12037","description":"Intmd rpr s/tr/ext >30.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICF1","description":"ICD-AICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01966","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01966","description":"CPT-01966","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISB1","description":"ICD-HISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiokymography","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0035","description":"Cardiokymography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Health Behavior Assessment_ Or Re-Assessment (Ie_ Health-Focused Clinical Interview_ Behavioral Observations_ Clinical Decision Making)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96156","description":"Health Behavior Assessment_ Or Re-Assessment (Ie_ Health-Focused Clinical Interview_ Behavioral Observations_ Clinical Decision Making)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJA1","description":"ICD-BIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cryptococcus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86641","description":"Cryptococcus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31293","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRC1","description":"ICD-PBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFA1","description":"ICD-GIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cell function assay w/stim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86352","description":"Cell function assay w/stim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote multi-day complex uroflowmetry (eg_ calibrated electronic equipment); set-up and patient education on use of equipment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0811T","description":"Remote multi-day complex uroflowmetry (eg_ calibrated electronic equipment); set-up and patient education on use of equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRD0","description":"ICD-LDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTD1","description":"ICD-FBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTB0","description":"ICD-GCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ped home apnea rec compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94774","description":"Ped home apnea rec compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Methotrexate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80204","description":"Methotrexate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat big toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28496","description":"Treat big toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNB1","description":"ICD-BGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spine fusion extra segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22634","description":"Spine fusion extra segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocollator unit portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0239","description":"Hydrocollator unit portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Yellow fever vaccine subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90717","description":"Yellow fever vaccine subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKF1","description":"ICD-OHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEE1","description":"ICD-AEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Buprenorphine (Implant Insertion And Removal); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual An","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2072","description":"Medication Assisted Treatment_ Buprenorphine (Implant Insertion And Removal); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual An","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNF0","description":"ICD-CFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt immunity to hep b docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3216F","description":"Pt immunity to hep b docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHA1","description":"ICD-ABHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood transfusion service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36430","description":"Blood transfusion service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAB0","description":"ICD-GAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr trunk 2.6-7.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13101","description":"Cmplx rpr trunk 2.6-7.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iiv3 vacc no prsv 6-35 mo im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90655","description":"Iiv3 vacc no prsv 6-35 mo im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Agriflu vaccine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2034","description":"Agriflu vaccine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of face wrinkles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15828","description":"Removal of face wrinkles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX4A","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKD1","description":"ICD-KDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB12C","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Calcium gluconate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0610","description":"Calcium gluconate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esano a_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4272","description":"Esano a_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73060","description":"X-ray exam of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ linezolid (hospira) not therapeutically equivalent to j2020_ 200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2021","description":"Injection_ linezolid (hospira) not therapeutically equivalent to j2020_ 200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNB0","description":"ICD-GCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDC0","description":"ICD-OJDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX56","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNA0","description":"ICD-JGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJD0","description":"ICD-FEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Great toe-hand transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26551","description":"Great toe-hand transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA115","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous tibial nerve stimulator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0736","description":"Transcutaneous tibial nerve stimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOD0","description":"ICD-KDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chlorpromazine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3230","description":"Chlorpromazine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGE1","description":"ICD-GBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trigeminal block anesthesia","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9212","description":"Trigeminal block anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlso corset front","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0970","description":"Tlso corset front","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITF1","description":"ICD-NITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE231","description":"Special Care Low _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIF0","description":"ICD-KIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rigid frame pre subclav","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0470","description":"Tlso rigid frame pre subclav","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKE1","description":"ICD-KCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSD0","description":"ICD-KFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC205","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJE0","description":"ICD-OKJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRA1","description":"ICD-HHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE205","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repl oral cushion combo mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7028","description":"Repl oral cushion combo mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPA1","description":"ICD-KDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUE1","description":"ICD-ADUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLF1","description":"ICD-BDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBF1","description":"ICD-AEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Segmentectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32484","description":"Segmentectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA23","description":"Default_ /14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destroy vulva lesions sim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56501","description":"Destroy vulva lesions sim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8E","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7524","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7524","description":"HCPCS-J7524","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq dev soft tiss add imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10036","description":"Perq dev soft tiss add imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMB0","description":"ICD-OJMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD235","description":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJC1","description":"ICD-JFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGD0","description":"ICD-BCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCC1","description":"ICD-OGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAA1","description":"ICD-GCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rx tst def 09+ rx/sbsts ur reprt pres/abs ea rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0082U","description":"Rx tst def 09+ rx/sbsts ur reprt pres/abs ea rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ bin_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5251","description":"Hearing aid_ prog_ bin_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD220","description":"Special Care High _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism National Imaging Associates_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1005","description":"Clinical Decision Support Mechanism National Imaging Associates_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic Examination_ Esophagus_ Including Scout Chest Radiograph(S) And Delayed Image(S)_ When Performed; Double-Contrast (Eg_ High-Density Barium And Effervescent Agent) S","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74221","description":"Radiologic Examination_ Esophagus_ Including Scout Chest Radiograph(S) And Delayed Image(S)_ When Performed; Double-Contrast (Eg_ High-Density Barium And Effervescent Agent) S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD154","description":"Clinically Complex _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4366","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","description":"HCPCS-Q4366","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1443","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","description":"HCPCS-M1443","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0201","description":"HCPCS-A0201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8013","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8013","description":"HCPCS-C8013","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHF0","description":"ICD-KDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYC0","description":"ICD-GGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METC1","description":"ICD-METC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOF1","description":"ICD-CHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA55","description":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIF0","description":"ICD-AIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92639","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","description":"CPT-92639","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWC1","description":"ICD-CFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAD1","description":"ICD-IDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hip flex inner socket ext fr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5643","description":"Hip flex inner socket ext fr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE22A","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vagina tissue part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57107","description":"Remove vagina tissue part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB220","description":"Special Care High _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urine incon plan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0509F","description":"Urine incon plan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAD1","description":"ICD-OHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDF1","description":"ICD-KCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAF0","description":"ICD-MLAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"External upper limb tremor stimulator of the peripheral nerves of the wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0734","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27502","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB23A","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB221","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAE0","description":"ICD-IEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUA1","description":"ICD-NBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1297","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQC0","description":"ICD-KFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBC1","description":"ICD-KDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL34","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onco (ovar) five proteins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81503","description":"Onco (ovar) five proteins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIME0","description":"ICD-OIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLB0","description":"ICD-FDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFE1","description":"ICD-FHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIA1","description":"ICD-MLIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUA1","description":"ICD-ADUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBB0","description":"ICD-AHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/ultrasound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45341","description":"Sigmoidoscopy w/ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCND1","description":"ICD-BCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"3 comp foot exam completed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9226","description":"3 comp foot exam completed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJD1","description":"ICD-OHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACB0","description":"ICD-FACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cognitive skills development","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97532","description":"Cognitive skills development","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAC1","description":"ICD-FEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICD0","description":"ICD-EICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGC1","description":"ICD-JGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYE1","description":"ICD-GFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHA1","description":"ICD-JGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Monitoring feature/devicenoc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9279","description":"Monitoring feature/devicenoc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical opening esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43351","description":"Surgical opening esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinogen test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85370","description":"Fibrinogen test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kidney dialysate delivry sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1510","description":"Kidney dialysate delivry sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUE0","description":"ICD-IEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD146","description":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDC1","description":"ICD-NJDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth repair of cleft lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10251","description":"Anesth repair of cleft lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICE1","description":"ICD-GICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay galactose transferase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82775","description":"Assay galactose transferase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ bin_ bte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5261","description":"Hearing aid_ digit_ bin_ bte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"T cells total count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86359","description":"T cells total count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Attendant control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2331","description":"Attendant control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospitalizations in which the patient was transferred directly to a non-acute care facility for any diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9801","description":"Hospitalizations in which the patient was transferred directly to a non-acute care facility for any diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATC0","description":"ICD-GATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCV2 3MCG TRS-SUCR 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0082A","description":"ADM SARSCV2 3MCG TRS-SUCR 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQC1","description":"ICD-PGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Accessing and retorquing loose implant screw - per screw","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6089","description":"Accessing and retorquing loose implant screw - per screw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Realignment of tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26437","description":"Realignment of tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pharmacist at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9479","description":"Pharmacist at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTD0","description":"ICD-FBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQF1","description":"ICD-KHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFE0","description":"ICD-JDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytogenomic Neoplasia (Genome-Wide) Microarray Analysis_ Interrogation Of Genomic Regions For Copy Number And Loss-Of-Heterozygosity Variants For Chromosomal Abnormalities","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81277","description":"Cytogenomic Neoplasia (Genome-Wide) Microarray Analysis_ Interrogation Of Genomic Regions For Copy Number And Loss-Of-Heterozygosity Variants For Chromosomal Abnormalities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6070","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOA0","description":"ICD-GFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJC1","description":"ICD-FFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIC0","description":"ICD-KAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC150","description":"Special Care High _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIF1","description":"ICD-GFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat craniofacial fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21431","description":"Treat craniofacial fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI w/cont_ breast_ uni","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8903","description":"MRI w/cont_ breast_ uni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay dipropylacetic acd tot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80164","description":"Assay dipropylacetic acd tot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Case management_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2022","description":"Case management_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGC1","description":"ICD-GFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0011","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCD1","description":"ICD-EHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOA0","description":"ICD-LAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx complx malar fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21365","description":"Opn tx complx malar fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGF0","description":"ICD-BGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXB1","description":"ICD-KHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNC1","description":"ICD-CFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWB1","description":"ICD-PLWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of epididymis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54860","description":"Removal of epididymis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESF1","description":"ICD-OESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCA1","description":"ICD-BDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMF1","description":"ICD-BHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBF1","description":"ICD-NGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLE0","description":"ICD-FBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGE1","description":"ICD-OHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSC0","description":"ICD-HHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFME0","description":"ICD-MFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infusion pump_ non-prog_temp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2626","description":"Infusion pump_ non-prog_temp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDD1","description":"ICD-CBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKD0","description":"ICD-KAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVA0","description":"ICD-KGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXA0","description":"ICD-BAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acoustic refl threshold tst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92568","description":"Acoustic refl threshold tst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28G","description":"Clinically Complex _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAB1","description":"ICD-BAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQD0","description":"ICD-GEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDD1","description":"ICD-CDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37296","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","description":"CPT-37296","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUE1","description":"ICD-KEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC13","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX5D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (thyroid)_ microRNA profiling by RT-PCR of 10 microRNA sequences_ utilizing fine needle aspirate_ algorithm reported as a positive or negative result for moderate to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0018U","description":"Oncology (thyroid)_ microRNA profiling by RT-PCR of 10 microRNA sequences_ utilizing fine needle aspirate_ algorithm reported as a positive or negative result for moderate to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXA0","description":"ICD-JDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVB1","description":"ICD-KDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEB0","description":"ICD-IGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNE1","description":"ICD-JBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBF1","description":"ICD-NBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cool quant sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0108T","description":"Cool quant sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE141","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of floor of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41108","description":"Biopsy of floor of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Superimposed prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5954","description":"Superimposed prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX40","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTB0","description":"ICD-NHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVA0","description":"ICD-KEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTB0","description":"ICD-ABTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLD1","description":"ICD-NBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHB0","description":"ICD-OCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECC1","description":"ICD-OECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder prosthesis removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23334","description":"Shoulder prosthesis removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Multi-position stnd fram sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0641","description":"Multi-position stnd fram sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXE1","description":"ICD-GDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect enlarged toe tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28340","description":"Resect enlarged toe tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAE1","description":"ICD-CBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DB21","description":"ICD-3DB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSD1","description":"ICD-CGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biofeedback train any meth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90901","description":"Biofeedback train any meth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOE0","description":"ICD-CEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; by instrument chemistry analyzers (eg_ utilizing immunoassay [eg_ EIA_ ELISA_ EMIT_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80307","description":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; by instrument chemistry analyzers (eg_ utilizing immunoassay [eg_ EIA_ ELISA_ EMIT_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC07","description":"Medium Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2JA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JA31","description":"ICD-2JA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMD1","description":"ICD-CFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Meningococcal conjugate vaccine_ serogroups A_ C_ W_ Y_ quadrivalent_ tetanus toxoid carrier (MenACWY-TT)_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90619","description":"Meningococcal conjugate vaccine_ serogroups A_ C_ W_ Y_ quadrivalent_ tetanus toxoid carrier (MenACWY-TT)_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB204","description":"Reduced Physical Function _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone biopsy trocar/needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20225","description":"Bone biopsy trocar/needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Humidifier nonheated w pap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0561","description":"Humidifier nonheated w pap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair arterial trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33786","description":"Repair arterial trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAB0","description":"ICD-CFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immediate breast prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19340","description":"Immediate breast prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove iris and lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66600","description":"Remove iris and lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWD0","description":"ICD-PGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values_ wit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0804T","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values_ wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIED1","description":"ICD-AIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEF1","description":"ICD-EEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDB0","description":"ICD-BHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1737","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","description":"HCPCS-J1737","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Provider who referred the patient to another provider did not receive a report from the provider to whom the patient was referred","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9970","description":"Provider who referred the patient to another provider did not receive a report from the provider to whom the patient was referred","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWC1","description":"ICD-KDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVE1","description":"ICD-NDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPB0","description":"ICD-BDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCB1","description":"ICD-BHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMF1","description":"ICD-ECMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRF0","description":"ICD-HDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMA1","description":"ICD-KGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mast radical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19305","description":"Mast radical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30120","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXD0","description":"ICD-KCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nonpneumatic sequential compression garment_ half leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1033","description":"Nonpneumatic sequential compression garment_ half leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARE0","description":"ICD-KARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glassia injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0257","description":"Glassia injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLD0","description":"ICD-OBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAF0","description":"ICD-MGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECF0","description":"ICD-NECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRA1","description":"ICD-CGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE256","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlso flex custom fab thoraci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0452","description":"Tlso flex custom fab thoraci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIA0","description":"ICD-NFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trach/laryn tube cuffed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7521","description":"Trach/laryn tube cuffed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVF0","description":"ICD-JGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove elbow bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24138","description":"Remove elbow bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIC0","description":"ICD-JCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA23","description":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDD1","description":"ICD-KDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4369","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","description":"HCPCS-Q4369","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNA0","description":"ICD-OKNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy dilate/fx repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31630","description":"Bronchoscopy dilate/fx repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62223","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for level V_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0754T","description":"Digitization of glass microscope slides for level V_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Muscle/tendon transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24301","description":"Muscle/tendon transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4378","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","description":"HCPCS-Q4378","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHC0","description":"ICD-CDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILC1","description":"ICD-JILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGA0","description":"ICD-NDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGID1","description":"ICD-JGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESA0","description":"ICD-CESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDB0","description":"ICD-IBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAED1","description":"ICD-GAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo transthoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93304","description":"Echo transthoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMC1","description":"ICD-KIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1164","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","description":"HCPCS-J1164","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQB1","description":"ICD-CGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILB0","description":"ICD-NILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht arm splnt ped f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4024","description":"Cast sup sht arm splnt ped f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68330","description":"Revise eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUF0","description":"ICD-GAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXB0","description":"ICD-BEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Msh2 gene full seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81295","description":"Msh2 gene full seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRA0","description":"ICD-DIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETF1","description":"ICD-CETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology_ prostate cancer_ mRNA expression assay of 12 genes (10 content and 2 housekeeping)_ RT-PCR test utilizing blood plasma and/or urine_ algorithms to predict high-grade","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0011M","description":"Oncology_ prostate cancer_ mRNA expression assay of 12 genes (10 content and 2 housekeeping)_ RT-PCR test utilizing blood plasma and/or urine_ algorithms to predict high-grade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fem/popl revasc stnt & ather","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37227","description":"Fem/popl revasc stnt & ather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision or removal of neurostimulator electrode array_ spinal_ with integrated neurostimulator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0785T","description":"Revision or removal of neurostimulator electrode array_ spinal_ with integrated neurostimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18X","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inversion/eversion correction device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9285","description":"Inversion/eversion correction device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ irinotecan liposome_ 1 mg (Onivyde)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9474","description":"Injection_ irinotecan liposome_ 1 mg (Onivyde)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKE1","description":"ICD-FIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIC0","description":"ICD-GFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSD0","description":"ICD-PHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of unstable kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27422","description":"Revision of unstable kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB60","description":"Very High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBF1","description":"ICD-MBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Osteochondral knee autograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27416","description":"Osteochondral knee autograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fo w/o joints cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3933","description":"Fo w/o joints cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D2003","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2003","description":"CDT-D2003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Red cell survival kinetics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78135","description":"Red cell survival kinetics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMC1","description":"ICD-BDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLA1","description":"ICD-JCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove carotid body lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60605","description":"Remove carotid body lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abduction bar jointed adjust","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2300","description":"Abduction bar jointed adjust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Re-explore parathyroids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60502","description":"Re-explore parathyroids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIC0","description":"ICD-BCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal surg urin trac obstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2401","description":"Fetal surg urin trac obstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATE0","description":"ICD-AATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Visit to determ ldct elig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0296","description":"Visit to determ ldct elig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Osteochondral knee allograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27415","description":"Osteochondral knee allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair oviduct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58750","description":"Repair oviduct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOB1","description":"ICD-PGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESC1","description":"ICD-LESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA240","description":"Reduced Physical Function _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVF0","description":"ICD-FFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB44","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDC0","description":"ICD-BDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA40","description":"Ultra High Rehab _ ADL Index 0-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIC1","description":"ICD-KBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prq card revasc mi 1 vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92941","description":"Prq card revasc mi 1 vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0927T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","description":"CPT-0927T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of heel spur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28119","description":"Removal of heel spur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE20C","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTF1","description":"ICD-BGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEE0","description":"ICD-EAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTA0","description":"ICD-AGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLB1","description":"ICD-ODLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrde addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61868","description":"Implant neuroelectrde addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA23C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYC0","description":"ICD-HHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0946T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","description":"CPT-0946T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50715","description":"Release of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUD0","description":"ICD-OKUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEC0","description":"ICD-BFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trimethobenzamide hcl 250mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0173","description":"Trimethobenzamide hcl 250mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB24C","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPD0","description":"ICD-JEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth spine manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64051","description":"Anesth spine manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient was not admitted to the ICU in the last 30 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9854","description":"Patient was not admitted to the ICU in the last 30 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAA0","description":"ICD-OBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl & rpl car modulj pls gn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0414T","description":"Rmvl & rpl car modulj pls gn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJF1","description":"ICD-OIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDA0","description":"ICD-AFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIB0","description":"ICD-OLIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp3 std mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0861","description":"Pwc gp3 std mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pfizer-BioNTech Covid-19 vaccine administration tris-sucrose pediatric - second dose (SARSCOV2 COVID-19 VAC mRNA 10mcg/0.2mL tris-sucrose IM DOSE 2)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1714","description":"Pfizer-BioNTech Covid-19 vaccine administration tris-sucrose pediatric - second dose (SARSCOV2 COVID-19 VAC mRNA 10mcg/0.2mL tris-sucrose IM DOSE 2)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARD0","description":"ICD-LARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Self care current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8987","description":"Self care current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home sleep test/type 3 porta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0399","description":"Home sleep test/type 3 porta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB60","description":"Medium Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXC0","description":"ICD-NEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEB1","description":"ICD-CFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mntr io press 24hrs/> uni/bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0329T","description":"Mntr io press 24hrs/> uni/bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coagulation time otr method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85348","description":"Coagulation time otr method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISC1","description":"ICD-LISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with single or multiple bronchial or endobronchial biopsy(ies)_ single or multiple sites_ with transendoscopic endobronchial ultrasound (ebus)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7512","description":"Bronchoscopy_ rigid or flexible_ with single or multiple bronchial or endobronchial biopsy(ies)_ single or multiple sites_ with transendoscopic endobronchial ultrasound (ebus)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEE0","description":"ICD-IAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Path consult intraop addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88332","description":"Path consult intraop addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWB0","description":"ICD-PDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bckdhb gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81205","description":"Bckdhb gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOF1","description":"ICD-PJOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous carboxyhb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88740","description":"Transcutaneous carboxyhb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJA0","description":"ICD-ODJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spinal Puncture_ Therapeutic_ For Drainage Of Cerebrospinal Fluid (By Needle Or Catheter); With Fluoroscopic Or Ct Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62329","description":"Spinal Puncture_ Therapeutic_ For Drainage Of Cerebrospinal Fluid (By Needle Or Catheter); With Fluoroscopic Or Ct Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter_ occlusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2628","description":"Catheter_ occlusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHF1","description":"ICD-OFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNB1","description":"ICD-GBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD24B","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQA0","description":"ICD-GDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIE1","description":"ICD-NAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCD1","description":"ICD-MCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECD0","description":"ICD-GECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx septal&nose fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21337","description":"Closed tx septal&nose fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHC1","description":"ICD-EAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of web finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26561","description":"Repair of web finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BB21","description":"ICD-2BB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","description":"HCPCS-M1401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Clostridium difficile toxin A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87803","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Clostridium difficile toxin A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWA0","description":"ICD-CEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNF1","description":"ICD-GDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKF0","description":"ICD-JDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHA1","description":"ICD-KBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of vitamin e","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84446","description":"Assay of vitamin e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD204","description":"Special Care Low _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEA0","description":"ICD-JEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHF1","description":"ICD-IDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAED1","description":"ICD-EAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parenting class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9444","description":"Parenting class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXD0","description":"ICD-OEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFED0","description":"ICD-AFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cysto w/ureter stricture tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52341","description":"Cysto w/ureter stricture tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHF0","description":"ICD-NAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVC1","description":"ICD-NKVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXF1","description":"ICD-BCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMF1","description":"ICD-MFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYB0","description":"ICD-PAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXB0","description":"ICD-NLXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJA0","description":"ICD-KAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAE1","description":"ICD-GDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Microbe susceptible disk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87184","description":"Microbe susceptible disk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAE0","description":"ICD-JHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA51","description":"Default_ /90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"1 or no ct sinus w/in 90d dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9354","description":"1 or no ct sinus w/in 90d dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUB1","description":"ICD-KEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ceftizoxime sodium / 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0715","description":"Ceftizoxime sodium / 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE105","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal cancer)_ cell-free DNA (cfDNA)_ methylation-based quantitative PCR assay (SEPTIN9_ IKZF1_ BCAT1_ Septin9-2_ VAV3_ BCAN)_ plasma_ reported as presence or a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0453U","description":"Oncology (colorectal cancer)_ cell-free DNA (cfDNA)_ methylation-based quantitative PCR assay (SEPTIN9_ IKZF1_ BCAT1_ Septin9-2_ VAV3_ BCAN)_ plasma_ reported as presence or a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRD0","description":"ICD-KHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUE0","description":"ICD-AEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLB0","description":"ICD-IFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1740","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1740","description":"HCPCS-C1740","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWA1","description":"ICD-PLWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNA1","description":"ICD-GCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18C","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJA1","description":"ICD-OKJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8X","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apheresis rbc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36512","description":"Apheresis rbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLC1","description":"ICD-OBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of pelvis brace","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20662","description":"Application of pelvis brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with bronchial alveolar lavage and transendoscopic endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7556","description":"Bronchoscopy_ rigid or flexible_ with bronchial alveolar lavage and transendoscopic endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAF1","description":"ICD-OFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTE1","description":"ICD-EBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prism lens/es","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2715","description":"Prism lens/es","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLF0","description":"ICD-MJLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMD1","description":"ICD-IDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB15A","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYF1","description":"ICD-DDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIA0","description":"ICD-GAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPD0","description":"ICD-FDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLB1","description":"ICD-KDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYB1","description":"ICD-OFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA20","description":"Default_ /14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFA0","description":"ICD-GIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPA0","description":"ICD-GFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection Fluocinolone Acetonide Intravitreal Implant_ 0.01mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9450","description":"Injection Fluocinolone Acetonide Intravitreal Implant_ 0.01mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYC0","description":"ICD-KEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biomechanical mapping_ transvaginal_ with report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0487T","description":"Biomechanical mapping_ transvaginal_ with report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoe heel thomas extend to b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3470","description":"Shoe heel thomas extend to b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAC1","description":"ICD-ADAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKE1","description":"ICD-JCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPD1","description":"ICD-FBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTD1","description":"ICD-NHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ropivacaine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2795","description":"Ropivacaine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLA1","description":"ICD-JHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Recement inlay onlay or part","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2910","description":"Recement inlay onlay or part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alveoloplasty w/extract 1-3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7311","description":"Alveoloplasty w/extract 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum_ low energy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0864T","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum_ low energy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mobility current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8978","description":"Mobility current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUE1","description":"ICD-NIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of imipramine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6036","description":"Assay of imipramine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ factor IX_ albumin fusion protein_ (recombinant)_ Idelvion_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7202","description":"Injection_ factor IX_ albumin fusion protein_ (recombinant)_ Idelvion_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOC1","description":"ICD-HGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98014","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","description":"CPT-98014","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE112","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKE1","description":"ICD-GFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB241","description":"Special Care High _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Refill/maint portable pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96521","description":"Refill/maint portable pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQE0","description":"ICD-KFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJB0","description":"ICD-CGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Fixed Bilateral Space Maintainer - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1558","description":"Removal Of Fixed Bilateral Space Maintainer - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hiv unsure baby of hiv+moms","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3491F","description":"Hiv unsure baby of hiv+moms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDD1","description":"ICD-ABDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMD0","description":"ICD-FGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHB0","description":"ICD-NEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 std port seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0820","description":"Pwc gp 2 std port seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHD1","description":"ICD-MJHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tablo Hemodialysis System For The Billable Dialysis Service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1629","description":"Tablo Hemodialysis System For The Billable Dialysis Service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of total testosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84403","description":"Assay of total testosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ arm_ padded_ for nighttime use_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6523","description":"Gradient compression garment_ arm_ padded_ for nighttime use_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOB1","description":"ICD-GDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCA1","description":"ICD-GHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUD0","description":"ICD-MAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRA0","description":"ICD-KCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fluocinolone acetonide_ intravitreal implant (Yutiq)_ 0.01 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7314","description":"Injection_ fluocinolone acetonide_ intravitreal implant (Yutiq)_ 0.01 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair amputee w/ leg re","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1190","description":"Wheelchair amputee w/ leg re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial or viral respiratory tract infection)_ pathogen-specific nucleic acid (DNA or RNA)_ 22 targets including severe acute respiratory syndrome corona","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0223U","description":"Infectious disease (bacterial or viral respiratory tract infection)_ pathogen-specific nucleic acid (DNA or RNA)_ 22 targets including severe acute respiratory syndrome corona","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBA1","description":"ICD-OIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC01","description":"Medium Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNF0","description":"ICD-CCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBED0","description":"ICD-NBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDB1","description":"ICD-OHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL0D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWF0","description":"ICD-LIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYF1","description":"ICD-HBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXE1","description":"ICD-CBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ elastography; first target lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76982","description":"Ultrasound_ elastography; first target lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB12B","description":"Special Care High _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Chlamydia trachomatis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87810","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Chlamydia trachomatis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHE1","description":"ICD-ODHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWA0","description":"ICD-HGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ext ecg recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0296T","description":"Ext ecg recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal and replacement of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; pulse generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33287","description":"Removal and replacement of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; pulse generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No hcv infect srn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9454","description":"No hcv infect srn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown 3/4 porcelain/ceramic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6783","description":"Crown 3/4 porcelain/ceramic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hd bed tilted 1st day vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4167F","description":"Hd bed tilted 1st day vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Conization of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57520","description":"Conization of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: head trauma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2187","description":"Patients with clinical indications for imaging of the head: head trauma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIC1","description":"ICD-BEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDA0","description":"ICD-MBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81404","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastime-bmez_ biosimilar_ (ziextenzo) 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9058","description":"Injection_ pegfilgrastime-bmez_ biosimilar_ (ziextenzo) 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKD0","description":"ICD-FGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1802","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1802","description":"CDT-D1802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Continuous_ Real-Time Monitoring And Maintenance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95713","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Continuous_ Real-Time Monitoring And Maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQA1","description":"ICD-HHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54505","description":"Biopsy of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAA0","description":"ICD-CCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4348","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","description":"HCPCS-Q4348","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61537","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUB0","description":"ICD-ICUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKF1","description":"ICD-NLKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPD1","description":"ICD-GAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA236","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYF0","description":"ICD-HHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 3 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP03","description":"Auto.test pane pricing code_ 3 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAA1","description":"ICD-MFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJC1","description":"ICD-JHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVB1","description":"ICD-FCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Data Review_ Interpretation And Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0713T","description":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Data Review_ Interpretation And Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEE0","description":"ICD-KIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown porcelain/ceramic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6740","description":"Crown porcelain/ceramic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFC0","description":"ICD-FDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQD1","description":"ICD-PAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release of skull seams","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61552","description":"Release of skull seams","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx cml chronic phase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9123","description":"Onc dx cml chronic phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55840","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36575","description":"Repair tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0205","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0205","description":"CDT-D0205","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKE0","description":"ICD-OIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome analysis 50-100","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88248","description":"Chromosome analysis 50-100","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ hydroxocobalamin_ intravenous_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3424","description":"Injection_ hydroxocobalamin_ intravenous_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA03","description":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOC1","description":"ICD-PLOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28102","description":"Remove/graft foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDA0","description":"ICD-NEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQA1","description":"ICD-GIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Human papillomavirus (HPV)_ oropharyngeal swab_ 14 high-risk types (ie_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 51_ 52_ 56_ 58_ 59_ 66_ and 68)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0429U","description":"Human papillomavirus (HPV)_ oropharyngeal swab_ 14 high-risk types (ie_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 51_ 52_ 56_ 58_ 59_ 66_ and 68)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPC0","description":"ICD-CFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IA11","description":"ICD-1IA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSF0","description":"ICD-OBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1106T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1106T","description":"CPT-1106T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDB0","description":"ICD-MCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0618","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","description":"HCPCS-J0618","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUB0","description":"ICD-KGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUD1","description":"ICD-GBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prgrmg eval npgs apnea 1 ses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0435T","description":"Prgrmg eval npgs apnea 1 ses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMC1","description":"ICD-OCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUD0","description":"ICD-NEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Intermittent Monitoring And Maintenance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95715","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Intermittent Monitoring And Maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0904","description":"HCPCS-C0904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNF1","description":"ICD-OGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEC0","description":"ICD-MGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct sft tsue nck w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70492","description":"Ct sft tsue nck w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ whole mitochondrial genome sequence with heteroplasmy detection and deletion analysis_ nuclear-encoded mitochondrial gene a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0417U","description":"Rare diseases (constitutional/heritable disorders)_ whole mitochondrial genome sequence with heteroplasmy detection and deletion analysis_ nuclear-encoded mitochondrial gene a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQB1","description":"ICD-LEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFB1","description":"ICD-NKFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hiv rna plan care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0575F","description":"Hiv rna plan care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXC0","description":"ICD-GBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC113","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ human fibrinogen concentrate (Fibryga)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7177","description":"Injection_ human fibrinogen concentrate (Fibryga)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of intranasal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30118","description":"Removal of intranasal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXE0","description":"ICD-BEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMB0","description":"ICD-MEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWE0","description":"ICD-OLWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACF1","description":"ICD-CACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKD0","description":"ICD-OEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCF1","description":"ICD-CFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIB1","description":"ICD-KCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRF0","description":"ICD-OHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trluml perip athrc brchiocph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0237T","description":"Trluml perip athrc brchiocph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert card electrodes dual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33211","description":"Insert card electrodes dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt tobacco screen rcvd tlk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4004F","description":"Pt tobacco screen rcvd tlk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDB0","description":"ICD-FIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Powered upper extremity range of motion assist device_ elbow_ wrist_ hand_ finger_ single or double upright(s)_ includes microp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8702","description":"Powered upper extremity range of motion assist device_ elbow_ wrist_ hand_ finger_ single or double upright(s)_ includes microp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC146","description":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ex h rate for sz ovr 30 day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0385T","description":"Ex h rate for sz ovr 30 day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Take-home supply of injectable naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2216","description":"Take-home supply of injectable naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNC1","description":"ICD-JCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTA0","description":"ICD-EDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDA0","description":"ICD-NCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mumps antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86735","description":"Mumps antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL14","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENB1","description":"ICD-BENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC24A","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/sac drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32659","description":"Thoracoscopy w/sac drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIE1","description":"ICD-MBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWE0","description":"ICD-LCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28F","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKF1","description":"ICD-GCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"GE GNOTYP GYPC EXONS 1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0188U","description":"GE GNOTYP GYPC EXONS 1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytogenetics dna probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88271","description":"Cytogenetics dna probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repr elbow lat ligmnt w/tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24343","description":"Repr elbow lat ligmnt w/tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy stent add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31637","description":"Bronchoscopy stent add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVE0","description":"ICD-OLVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cap bacterial assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0012F","description":"Cap bacterial assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOF0","description":"ICD-KIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sprvsd xrcz back pn >12 wks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4242F","description":"Sprvsd xrcz back pn >12 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76516","description":"Echo exam of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQF0","description":"ICD-ODQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGC1","description":"ICD-JDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemo by other than infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0083","description":"Chemo by other than infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7520","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDB1","description":"ICD-GCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGF0","description":"ICD-BDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Duodenal motility study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91022","description":"Duodenal motility study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (von Willebrand disease [VWD])_ von Willebrand propeptide_ enzyme-linked immunosorbent assays (ELISA)_ plasma_ diagnostic report of von Willebrand factor (VWF) prop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0281U","description":"Hematology (von Willebrand disease [VWD])_ von Willebrand propeptide_ enzyme-linked immunosorbent assays (ELISA)_ plasma_ diagnostic report of von Willebrand factor (VWF) prop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPF1","description":"ICD-GAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove electrode/thoracotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33237","description":"Remove electrode/thoracotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8H","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRD1","description":"ICD-OFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ext pwrd shlder lock/unlock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6648","description":"Ext pwrd shlder lock/unlock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of urethra abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53060","description":"Drainage of urethra abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHE0","description":"ICD-FHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUA1","description":"ICD-NFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Srs cranial lesion simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61796","description":"Srs cranial lesion simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNB1","description":"ICD-CHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI brain stem w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70551","description":"MRI brain stem w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apheresis platelets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36513","description":"Apheresis platelets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD14A","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hhv-6 dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87532","description":"Hhv-6 dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYF0","description":"ICD-KAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIB1","description":"ICD-OBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Proton trmt simple w/o comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77520","description":"Proton trmt simple w/o comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKC0","description":"ICD-FCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI chest spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72147","description":"MRI chest spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDED0","description":"ICD-IDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder flexion-abduction j","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6645","description":"Shoulder flexion-abduction j","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHB1","description":"ICD-EIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNC0","description":"ICD-BGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB220","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRC1","description":"ICD-OCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSC0","description":"ICD-OCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Strapping of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29240","description":"Strapping of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBB1","description":"ICD-OBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9310","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9310","description":"HCPCS-C9310","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCC0","description":"ICD-JBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAF1","description":"ICD-MBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lactoferrin fecal (qual)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83630","description":"Lactoferrin fecal (qual)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINC1","description":"ICD-OINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDA1","description":"ICD-CGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGA1","description":"ICD-KHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Init eval for condition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1119F","description":"Init eval for condition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKF1","description":"ICD-JHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (mild cognitive impairment)_ analysis of B-amyloid 1-42 and 1-40_ chemiluminescence enzyme immunoassay_ cerebral spinal fluid_ reported as positive_ likely positive_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0358U","description":"Neurology (mild cognitive impairment)_ analysis of B-amyloid 1-42 and 1-40_ chemiluminescence enzyme immunoassay_ cerebral spinal fluid_ reported as positive_ likely positive_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWD1","description":"ICD-OLWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJB1","description":"ICD-GCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHE0","description":"ICD-BFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1359","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat hand dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26675","description":"Treat hand dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXB1","description":"ICD-NGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Levorphanol tartrate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1960","description":"Levorphanol tartrate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOF0","description":"ICD-PGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALC1","description":"ICD-EALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVC0","description":"ICD-NBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDE0","description":"ICD-OFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIA1","description":"ICD-JAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQB1","description":"ICD-GAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of cryoglobulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82595","description":"Assay of cryoglobulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRE0","description":"ICD-LBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD235","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOA1","description":"ICD-GDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLE1","description":"ICD-FHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHD1","description":"ICD-BIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal donor liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47142","description":"Partial removal donor liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq dev breast 1st mr guide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19287","description":"Perq dev breast 1st mr guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWA0","description":"ICD-ODWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPA0","description":"ICD-CEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSC0","description":"ICD-OFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38B","description":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFC0","description":"ICD-KCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASC0","description":"ICD-HASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4407","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","description":"HCPCS-Q4407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DA11","description":"ICD-3DA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0544","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","description":"HCPCS-G0544","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMB1","description":"ICD-FGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gel cap for trach voice pros","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8512","description":"Gel cap for trach voice pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVF0","description":"ICD-JDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX54","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAC0","description":"ICD-ACAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUE0","description":"ICD-FEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPC1","description":"ICD-CHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cataract surg w/iol 1 stage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66983","description":"Cataract surg w/iol 1 stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWC0","description":"ICD-DHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPB0","description":"ICD-OBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDB1","description":"ICD-FDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special eye exam initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92225","description":"Special eye exam initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATA1","description":"ICD-NATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tail bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27080","description":"Removal of tail bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 hd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0824","description":"Pwc gp 2 hd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGD1","description":"ICD-ODGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMF0","description":"ICD-IHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Single vitamin nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9152","description":"Single vitamin nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB150","description":"Reduced Physical Function _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stnd wt frame power whlchr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0010","description":"Stnd wt frame power whlchr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brst cncr stage > t1n0m0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8881","description":"Brst cncr stage > t1n0m0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINE1","description":"ICD-JINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPB1","description":"ICD-CHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIE1","description":"ICD-MLIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB5C","description":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGND1","description":"ICD-BGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-da","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB46","description":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILC1","description":"ICD-CILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDF0","description":"ICD-IHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neg microalbuminuria rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3061F","description":"Neg microalbuminuria rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ureteral reflux study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78740","description":"Ureteral reflux study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00932","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00932","description":"CPT-00932","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHA0","description":"ICD-IGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEED0","description":"ICD-FEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETD0","description":"ICD-IETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCB1","description":"ICD-CDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thumb tendon transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26510","description":"Thumb tendon transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINC0","description":"ICD-NINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fx growth plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27516","description":"Treat thigh fx growth plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB14C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of arm nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64861","description":"Repair of arm nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28H","description":"Clinically Complex _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYA0","description":"ICD-GHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA42","description":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: new or change in headache above 50 years of age","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2188","description":"Patients with clinical indications for imaging of the head: new or change in headache above 50 years of age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEE1","description":"ICD-NEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLF1","description":"ICD-NHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGF1","description":"ICD-KBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXD1","description":"ICD-OBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLD0","description":"ICD-MFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Icm/ilr remote tech serv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93299","description":"Icm/ilr remote tech serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psych diag eval w/med srvcs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90792","description":"Psych diag eval w/med srvcs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWD0","description":"ICD-PDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJB1","description":"ICD-NKJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHF1","description":"ICD-KGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ Trivisc_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7329","description":"Hyaluronan or derivative_ Trivisc_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefazolin sodium (hikma)_ not therapeutically equivalent to j0690_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0688","description":"Injection_ cefazolin sodium (hikma)_ not therapeutically equivalent to j0690_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIE1","description":"ICD-GEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intercep dental tx primary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8050","description":"Intercep dental tx primary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSD1","description":"ICD-OBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBB0","description":"ICD-ECBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLB0","description":"ICD-IHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQF1","description":"ICD-DEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of long leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29355","description":"Application of long leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilate esophagus 1/mult pass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43450","description":"Dilate esophagus 1/mult pass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Conform band s w <3in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6445","description":"Conform band s w <3in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFA0","description":"ICD-JGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of foot and ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28262","description":"Revision of foot and ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC205","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE22D","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; first physician or other qualified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0820T","description":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; first physician or other qualified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit 2.5cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12041","description":"Intmd rpr n-hf/genit 2.5cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fev >/=40% predicted value","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3042F","description":"Fev >/=40% predicted value","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place breast rad tube/caths","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19298","description":"Place breast rad tube/caths","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rt heart cath congenital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93530","description":"Rt heart cath congenital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUA0","description":"ICD-ADUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were not prescribed/administered androgen deprivation therapy in combination with external beam radiotherapy to the prostate_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9897","description":"Patients who were not prescribed/administered androgen deprivation therapy in combination with external beam radiotherapy to the prostate_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove torus mandibularis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7473","description":"Remove torus mandibularis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clsd ostomy pouch w/flange","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5054","description":"Clsd ostomy pouch w/flange","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Muscle-skin graft arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15736","description":"Muscle-skin graft arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adjacent tissue transfer or rearrangement_ any area; each additional 30.0 sq cm_ or part thereof (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14302","description":"Adjacent tissue transfer or rearrangement_ any area; each additional 30.0 sq cm_ or part thereof (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETD1","description":"ICD-KETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOA1","description":"ICD-KFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9161","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","description":"HCPCS-J9161","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Paraffin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4265","description":"Paraffin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Moderate (45 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiaryā€™s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2008","description":"Moderate (45 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiaryā€™s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nonvascular shunt x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75809","description":"Nonvascular shunt x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37286","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","description":"CPT-37286","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB116","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Audiometry air only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0208T","description":"Audiometry air only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB140","description":"Special Care High _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBD0","description":"ICD-BFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spine disk surgery thorax","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63077","description":"Spine disk surgery thorax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Other pt/ot current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8990","description":"Other pt/ot current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comprssion thxpy prescribed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4267F","description":"Comprssion thxpy prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Molecular testing for a public health related pathogen_ including coronavirus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0606","description":"Molecular testing for a public health related pathogen_ including coronavirus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration maxillary sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31256","description":"Exploration maxillary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18E","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHD0","description":"ICD-IEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAE1","description":"ICD-JBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coordinating Stroke Care To Promote Prevention And Cultivate Positive Outcomes Mips Value Pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0054","description":"Coordinating Stroke Care To Promote Prevention And Cultivate Positive Outcomes Mips Value Pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTC1","description":"ICD-MLTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of calcium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82310","description":"Assay of calcium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGC0","description":"ICD-CCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUA0","description":"ICD-GGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPC1","description":"ICD-GEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESB0","description":"ICD-CESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62200","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-prscrp lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0510","description":"Non-prscrp lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"NuDYN SL or NuDYN SLW_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4286","description":"NuDYN SL or NuDYN SLW_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGA0","description":"ICD-BBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D2004","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2004","description":"CDT-D2004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWA1","description":"ICD-GIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJE1","description":"ICD-BCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFD1","description":"ICD-GIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBE1","description":"ICD-EGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC21C","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ot evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97003","description":"Ot evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOA0","description":"ICD-PLOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lvef mod/sever deprs syst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3021F","description":"Lvef mod/sever deprs syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLA1","description":"ICD-NFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKME0","description":"ICD-MKME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEC0","description":"ICD-MAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGD1","description":"ICD-OLGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVA1","description":"ICD-FEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Each addtnl cast post","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2953","description":"Each addtnl cast post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMA0","description":"ICD-KEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB5D","description":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDB1","description":"ICD-BCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ adalimumab-afzb (abrilada)_ biosimilar_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5132","description":"Injection_ adalimumab-afzb (abrilada)_ biosimilar_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHA1","description":"ICD-AEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFD1","description":"ICD-BCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Didanosine_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0137","description":"Didanosine_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18G","description":"Clinically Complex _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPE0","description":"ICD-FDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADB1","description":"ICD-JADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWE1","description":"ICD-HAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILA0","description":"ICD-AILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQC0","description":"ICD-DGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENE0","description":"ICD-BENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Particle agglut antbdy titr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86406","description":"Particle agglut antbdy titr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKF1","description":"ICD-FFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0532U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","description":"CPT-0532U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKF1","description":"ICD-JBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTF1","description":"ICD-MJTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIE1","description":"ICD-FFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clean & inspect rem dent max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9932","description":"Clean & inspect rem dent max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of gonadotropin (fsh)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83001","description":"Assay of gonadotropin (fsh)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD25D","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVD0","description":"ICD-NDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRE1","description":"ICD-ODRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTA0","description":"ICD-ACTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTF1","description":"ICD-GDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intestine transplant live","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44136","description":"Intestine transplant live","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVF0","description":"ICD-OBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDC0","description":"ICD-NGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVB0","description":"ICD-KEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES10A","description":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUB0","description":"ICD-NCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sunglass frames","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0518","description":"Sunglass frames","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCD1","description":"ICD-JHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hib prp-t vaccine 4 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90648","description":"Hib prp-t vaccine 4 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lower extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93925","description":"Lower extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARE1","description":"ICD-LARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion_ sotrovimab_ includes infusion and post administration monitoring in the home or residence; this includes a beneficiary_s home that has been made provider","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0248","description":"Intravenous infusion_ sotrovimab_ includes infusion and post administration monitoring in the home or residence; this includes a beneficiary_s home that has been made provider","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFB1","description":"ICD-KAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC14","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental recement crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2920","description":"Dental recement crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1491","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","description":"HCPCS-M1491","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACA1","description":"ICD-MACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASC0","description":"ICD-GASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATC0","description":"ICD-AATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEF0","description":"ICD-NIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glasses air conduction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5070","description":"Glasses air conduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98001","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","description":"CPT-98001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ propofol_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2704","description":"Inj_ propofol_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hep c quant rna tstng docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3220F","description":"Hep c quant rna tstng docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBE1","description":"ICD-FBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAC0","description":"ICD-ODAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGE1","description":"ICD-FHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Beta-bloc rx pt w/abn lvef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8450","description":"Beta-bloc rx pt w/abn lvef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Strapping of hip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29520","description":"Strapping of hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Megestrol 20 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0179","description":"Megestrol 20 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLC0","description":"ICD-FHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAF0","description":"ICD-FGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens variable asphericity bi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2430","description":"Lens variable asphericity bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25645","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDC1","description":"ICD-MGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDC1","description":"ICD-KDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBA0","description":"ICD-OEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBB0","description":"ICD-MCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hdtrans bench w/wo comm open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0248","description":"Hdtrans bench w/wo comm open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAED1","description":"ICD-NAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHC0","description":"ICD-MLHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBED1","description":"ICD-FBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of anal tags","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46230","description":"Removal of anal tags","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision or replacement of chest wall respiratory sensor electrode or electrode array_ including connection to existing pulse generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0467T","description":"Revision or replacement of chest wall respiratory sensor electrode or electrode array_ including connection to existing pulse generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ertapenem injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1335","description":"Ertapenem injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLF1","description":"ICD-EGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41017","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive review of data","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88325","description":"Comprehensive review of data","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25028","description":"Drainage of forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30435","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD117","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKB1","description":"ICD-BGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJC1","description":"ICD-GGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIC0","description":"ICD-KEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Buttock fasciotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27027","description":"Buttock fasciotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"AstraZeneca COVID-19 vaccine administration ā€” second dose","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1706","description":"AstraZeneca COVID-19 vaccine administration ā€” second dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYB0","description":"ICD-KGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneum compressor segmental","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0651","description":"Pneum compressor segmental","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATE0","description":"ICD-MATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Propulsion whl excludes tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2224","description":"Propulsion whl excludes tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLE0","description":"ICD-ABLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray of brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70010","description":"Contrast x-ray of brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJB0","description":"ICD-BDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQB0","description":"ICD-LFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay alkaline phosphatases","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84080","description":"Assay alkaline phosphatases","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCD1","description":"ICD-MLCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1EA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EA31","description":"ICD-1EA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWA1","description":"ICD-OBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNC0","description":"ICD-BBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat ankle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27846","description":"Treat ankle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glucagon tolerance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82946","description":"Glucagon tolerance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYE1","description":"ICD-CHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trans shoe calip plate exist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3600","description":"Trans shoe calip plate exist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC231","description":"Special Care High _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWD1","description":"ICD-CDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQF1","description":"ICD-DBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq dev breast 1st strtctc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19283","description":"Perq dev breast 1st strtctc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHE1","description":"ICD-AIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rheumatoid factor quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86431","description":"Rheumatoid factor quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUE1","description":"ICD-FDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXE1","description":"ICD-JFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ak 4 bar link w/fric swing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5611","description":"Ak 4 bar link w/fric swing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL25","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Split blood or products","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86985","description":"Split blood or products","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transparent film >16<=48 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6258","description":"Transparent film >16<=48 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft subclav-subclav","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35511","description":"Art byp grft subclav-subclav","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB130","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3CB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CB11","description":"ICD-3CB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth eye exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14851","description":"Anesth eye exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBD1","description":"ICD-JFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFE0","description":"ICD-KEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ONC BRST CA DNA PIK3CA 11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0177U","description":"ONC BRST CA DNA PIK3CA 11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUE1","description":"ICD-MDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDB1","description":"ICD-CEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSB1","description":"ICD-CBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amb infusion pump mechanical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0779","description":"Amb infusion pump mechanical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release finger contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26525","description":"Release finger contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYB0","description":"ICD-GCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJA0","description":"ICD-GDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBE1","description":"ICD-MJBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIE1","description":"ICD-EFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Needle biopsy lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38505","description":"Needle biopsy lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood mucoprotein","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P2038","description":"Blood mucoprotein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0944T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","description":"CPT-0944T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extraction coronal remnants","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7111","description":"Extraction coronal remnants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of cloacal anomaly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46746","description":"Repair of cloacal anomaly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36590","description":"Removal tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote monitoring of physiologic parameter(s) (eg_ weight_ blood pressure_ pulse oximetry_ respiratory flow rate)_ initial; set-up and patient education on use of equipment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99453","description":"Remote monitoring of physiologic parameter(s) (eg_ weight_ blood pressure_ pulse oximetry_ respiratory flow rate)_ initial; set-up and patient education on use of equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVF0","description":"ICD-NEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFC0","description":"ICD-OHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision_ benign lesion including margins_ except skin tag (unless listed elsewhere)_ trunk_ arms or legs; excised diameter 2.1 to 3.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11403","description":"Excision_ benign lesion including margins_ except skin tag (unless listed elsewhere)_ trunk_ arms or legs; excised diameter 2.1 to 3.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPE0","description":"ICD-JCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRA0","description":"ICD-HBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove drug implant device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11982","description":"Remove drug implant device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ vutrisiran_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0225","description":"Injection_ vutrisiran_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration maxillary sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31020","description":"Exploration maxillary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYD0","description":"ICD-DAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCC0","description":"ICD-BBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWC0","description":"ICD-DEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23520","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFED0","description":"ICD-NFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nephrology (chronic kidney disease)_ nuclear magnetic resonance spectroscopy measurement of myo-inositol_ valine_ and creatinine_ algorithmically combined with cystatin C (by","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0259U","description":"Nephrology (chronic kidney disease)_ nuclear magnetic resonance spectroscopy measurement of myo-inositol_ valine_ and creatinine_ algorithmically combined with cystatin C (by","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice evaluation preelecti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0337","description":"Hospice evaluation preelecti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBD0","description":"ICD-NCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQF0","description":"ICD-PLQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPB0","description":"ICD-CHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wedging of cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29740","description":"Wedging of cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMA0","description":"ICD-KAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPD0","description":"ICD-OBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARA0","description":"ICD-CARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYF1","description":"ICD-KIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection into hemorrhoid(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46500","description":"Injection into hemorrhoid(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD21A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCF0","description":"ICD-MDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0613U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","description":"CPT-0613U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Splint wrist or ankle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8451","description":"Splint wrist or ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Space maintainer_ fixed_ bilateral_ maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1516","description":"Space maintainer_ fixed_ bilateral_ maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLF1","description":"ICD-BBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair rotator cuff acute","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23410","description":"Repair rotator cuff acute","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Platelets leukocytes reduced","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9031","description":"Platelets leukocytes reduced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Medicalis_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1003","description":"Clinical Decision Support Mechanism Medicalis_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSC1","description":"ICD-OBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIF1","description":"ICD-AFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAB1","description":"ICD-FIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove ureter calculus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51065","description":"Remove ureter calculus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRF1","description":"ICD-HGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of cadmium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82300","description":"Assay of cadmium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILA1","description":"ICD-CILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEF1","description":"ICD-CIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDA1","description":"ICD-AFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTF0","description":"ICD-ACTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast)_ augmentative algorithmic analysis of digitized whole slide imaging of 8 histologic and immunohistochemical features_ reported as a recurrence score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0418U","description":"Oncology (breast)_ augmentative algorithmic analysis of digitized whole slide imaging of 8 histologic and immunohistochemical features_ reported as a recurrence score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWB1","description":"ICD-KDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMC1","description":"ICD-KCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTB0","description":"ICD-GBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYA1","description":"ICD-DAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCE0","description":"ICD-OHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLE1","description":"ICD-ACLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIB1","description":"ICD-OIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foam propulsion tire each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2218","description":"Foam propulsion tire each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Metaproterenol non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7668","description":"Metaproterenol non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABB0","description":"ICD-GABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA244","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Curette/treat cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65435","description":"Curette/treat cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAF0","description":"ICD-ODAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFA1","description":"ICD-BAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0557U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","description":"CPT-0557U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAE1","description":"ICD-MKAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTD0","description":"ICD-IGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"S&i stent/chest vert art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0076T","description":"S&i stent/chest vert art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRF0","description":"ICD-OBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Substernal Implantable Defibrillator Pulse Generator Only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0580T","description":"Removal Of Substernal Implantable Defibrillator Pulse Generator Only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Self-mgmt educ/train 5-8 pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98962","description":"Self-mgmt educ/train 5-8 pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilate ic vasospasm add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61641","description":"Dilate ic vasospasm add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Establish access to artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36100","description":"Establish access to artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86849","description":"Immunology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB24C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIF0","description":"ICD-BGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal and reimplantation of anterior segment intraocular nonbiodegradable drug-eluting implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0661T","description":"Removal and reimplantation of anterior segment intraocular nonbiodegradable drug-eluting implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noner transport lodgng recip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0180","description":"Noner transport lodgng recip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSB0","description":"ICD-DDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERE0","description":"ICD-LERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJA1","description":"ICD-OLJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hocm 200-249mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9960","description":"Hocm 200-249mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAID1","description":"ICD-IAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neostigmine methylslfte inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2710","description":"Neostigmine methylslfte inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEC1","description":"ICD-KHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAA1","description":"ICD-MHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct lower jaw bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21255","description":"Reconstruct lower jaw bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LC31","description":"ICD-2LC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Med serv eve/wkend/holiday","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99051","description":"Med serv eve/wkend/holiday","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2DC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DC21","description":"ICD-2DC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHB1","description":"ICD-CFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVB1","description":"ICD-OKVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIB0","description":"ICD-JHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDF0","description":"ICD-MDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABE0","description":"ICD-IABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc renal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50549","description":"Laparoscope proc renal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLB0","description":"ICD-JFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8F","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise/repair mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40814","description":"Excise/repair mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor IX (antihemophilic factor_ recombinant)_ glycopegylated_ Rebinyn_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9468","description":"Injection_ Factor IX (antihemophilic factor_ recombinant)_ glycopegylated_ Rebinyn_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSF1","description":"ICD-PLSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 5 genotyping (HPA-5)_ ITGA2 (integrin_ alpha 2 [CD49B_ alpha 2 subunit of VLA-2 receptor] [GPIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81109","description":"Human Platelet Antigen 5 genotyping (HPA-5)_ ITGA2 (integrin_ alpha 2 [CD49B_ alpha 2 subunit of VLA-2 receptor] [GPIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACE1","description":"ICD-KACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ levothyroxine sodium (fresenius kabi) not therapeutically equivalent to j0650_ 10 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0651","description":"Injection_ levothyroxine sodium (fresenius kabi) not therapeutically equivalent to j0650_ 10 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Joint survey single view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77077","description":"Joint survey single view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"V-band gastroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43842","description":"V-band gastroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGD1","description":"ICD-KEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRD1","description":"ICD-PBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLA1","description":"ICD-NBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOC0","description":"ICD-GFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early ind/delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9356","description":"Early ind/delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDB1","description":"ICD-ICDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACC0","description":"ICD-AACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eye exam with photos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92235","description":"Eye exam with photos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test one limb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95860","description":"Muscle test one limb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFF1","description":"ICD-KGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC141","description":"Special Care High _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYC0","description":"ICD-PHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLC1","description":"ICD-OLLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDC0","description":"ICD-JEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJE0","description":"ICD-JEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of bowel pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57270","description":"Repair of bowel pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDF0","description":"ICD-MBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYA1","description":"ICD-CIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASF0","description":"ICD-HASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gamma globulin > 10 cc inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1560","description":"Gamma globulin > 10 cc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBB1","description":"ICD-NLBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mr-staph dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87641","description":"Mr-staph dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPF0","description":"ICD-FEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ glycopyrrolate (Fresenius Kabi)_ not therapeutically equivalent to J1596_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1598","description":"Injection_ glycopyrrolate (Fresenius Kabi)_ not therapeutically equivalent to J1596_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28A","description":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRB1","description":"ICD-GHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSF1","description":"ICD-LGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIB0","description":"ICD-EIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGC0","description":"ICD-NKGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASA1","description":"ICD-DASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01220","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01220","description":"CPT-01220","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Membrane graft or membrane wrap_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4205","description":"Membrane graft or membrane wrap_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"5% dextrose in lactated ringer_s_ 1000 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5011","description":"5% dextrose in lactated ringer_s_ 1000 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE15B","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECF0","description":"ICD-JECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ophthalmic mitomycin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7315","description":"Ophthalmic mitomycin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDA0","description":"ICD-GEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEA1","description":"ICD-FCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLC1","description":"ICD-NCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tympanometry & reflex thresh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92550","description":"Tympanometry & reflex thresh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSC0","description":"ICD-LFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDE1","description":"ICD-MCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXE1","description":"ICD-JBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lymph vessel x-ray arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75801","description":"Lymph vessel x-ray arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC3C","description":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iv tubing extension set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1015","description":"Iv tubing extension set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who died during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1356","description":"Patients who died during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPD1","description":"ICD-OHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUC0","description":"ICD-MLUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBND0","description":"ICD-GBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPB1","description":"ICD-FGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYD1","description":"ICD-OGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKF1","description":"ICD-BGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIC1","description":"ICD-OIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTA0","description":"ICD-BHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCD1","description":"ICD-NBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHC0","description":"ICD-OKHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Co-management services with the following elements: new diagnosis or acute exacerbation and stabilization of existing condition; condition which may benefit from joint care pl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9038","description":"Co-management services with the following elements: new diagnosis or acute exacerbation and stabilization of existing condition; condition which may benefit from joint care pl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"F9 (coagulation factor IX) (eg_ hemophilia B)_ full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81238","description":"F9 (coagulation factor IX) (eg_ hemophilia B)_ full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICF1","description":"ICD-OICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKC0","description":"ICD-CCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFF0","description":"ICD-OAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGD1","description":"ICD-BGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAF0","description":"ICD-NJAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00144","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00144","description":"CPT-00144","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98985","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","description":"CPT-98985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMF0","description":"ICD-CGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHC0","description":"ICD-AHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy and atherectomy_ i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9766","description":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy and atherectomy_ i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDA1","description":"ICD-JBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ondansetron hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2405","description":"Ondansetron hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMB0","description":"ICD-MDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGF1","description":"ICD-GAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHF1","description":"ICD-IAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ voriconazole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3465","description":"Injection_ voriconazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ovary(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58943","description":"Removal of ovary(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01961","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01961","description":"CPT-01961","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7527","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYA0","description":"ICD-CFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOE0","description":"ICD-GHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALB0","description":"ICD-BALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYC0","description":"ICD-PDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Provisional retainer crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6793","description":"Provisional retainer crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWD0","description":"ICD-GIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22845","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEC1","description":"ICD-BBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMF0","description":"ICD-GCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal finger bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26235","description":"Partial removal finger bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWA0","description":"ICD-PLWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFD0","description":"ICD-OFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHF1","description":"ICD-ABHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVA0","description":"ICD-FBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVD0","description":"ICD-KFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTB0","description":"ICD-OHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBD1","description":"ICD-EEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHB0","description":"ICD-OKHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWE1","description":"ICD-PHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICD1","description":"ICD-BICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54055","description":"Destruction penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDA0","description":"ICD-GHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay rbc protoporphyrin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84202","description":"Assay rbc protoporphyrin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAD1","description":"ICD-GIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUF0","description":"ICD-BGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcvng anti r-viral thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4270F","description":"Pt rcvng anti r-viral thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient was provided hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9710","description":"Patient was provided hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatry (anxiety disorders)_ mRNA_ gene expression profiling by RNA sequencing of 15 biomarkers_ whole blood_ algorithm reported as predictive risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0437U","description":"Psychiatry (anxiety disorders)_ mRNA_ gene expression profiling by RNA sequencing of 15 biomarkers_ whole blood_ algorithm reported as predictive risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB34","description":"Medium Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICA1","description":"ICD-CICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens aniseikonic single","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2118","description":"Lens aniseikonic single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal aneuploidy (trisomy 21_ 18_ and 13) DNA sequence analysis of selected regions using maternal plasma without fetal fraction cutoff_ algorithm reported as a risk score for","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0168U","description":"Fetal aneuploidy (trisomy 21_ 18_ and 13) DNA sequence analysis of selected regions using maternal plasma without fetal fraction cutoff_ algorithm reported as a risk score for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYE0","description":"ICD-LAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB212","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9914","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9914","description":"CDT-D9914","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSF0","description":"ICD-LCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special pump services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99192","description":"Special pump services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC131","description":"Special Care High _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDD0","description":"ICD-OFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-2 quant&revrse trnscripj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87539","description":"Hiv-2 quant&revrse trnscripj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCC0","description":"ICD-MKCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEF1","description":"ICD-EAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQA0","description":"ICD-CBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKA0","description":"ICD-OCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA213","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mra_ w/o dye_ spinal canal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8932","description":"Mra_ w/o dye_ spinal canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSC0","description":"ICD-GBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANF0","description":"ICD-CANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIB0","description":"ICD-MFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cryopreservation embryo(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89258","description":"Cryopreservation embryo(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB11","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rbc antibody identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86870","description":"Rbc antibody identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pediatrics (congenital epigenetic disorders)_ whole genome methylation analysis by microarray for 50 or more genes_ blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0318U","description":"Pediatrics (congenital epigenetic disorders)_ whole genome methylation analysis by microarray for 50 or more genes_ blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUA0","description":"ICD-NIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBA1","description":"ICD-MKBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pros sock single ply bk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8470","description":"Pros sock single ply bk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCB1","description":"ICD-NCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUB0","description":"ICD-MHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHC1","description":"ICD-JEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRE1","description":"ICD-KFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKF1","description":"ICD-GFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICA0","description":"ICD-CICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8014","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8014","description":"HCPCS-C8014","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Construct bowel bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50820","description":"Construct bowel bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Th/wght bear quad-lat brim c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2520","description":"Th/wght bear quad-lat brim c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCME0","description":"ICD-GCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMB1","description":"ICD-FCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAC0","description":"ICD-EGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fit aphakia spectcl monofocl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92352","description":"Fit aphakia spectcl monofocl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIND0","description":"ICD-BIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBB1","description":"ICD-KEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADB0","description":"ICD-OADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7524","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAD0","description":"ICD-MHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTC1","description":"ICD-NGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tooth transplantation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7272","description":"Tooth transplantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enlargemnt of eye prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2625","description":"Enlargemnt of eye prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHC0","description":"ICD-KBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBF0","description":"ICD-OFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGD1","description":"ICD-CHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism (warfarin drug response)_ targeted sequence analysis (ie_ CYP2C9_ CYP4F2_ VKORC1_ rs12777823)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0030U","description":"Drug metabolism (warfarin drug response)_ targeted sequence analysis (ie_ CYP2C9_ CYP4F2_ VKORC1_ rs12777823)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of oxalate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83945","description":"Assay of oxalate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adult size pull-on sm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4525","description":"Adult size pull-on sm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echocardiography image post processing for computer aided detection of heart failure with preserved ejection fraction_ including interpretation and report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9786","description":"Echocardiography image post processing for computer aided detection of heart failure with preserved ejection fraction_ including interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIED0","description":"ICD-OIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAF1","description":"ICD-GHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJE0","description":"ICD-BCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAD0","description":"ICD-BIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative Magnetic Resonance For Analysis Of Tissue Composition (Eg_ Fat_ Iron_ Water Content)_ Including Multiparametric Data Acquisition_ Data Preparation And Transmissio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0697T","description":"Quantitative Magnetic Resonance For Analysis Of Tissue Composition (Eg_ Fat_ Iron_ Water Content)_ Including Multiparametric Data Acquisition_ Data Preparation And Transmissio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQC0","description":"ICD-GFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sperm isolation complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89261","description":"Sperm isolation complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation device evaluation (in person) of intracardiac ischemia monitoring system with analysis_ review_ and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0529T","description":"Interrogation device evaluation (in person) of intracardiac ischemia monitoring system with analysis_ review_ and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQC1","description":"ICD-PJQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKB1","description":"ICD-NHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap myotomy heller","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43279","description":"Lap myotomy heller","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDA0","description":"ICD-EBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9174","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","description":"HCPCS-J9174","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIA0","description":"ICD-FHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRB0","description":"ICD-HDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRE0","description":"ICD-GBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replc tth&acrlc on mtl frmwk","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5670","description":"Replc tth&acrlc on mtl frmwk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAF1","description":"ICD-KCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTF1","description":"ICD-NJTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVF1","description":"ICD-NDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAD1","description":"ICD-NHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIF0","description":"ICD-GDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ureter stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50620","description":"Removal of ureter stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE160","description":"Special Care Low _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLA0","description":"ICD-AFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepc mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8549","description":"Hepc mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXB0","description":"ICD-JFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYC1","description":"ICD-KFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecg/review interpret only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93272","description":"Ecg/review interpret only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove int/ext hem 1 group","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46255","description":"Remove int/ext hem 1 group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCD1","description":"ICD-NKCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit enzyme replace diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9357","description":"Hit enzyme replace diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18G","description":"Clinically Complex _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Access av dial grft for eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36147","description":"Access av dial grft for eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDB1","description":"ICD-CDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLE1","description":"ICD-OGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLF0","description":"ICD-JHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0102","description":"HCPCS-A0102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRC1","description":"ICD-LIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOC1","description":"ICD-HFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBE1","description":"ICD-NLBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone scn b/4 txmnt/aftr dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3269F","description":"Bone scn b/4 txmnt/aftr dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQE0","description":"ICD-PBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYC1","description":"ICD-DAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBB1","description":"ICD-BEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hysterectomy/revise vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58280","description":"Hysterectomy/revise vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQD0","description":"ICD-OCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC150","description":"Special Care Low _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bedside drainage bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4357","description":"Bedside drainage bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy roof of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42100","description":"Biopsy roof of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAC1","description":"ICD-CCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ disp_ binaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5263","description":"Hearing aid_ disp_ binaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOA0","description":"ICD-LBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21249","description":"Reconstruction of jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTA1","description":"ICD-MFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCA1","description":"ICD-BGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDD1","description":"ICD-AFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAE0","description":"ICD-EAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amphotericin b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0285","description":"Amphotericin b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01470","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01470","description":"CPT-01470","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX43","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0141A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFD1","description":"ICD-OIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"So 8 abd restraint pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3650","description":"So 8 abd restraint pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTE1","description":"ICD-GBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5172","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5172","description":"HCPCS-Q5172","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJME1","description":"ICD-OJME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCE1","description":"ICD-NFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amnicore pro+_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4299","description":"Amnicore pro+_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Genital surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55899","description":"Genital surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMB0","description":"ICD-KAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0526U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","description":"CPT-0526U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAF1","description":"ICD-GDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lwr ext dynamic prosth pylon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5985","description":"Lwr ext dynamic prosth pylon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOD1","description":"ICD-CHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28B","description":"Clinically Complex _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radical resection of elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24149","description":"Radical resection of elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXA0","description":"ICD-BCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMB0","description":"ICD-GDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFE0","description":"ICD-ODFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inpt/tele follow up 25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0407","description":"Inpt/tele follow up 25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJB0","description":"ICD-NFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDC1","description":"ICD-NCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC24B","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAC1","description":"ICD-GCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ho w/o joints cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3919","description":"Ho w/o joints cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including target assessment_ initial motor threshold determination_ neuronavigati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0890T","description":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including target assessment_ initial motor threshold determination_ neuronavigati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDB0","description":"ICD-AEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dil macular/fundus not perfo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8398","description":"Dil macular/fundus not perfo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assessment of a patient","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0191","description":"Assessment of a patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adenoma(s) or colorectal cancer not detected during screening colonoscopy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9935","description":"Adenoma(s) or colorectal cancer not detected during screening colonoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCC1","description":"ICD-KCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCB1","description":"ICD-IHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRF1","description":"ICD-PIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resp suction oral interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7047","description":"Resp suction oral interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Regional block anesthesia","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9211","description":"Regional block anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKD0","description":"ICD-GDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLF0","description":"ICD-CGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nonemergency transport bus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0110","description":"Nonemergency transport bus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Instll rx agnt into rnal tub","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50391","description":"Instll rx agnt into rnal tub","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCA0","description":"ICD-FDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKC0","description":"ICD-BDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOB0","description":"ICD-GIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUE0","description":"ICD-IGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anti-inflm/anlgsc otc assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1007F","description":"Anti-inflm/anlgsc otc assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tooth reimplantation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7270","description":"Tooth reimplantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHF0","description":"ICD-EAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIA1","description":"ICD-CHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ixabepilone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9207","description":"Ixabepilone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hard protect helmet prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A8001","description":"Hard protect helmet prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITF1","description":"ICD-JITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEE0","description":"ICD-MEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVA1","description":"ICD-JIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental Case Management - Patients With Special Health Care Needs","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9997","description":"Dental Case Management - Patients With Special Health Care Needs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9738","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGC0","description":"ICD-KAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Myomectomy vag method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58145","description":"Myomectomy vag method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGD1","description":"ICD-JBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15934","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Odontics eposteal implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6040","description":"Odontics eposteal implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ext ecg scan w/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0297T","description":"Ext ecg scan w/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablation Of Malignant Prostate Tissue_ Transrectal_ With High Intensity-Focused Ultrasound (Hifu)_ Including Ultrasound Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55880","description":"Ablation Of Malignant Prostate Tissue_ Transrectal_ With High Intensity-Focused Ultrasound (Hifu)_ Including Ultrasound Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC33","description":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDB0","description":"ICD-NFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPF0","description":"ICD-JEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKA0","description":"ICD-BCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC45","description":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology_ whole blood or buccal_ DNA single-nucleotide polymorphism (SNP) genotyping by real-time PCR of 24 genes_ with variant analysis and reported phenotypes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0460U","description":"Oncology_ whole blood or buccal_ DNA single-nucleotide polymorphism (SNP) genotyping by real-time PCR of 24 genes_ with variant analysis and reported phenotypes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB23D","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC256","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit antibiotic q4h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9504","description":"Hit antibiotic q4h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICB1","description":"ICD-NICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stent_ non-coronary_ temporary_ with delivery system (propel)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1091","description":"Stent_ non-coronary_ temporary_ with delivery system (propel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQB1","description":"ICD-PAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE25A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECD0","description":"ICD-OECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LB11","description":"ICD-4LB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pet not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0235","description":"Pet not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD221","description":"Special Care Low _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGC0","description":"ICD-BBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clin node stgng docdb/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3323F","description":"Clin node stgng docdb/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp aortobi-iliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35638","description":"Art byp aortobi-iliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKF0","description":"ICD-OIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ levothyroxine sodium (hikma) not therapeutically equivalent to j0650_ 10 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0652","description":"Injection_ levothyroxine sodium (hikma) not therapeutically equivalent to j0650_ 10 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant ventricular device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33975","description":"Implant ventricular device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOD1","description":"ICD-LBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Supprelin la implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9226","description":"Supprelin la implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Closure of salivary fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42600","description":"Closure of salivary fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore adrenal gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60545","description":"Explore adrenal gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLF1","description":"ICD-JHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTF0","description":"ICD-MGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWD0","description":"ICD-OIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADC1","description":"ICD-NADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQB0","description":"ICD-GGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLB1","description":"ICD-EFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCC0","description":"ICD-MDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-auto graft addl tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4285","description":"Non-auto graft addl tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITA1","description":"ICD-KITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGME0","description":"ICD-GGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDF0","description":"ICD-MJDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHE0","description":"ICD-JEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0005","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Battery chrgr six volt otto","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7362","description":"Battery chrgr six volt otto","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLE1","description":"ICD-CBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDC0","description":"ICD-IDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEE0","description":"ICD-OAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extracorporeal shock wave for integumentary wound healing_ high energy_ including topical application and dressing care; initial wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0512T","description":"Extracorporeal shock wave for integumentary wound healing_ high energy_ including topical application and dressing care; initial wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Stanson_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1010","description":"Clinical Decision Support Mechanism Stanson_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 1 std port seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0813","description":"Pwc gp 1 std port seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hocm <=149 mg/ml iodine_ 1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9958","description":"Hocm <=149 mg/ml iodine_ 1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00938","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00938","description":"CPT-00938","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Post 1 srfc resinbased cmpst","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2391","description":"Post 1 srfc resinbased cmpst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documented reason for not screening or recommending a follow-up for high blood pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9745","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDC1","description":"ICD-IGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Duplex scan of hemodialysis fistula_ computer-aided_ limited (volume flow_ diameter_ and depth_ including only body of fistula)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0876T","description":"Duplex scan of hemodialysis fistula_ computer-aided_ limited (volume flow_ diameter_ and depth_ including only body of fistula)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOA0","description":"ICD-LGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDF0","description":"ICD-CHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDD1","description":"ICD-OLDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Post removal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2955","description":"Post removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of lower leg tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27685","description":"Revision of lower leg tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gauze >16<=48 sq in watr/sal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6229","description":"Gauze >16<=48 sq in watr/sal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEC1","description":"ICD-GBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYA1","description":"ICD-KFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPE1","description":"ICD-FBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of spinal herniation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63700","description":"Repair of spinal herniation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESE0","description":"ICD-DESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tafasitamab-cxix_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9349","description":"Injection_ tafasitamab-cxix_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wearable artificial kidney","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1632","description":"Wearable artificial kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUB1","description":"ICD-EDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cstm manual wheelchair/base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0008","description":"Cstm manual wheelchair/base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTF1","description":"ICD-EGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_ risk adj hi_ initial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9003","description":"Mccd_ risk adj hi_ initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMC1","description":"ICD-NBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient screened for tobacco use and identified as a tobacco user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1283","description":"Patient screened for tobacco use and identified as a tobacco user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEA0","description":"ICD-MEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52310","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEA1","description":"ICD-CGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKA0","description":"ICD-FFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUA0","description":"ICD-BBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFE0","description":"ICD-KCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWE0","description":"ICD-LFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAC1","description":"ICD-EHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYB0","description":"ICD-KHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCD1","description":"ICD-KCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELB1","description":"ICD-OELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIF1","description":"ICD-JCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair accessory_ lateral thigh or knee support_ any type including fixed mounting hardware_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0953","description":"Wheelchair accessory_ lateral thigh or knee support_ any type including fixed mounting hardware_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA10","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEF1","description":"ICD-JGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pralatrexate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9307","description":"Pralatrexate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVD0","description":"ICD-NCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dvt prophylx recvd day 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4070F","description":"Dvt prophylx recvd day 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWA1","description":"ICD-GBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radio/surgical implant index","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6190","description":"Radio/surgical implant index","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELD0","description":"ICD-OELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Migration inhibitory factor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86378","description":"Migration inhibitory factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPB0","description":"ICD-CEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ASXL1 (additional sex combs like 1_ transcriptional regulator) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms_ chronic myelomonocytic leukemia)_ gene analysis; fu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81175","description":"ASXL1 (additional sex combs like 1_ transcriptional regulator) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms_ chronic myelomonocytic leukemia)_ gene analysis; fu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLA0","description":"ICD-KDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYD1","description":"ICD-DCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX2A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML02","description":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRF0","description":"ICD-GHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical; with ligation of sphenopalatine artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31241","description":"Nasal/sinus endoscopy_ surgical; with ligation of sphenopalatine artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHA0","description":"ICD-JCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Office-Based Treatment For Opioid Use Disorder_ Including Care Coordination_ Individual Therapy And Group Therapy And Counseling; Each Additional 30 Minutes Beyond The First 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2088","description":"Office-Based Treatment For Opioid Use Disorder_ Including Care Coordination_ Individual Therapy And Group Therapy And Counseling; Each Additional 30 Minutes Beyond The First 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPE1","description":"ICD-BBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy remove lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46610","description":"Anoscopy remove lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct head/brain w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70450","description":"Ct head/brain w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1371","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","description":"HCPCS-M1371","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRE1","description":"ICD-CCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1027T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1027T","description":"CPT-1027T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA36","description":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMD0","description":"ICD-NFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARF1","description":"ICD-PARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pin hand dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26676","description":"Pin hand dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAA1","description":"ICD-CGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lung ventilation imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78579","description":"Lung ventilation imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"64 lead ecg w/i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0178T","description":"64 lead ecg w/i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pm device progr eval dual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93280","description":"Pm device progr eval dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWF0","description":"ICD-PCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWD1","description":"ICD-PDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJC0","description":"ICD-CCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDD1","description":"ICD-IHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCD1","description":"ICD-EGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive Care Management Services For A Single High-Risk Disease_ E.G._ Principal Care Management_ At Least 30 Minutes Of Physician Or Other Qualified Health Care Profes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2064","description":"Comprehensive Care Management Services For A Single High-Risk Disease_ E.G._ Principal Care Management_ At Least 30 Minutes Of Physician Or Other Qualified Health Care Profes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAB0","description":"ICD-FHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUC0","description":"ICD-NLUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJD1","description":"ICD-GFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ruconest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0596","description":"Injection_ ruconest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNB1","description":"ICD-FHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GB11","description":"ICD-3GB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA10B","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBB0","description":"ICD-CDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHC1","description":"ICD-IEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home episodic case 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0272","description":"Home episodic case 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Advanced brain imaging (CTA_ CT_ MRA or MRI) was ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9538","description":"Advanced brain imaging (CTA_ CT_ MRA or MRI) was ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRA0","description":"ICD-GHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Buprenorphine (Injectable); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ An","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2069","description":"Medication Assisted Treatment_ Buprenorphine (Injectable); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ An","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft carotid-brchial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35510","description":"Art byp grft carotid-brchial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Laser Surgical Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0617","description":"Hospital Special Treatment Room Support Component (Hstrsc) Laser Surgical Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIA1","description":"ICD-IFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tmj arthroscopy discectomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7876","description":"Tmj arthroscopy discectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOC0","description":"ICD-GDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRA1","description":"ICD-DIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJE1","description":"ICD-FDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of infusion pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36261","description":"Revision of infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1150","description":"Left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adenovirus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86603","description":"Adenovirus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s])_ including vessel catheterization_ all imaging guidance_ and pulse generator initial ana","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33276","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s])_ including vessel catheterization_ all imaging guidance_ and pulse generator initial ana","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENE1","description":"ICD-BENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pressure sensor system_ includes all components (eg_ introducer sensor)_ intramuscular (imp)_ exc mobile (wireless) software app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1834","description":"Pressure sensor system_ includes all components (eg_ introducer sensor)_ intramuscular (imp)_ exc mobile (wireless) software app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGE0","description":"ICD-KEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4544","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","description":"HCPCS-A4544","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pedcle fh/ch/ch/m/n/ax/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15574","description":"Pedcle fh/ch/ch/m/n/ax/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQF0","description":"ICD-PGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHE1","description":"ICD-JBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bupren/nal over 10mg bupreno","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0575","description":"Bupren/nal over 10mg bupreno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMC0","description":"ICD-JCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEA1","description":"ICD-CBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Other counselor at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9475","description":"Other counselor at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunoglobulin assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86023","description":"Immunoglobulin assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQF0","description":"ICD-GFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAA1","description":"ICD-OGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45120","description":"Removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYC0","description":"ICD-LDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMB0","description":"ICD-GAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERF0","description":"ICD-OERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Magnetically controlled capsule endoscopy_ esophagus through stomach_ including intraprocedural positioning of capsule_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0651T","description":"Magnetically controlled capsule endoscopy_ esophagus through stomach_ including intraprocedural positioning of capsule_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJD0","description":"ICD-BGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFF1","description":"ICD-CIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD10A","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exhaled air analysis o2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94680","description":"Exhaled air analysis o2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echocardiography_ transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg_TAVR_ transcatheter pulmonary valve repl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93355","description":"Echocardiography_ transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg_TAVR_ transcatheter pulmonary valve repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal fb skin/areolar tiss","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7530","description":"Removal fb skin/areolar tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMD0","description":"ICD-ADMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUD0","description":"ICD-OBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTF1","description":"ICD-NBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31601","description":"Incision of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGD1","description":"ICD-BAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBC1","description":"ICD-MHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD155","description":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iiv3 vaccine 3 yrs+ im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90658","description":"Iiv3 vaccine 3 yrs+ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCB0","description":"ICD-MLCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC204","description":"Special Care Low _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ladies shoes hightop depth i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3217","description":"Ladies shoes hightop depth i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plicamycin (mithramycin) inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9270","description":"Plicamycin (mithramycin) inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLA1","description":"ICD-ABLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOB1","description":"ICD-GGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB12","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAA0","description":"ICD-FEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscp harv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2112","description":"Knee arthroscp harv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2AC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AC21","description":"ICD-2AC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8G","description":"Low Rehab_ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRA0","description":"ICD-PLRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHE0","description":"ICD-MDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDD0","description":"ICD-BDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Calibrated microcap tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4651","description":"Calibrated microcap tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE204","description":"Special Care High _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNB1","description":"ICD-JCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj ivig privigen 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1459","description":"Inj ivig privigen 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIED0","description":"ICD-MIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay blood catecholamines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82383","description":"Assay blood catecholamines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHC0","description":"ICD-NAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exam/biopsy of vag w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57421","description":"Exam/biopsy of vag w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE217","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKA0","description":"ICD-FAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCB1","description":"ICD-AGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBC0","description":"ICD-NEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUF1","description":"ICD-EDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIA0","description":"ICD-FAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Phone e/m phys/qhp 5-10 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99441","description":"Phone e/m phys/qhp 5-10 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRB1","description":"ICD-PGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEID1","description":"ICD-MEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJID1","description":"ICD-MJID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEF1","description":"ICD-MFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFE1","description":"ICD-NAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Office consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99245","description":"Office consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEA1","description":"ICD-FBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of arm foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24201","description":"Removal of arm foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMD0","description":"ICD-MBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDA1","description":"ICD-CCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth heart surg <1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56151","description":"Anesth heart surg <1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILB0","description":"ICD-KILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dentures mand part resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5212","description":"Dentures mand part resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBC1","description":"ICD-FFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHD1","description":"ICD-CBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMA0","description":"ICD-CBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTD0","description":"ICD-AFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB54","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1903","description":"HCPCS-B1903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 1ST DOSE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0011A","description":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 1ST DOSE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERA0","description":"ICD-DERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWE0","description":"ICD-CGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMF1","description":"ICD-AFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUC0","description":"ICD-KHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Av fusion/forearm vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36820","description":"Av fusion/forearm vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD254","description":"Special Care Low _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinolytic plasminogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85421","description":"Fibrinolytic plasminogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCF1","description":"ICD-OHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Total or near total esophagectomy_ with thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy_ with or without pyloroplasty (ie_ McKeown esophagectomy or tri-i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43112","description":"Total or near total esophagectomy_ with thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy_ with or without pyloroplasty (ie_ McKeown esophagectomy or tri-i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental gold foil three surfa","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2430","description":"Dental gold foil three surfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENC1","description":"ICD-KENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Palatal lift prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5955","description":"Palatal lift prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATE1","description":"ICD-IATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPA1","description":"ICD-NAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Analyze neurostim complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95972","description":"Analyze neurostim complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEE0","description":"ICD-GHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 3 hd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0850","description":"Pwc gp 3 hd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPF1","description":"ICD-BGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHF1","description":"ICD-JBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIE1","description":"ICD-OEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fo pip dip jnt/sprng pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3925","description":"Fo pip dip jnt/sprng pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24500","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLD1","description":"ICD-NLLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGME1","description":"ICD-IGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNC1","description":"ICD-GFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of long arm cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29065","description":"Application of long arm cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIE0","description":"ICD-IEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBD1","description":"ICD-FBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDA1","description":"ICD-GFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ inotuzumab ozogamicin_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9028","description":"Injection_ inotuzumab ozogamicin_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPC0","description":"ICD-BEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUF1","description":"ICD-KGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGD1","description":"ICD-CFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plague vaccine_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90727","description":"Plague vaccine_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Valvuloplasty tricuspid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33463","description":"Valvuloplasty tricuspid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB14B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQE1","description":"ICD-HCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47600","description":"Removal of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJC0","description":"ICD-GCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECD1","description":"ICD-GECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDD0","description":"ICD-GFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES356","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18F","description":"Special Care High _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc rsn no scr uter malig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9619","description":"Doc rsn no scr uter malig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETD1","description":"ICD-OETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEA1","description":"ICD-AFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBME1","description":"ICD-JBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARE0","description":"ICD-LARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVE1","description":"ICD-BBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNC0","description":"ICD-OGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYC0","description":"ICD-CDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRE1","description":"ICD-HFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCE1","description":"ICD-ODCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHB0","description":"ICD-NFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18E","description":"Special Care Low _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35180","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCME0","description":"ICD-BCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWD0","description":"ICD-PFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inpt/tele follow up 35","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0408","description":"Inpt/tele follow up 35","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alkaloids_ urine_ quantitative","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6041","description":"Alkaloids_ urine_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE15C","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9804","description":"HCPCS-C9804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orthopedic mens shoes oxford","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3219","description":"Orthopedic mens shoes oxford","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLC1","description":"ICD-MHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRF1","description":"ICD-DFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ra disease activity high","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3472F","description":"Ra disease activity high","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vaccinia (smallpox) virus vaccine_ live_ lyophilized_ 0.3 mL dosage_ for percutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90622","description":"Vaccinia (smallpox) virus vaccine_ live_ lyophilized_ 0.3 mL dosage_ for percutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ophthalmoscopy_ Extended; With Drawing Of Optic Nerve Or Macula (Eg_ For Glaucoma_ Macular Pathology_ Tumor) With Interpretation And Report_ Unilateral Or Bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92202","description":"Ophthalmoscopy_ Extended; With Drawing Of Optic Nerve Or Macula (Eg_ For Glaucoma_ Macular Pathology_ Tumor) With Interpretation And Report_ Unilateral Or Bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJD1","description":"ICD-FBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCD0","description":"ICD-NLCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAD0","description":"ICD-NJAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXF1","description":"ICD-OGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIA1","description":"ICD-BGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSF0","description":"ICD-PKSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Critical care addl 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99292","description":"Critical care addl 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB05","description":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Platelets_ pheresis_ pathogen-reduced_ each unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9073","description":"Platelets_ pheresis_ pathogen-reduced_ each unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQA1","description":"ICD-PHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDME0","description":"ICD-FDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1117","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLD0","description":"ICD-EGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIB1","description":"ICD-MEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEE1","description":"ICD-NJEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"M.avium-intra dna amp prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87561","description":"M.avium-intra dna amp prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct pelvis w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72192","description":"Ct pelvis w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACB0","description":"ICD-MACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDC1","description":"ICD-FCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trimethylamine/trimethylamine N-oxide (TMA/TMAO) profile_ tandem mass spectrometry (MS/MS)_ urine_ with algorithmic analysis and interpretive report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0256U","description":"Trimethylamine/trimethylamine N-oxide (TMA/TMAO) profile_ tandem mass spectrometry (MS/MS)_ urine_ with algorithmic analysis and interpretive report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUF0","description":"ICD-IGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lang comp goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9160","description":"Lang comp goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52276","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEF0","description":"ICD-CGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLC1","description":"ICD-EHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRB1","description":"ICD-KIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Semen anal vol/count/mot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89320","description":"Semen anal vol/count/mot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Factor ix recombinan rixubis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7200","description":"Factor ix recombinan rixubis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autologous Cellular Implant Derived From Adipose Tissue For The Treatment Of Osteoarthritis Of The Knees; Tissue Harvesting And Cellular Implant Creation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0565T","description":"Autologous Cellular Implant Derived From Adipose Tissue For The Treatment Of Osteoarthritis Of The Knees; Tissue Harvesting And Cellular Implant Creation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD216","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC134","description":"Clinically Complex _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Scap thorac prosth tiss shap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6570","description":"Scap thorac prosth tiss shap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL11","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not providing safety concerns screen or for not providing recommendations_ orders or referrals for positive screen (e.g._ patient in pal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9924","description":"Documentation of medical reason(s) for not providing safety concerns screen or for not providing recommendations_ orders or referrals for positive screen (e.g._ patient in pal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD13C","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTE0","description":"ICD-MJTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUB0","description":"ICD-FAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXC1","description":"ICD-OHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL01","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Keramatrix_ per square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4165","description":"Keramatrix_ per square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQD0","description":"ICD-LAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic digital breast tomosynthesis_ unilateral or bilateral (list separately in addition to 77065-77067)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0279","description":"Diagnostic digital breast tomosynthesis_ unilateral or bilateral (list separately in addition to 77065-77067)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX31","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ef ped caloric dense>/=0.7kc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4160","description":"Ef ped caloric dense>/=0.7kc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWB0","description":"ICD-OJWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIB0","description":"ICD-OKIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44365","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGC0","description":"ICD-NCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRF0","description":"ICD-HIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"SEPT9 (Septin9) (eg_ colorectal cancer) methylation analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81327","description":"SEPT9 (Septin9) (eg_ colorectal cancer) methylation analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECD1","description":"ICD-FECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ATXN3 (ataxin 3) (eg_ spinocerebellar ataxia_ Machado-Joseph disease) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81180","description":"ATXN3 (ataxin 3) (eg_ spinocerebellar ataxia_ Machado-Joseph disease) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKC1","description":"ICD-NAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect recur gyn mal w/lym","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58958","description":"Resect recur gyn mal w/lym","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTD0","description":"ICD-OHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBA0","description":"ICD-GCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAB1","description":"ICD-BHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ triamcinolone acetonide_ preservative-free_ extended-release_ microsphere formulation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3304","description":"Injection_ triamcinolone acetonide_ preservative-free_ extended-release_ microsphere formulation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAD1","description":"ICD-CIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTA1","description":"ICD-ABTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lvonorgestrl-Rls Iu Coc Sys 19.5 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9984","description":"Lvonorgestrl-Rls Iu Coc Sys 19.5 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPD1","description":"ICD-NGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUF1","description":"ICD-MEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of midfoot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28304","description":"Incision of midfoot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Pancreatic Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1098","description":"Radiation Therapy For Pancreatic Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVE1","description":"ICD-GIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intrnl bleaching per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9974","description":"Intrnl bleaching per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTB1","description":"ICD-IHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise epiphyseal bar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20150","description":"Excise epiphyseal bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHA0","description":"ICD-AAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIF0","description":"ICD-NKIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJD1","description":"ICD-BBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOF0","description":"ICD-KDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAC1","description":"ICD-GBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A5101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5101","description":"HCPCS-A5101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kras gene addl variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81276","description":"Kras gene addl variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQB1","description":"ICD-HBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transoral_ with volume adjustment of intragastric bariatric balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0813T","description":"Esophagogastroduodenoscopy_ flexible_ transoral_ with volume adjustment of intragastric bariatric balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAE0","description":"ICD-BCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEE0","description":"ICD-JFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not on a statin (e.g._ pregnancy_ in vitro fertilization_ clomiphene Rx_ ESRD_ cirrhosis_ muscular pain and disease during the measureme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9940","description":"Documentation of medical reason(s) for not on a statin (e.g._ pregnancy_ in vitro fertilization_ clomiphene Rx_ ESRD_ cirrhosis_ muscular pain and disease during the measureme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ileoscopy_through stoma; with transendoscopic stent placement (includes predilation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6018","description":"Ileoscopy_through stoma; with transendoscopic stent placement (includes predilation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVA0","description":"ICD-ODVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYA0","description":"ICD-LDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIC1","description":"ICD-BDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clearance of tear duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68530","description":"Clearance of tear duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKB1","description":"ICD-JCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAE0","description":"ICD-NHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCB0","description":"ICD-FCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Smear complex stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87209","description":"Smear complex stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt rec ace/arb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8506","description":"Pt rec ace/arb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plmt nephrostomy catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50432","description":"Plmt nephrostomy catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATF1","description":"ICD-OATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFA1","description":"ICD-NHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18H","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCB1","description":"ICD-FGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0604","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0604","description":"HCPCS-A0604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLE0","description":"ICD-EGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA12D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMB0","description":"ICD-MHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIME1","description":"ICD-OIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSE0","description":"ICD-KHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITB0","description":"ICD-BITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy arm/elbow soft tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24066","description":"Biopsy arm/elbow soft tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (pan-tumor)_ genetic profiling of 8 DNA-regulatory (epigenetic) markers by quantitative polymerase chain reaction (qPCR)_ whole blood_ reported as a high or low proba","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0332U","description":"Oncology (pan-tumor)_ genetic profiling of 8 DNA-regulatory (epigenetic) markers by quantitative polymerase chain reaction (qPCR)_ whole blood_ reported as a high or low proba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCA0","description":"ICD-NDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Metyrapone panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80436","description":"Metyrapone panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bimatoprost_ intracameral implant_ 1 microgram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7351","description":"Injection_ bimatoprost_ intracameral implant_ 1 microgram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1136","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEA0","description":"ICD-GEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEB1","description":"ICD-IBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28H","description":"Special Care Low _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inlay repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2981","description":"Inlay repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00868","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00868","description":"CPT-00868","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVD0","description":"ICD-FEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXC1","description":"ICD-CFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQB1","description":"ICD-PBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx multi myeloma unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9130","description":"Onc dx multi myeloma unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELF0","description":"ICD-JELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXD0","description":"ICD-BEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFB1","description":"ICD-FIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Total lung lavage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32997","description":"Total lung lavage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGE0","description":"ICD-CEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBE1","description":"ICD-JHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEB1","description":"ICD-JGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEA1","description":"ICD-KGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNF0","description":"ICD-KCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy_ flexible; with injection(s) for augmentation (eg_ percutaneous_ transoral)_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31574","description":"Laryngoscopy_ flexible; with injection(s) for augmentation (eg_ percutaneous_ transoral)_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise hernia & sperm veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55540","description":"Revise hernia & sperm veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGE1","description":"ICD-KGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX16","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRD1","description":"ICD-OHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ phenobarbital sodium (sezaby)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2561","description":"Injection_ phenobarbital sodium (sezaby)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGB0","description":"ICD-OGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNE1","description":"ICD-BFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYC1","description":"ICD-LIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Programming Device Evaluation (In Person) Of Implantable Cardioverter-Defibrillator System With Substernal Electrode_ With Iterative Adjustment Of The Implantable Device To Te","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0575T","description":"Programming Device Evaluation (In Person) Of Implantable Cardioverter-Defibrillator System With Substernal Electrode_ With Iterative Adjustment Of The Implantable Device To Te","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB21A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onlay repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2982","description":"Onlay repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBME0","description":"ICD-GBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPF0","description":"ICD-OCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA4D","description":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKA0","description":"ICD-JGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj ferric carboxymaltos 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1439","description":"Inj ferric carboxymaltos 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJB1","description":"ICD-OAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHA0","description":"ICD-MKHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFF0","description":"ICD-JAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHD0","description":"ICD-MLHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESF0","description":"ICD-HESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mcp joint repl 2 pc or more","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8631","description":"Mcp joint repl 2 pc or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUC1","description":"ICD-EAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFF0","description":"ICD-BEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implantation of patient-activated cardiac event recorder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33282","description":"Implantation of patient-activated cardiac event recorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy chemodenervation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52287","description":"Cystoscopy chemodenervation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFE1","description":"ICD-GFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA23A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGB0","description":"ICD-FHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove penis & nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54130","description":"Remove penis & nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKB1","description":"ICD-NJKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOF0","description":"ICD-ODOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain ovary abscess open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58820","description":"Drain ovary abscess open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospitalist visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0310","description":"Hospitalist visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA204","description":"Reduced Physical Function _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Continuous measurement of wheeze rate during treatment assessment or during sleep for documentation of nocturnal wheeze and cough for diagnostic evaluation 3 to 24 hours","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0244T","description":"Continuous measurement of wheeze rate during treatment assessment or during sleep for documentation of nocturnal wheeze and cough for diagnostic evaluation 3 to 24 hours","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNC0","description":"ICD-CHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFB0","description":"ICD-NGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOE0","description":"ICD-DAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Retainer Crown - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6753","description":"Retainer Crown - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASE1","description":"ICD-CASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6007","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHB1","description":"ICD-FHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKF0","description":"ICD-CCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA02","description":"Medium Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95722","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJA1","description":"ICD-KHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEF1","description":"ICD-NBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQE1","description":"ICD-PGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHC0","description":"ICD-FHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQB1","description":"ICD-KBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIB1","description":"ICD-NDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEC0","description":"ICD-KCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA1A","description":"Default_ /PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Phenotype dna hiv w/clt add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87904","description":"Phenotype dna hiv w/clt add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low risk prostate cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3271F","description":"Low risk prostate cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ cell-free circulating DNA analysis of 83 or more genes_ interrogation for sequence variants_ gene copy number a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0326U","description":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ cell-free circulating DNA analysis of 83 or more genes_ interrogation for sequence variants_ gene copy number a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01962","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01962","description":"CPT-01962","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUE0","description":"ICD-NFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interstitial radioelement application; simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77776","description":"Interstitial radioelement application; simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQA0","description":"ICD-PBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMB0","description":"ICD-ABMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQF0","description":"ICD-KGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLB1","description":"ICD-ABLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLB1","description":"ICD-BGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMB1","description":"ICD-ADMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA)_ human papillomavirus (HPV) for five or more separately reported high-risk HPV types (eg_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0500T","description":"Infectious agent detection by nucleic acid (DNA or RNA)_ human papillomavirus (HPV) for five or more separately reported high-risk HPV types (eg_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acetone assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82010","description":"Acetone assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFA1","description":"ICD-ODFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIA1","description":"ICD-FHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIA1","description":"ICD-BDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHA0","description":"ICD-CEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFND1","description":"ICD-OFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB20D","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJE0","description":"ICD-BIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTF0","description":"ICD-FDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINE0","description":"ICD-FINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBB0","description":"ICD-CEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pmkr_ single_ non rate-resp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2620","description":"Pmkr_ single_ non rate-resp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33665","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHE1","description":"ICD-MFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOA0","description":"ICD-KIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adj motion knee jnt lerman t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2186","description":"Adj motion knee jnt lerman t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch drain/barr lk flng/f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4427","description":"Ost pch drain/barr lk flng/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAD0","description":"ICD-BAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECC0","description":"ICD-IECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ibd mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8758","description":"Ibd mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0924T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","description":"CPT-0924T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skel musc relaxant 3 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80370","description":"Skel musc relaxant 3 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; characterization of alleles (eg_ expanded size)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81285","description":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; characterization of alleles (eg_ expanded size)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0553U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","description":"CPT-0553U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALE0","description":"ICD-KALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of knee cartilage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27403","description":"Repair of knee cartilage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIID1","description":"ICD-MIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAF0","description":"ICD-OKAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOE0","description":"ICD-OEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: headache radiating to the neck","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2190","description":"Patients with clinical indications for imaging of the head: headache radiating to the neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40845","description":"Reconstruction of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFE0","description":"ICD-NEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove part thorax vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22112","description":"Remove part thorax vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPA1","description":"ICD-KEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLC0","description":"ICD-ABLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVD1","description":"ICD-BDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apheresis wbc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36511","description":"Apheresis wbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVD1","description":"ICD-JFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACE1","description":"ICD-GACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWF0","description":"ICD-KGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTB1","description":"ICD-FFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICA0","description":"ICD-FICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surgery of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45051","description":"Anesth surgery of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95145","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01215","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01215","description":"CPT-01215","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRF0","description":"ICD-HHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABD0","description":"ICD-OABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hla class ii high defin qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86833","description":"Hla class ii high defin qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lutetium Lu 177 vipivotide tetraxetan_ therapeutic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9607","description":"Lutetium Lu 177 vipivotide tetraxetan_ therapeutic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastrointestinal myoelectrical activity study_ stomach through colon_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0779T","description":"Gastrointestinal myoelectrical activity study_ stomach through colon_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB3D","description":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daxibotulinumtoxina-lanm_ 1 unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9160","description":"Injection_ daxibotulinumtoxina-lanm_ 1 unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHB1","description":"ICD-KAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Microprcsr cu combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0482","description":"Microprcsr cu combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXB1","description":"ICD-GIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2DB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DB21","description":"ICD-2DB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLF0","description":"ICD-ADLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC56","description":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBB0","description":"ICD-IBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEA1","description":"ICD-BCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES324","description":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ mon_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5245","description":"Hearing aid_ prog_ mon_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nonfamily hc train/session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5116","description":"Nonfamily hc train/session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1303","description":"HCPCS-B1303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCS","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX1A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLA0","description":"ICD-OKLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLB1","description":"ICD-CFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQC1","description":"ICD-DFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJB1","description":"ICD-NGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"C-1 esterase_ cinryze","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0598","description":"C-1 esterase_ cinryze","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWB1","description":"ICD-ODWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Free assay (ft-3)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84481","description":"Free assay (ft-3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEF0","description":"ICD-NFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Admin hepatitis b vaccine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0010","description":"Admin hepatitis b vaccine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUE0","description":"ICD-OGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAD1","description":"ICD-ECAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1127","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Anifrolumab-Fnia_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9086","description":"Injection_ Anifrolumab-Fnia_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat radius fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24650","description":"Treat radius fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFB0","description":"ICD-GFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reattach tooth fragment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2921","description":"Reattach tooth fragment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE21C","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ext ureth clmp or compr dvc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4356","description":"Ext ureth clmp or compr dvc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ famotidine_ 20 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0028","description":"Injection_ famotidine_ 20 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMB1","description":"ICD-ACMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lang express goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9163","description":"Lang express goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99285","description":"Emergency dept visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQA0","description":"ICD-CCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCF0","description":"ICD-BDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGF1","description":"ICD-OEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCA0","description":"ICD-FGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocollator unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0225","description":"Hydrocollator unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES220","description":"Extensive Services _ ADL Index 2-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINC1","description":"ICD-CINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJC0","description":"ICD-KHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB126","description":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Portable gaseous 02","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0431","description":"Portable gaseous 02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft ipsilat carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35501","description":"Art byp grft ipsilat carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQC0","description":"ICD-PIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental inlay metalic 1 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2510","description":"Dental inlay metalic 1 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (melanoma)_ artificial intelligence (AI)-enabled quantitative mass spectrometry analysis of 142 unique pairs of glycopeptide and product fragments_ plasma_ prognostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0357U","description":"Oncology (melanoma)_ artificial intelligence (AI)-enabled quantitative mass spectrometry analysis of 142 unique pairs of glycopeptide and product fragments_ plasma_ prognostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22841","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical procedures that included the use of silicone oil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9756","description":"Surgical procedures that included the use of silicone oil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQA1","description":"ICD-PGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQC1","description":"ICD-PIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFB1","description":"ICD-CIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIC1","description":"ICD-CEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAE1","description":"ICD-JEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKE1","description":"ICD-NAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Irrigation maxillary sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31000","description":"Irrigation maxillary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; percutaneous approach_ including transseptal puncture_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0483T","description":"Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; percutaneous approach_ including transseptal puncture_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl/rplc nstim apnea pls gn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0431T","description":"Rmvl/rplc nstim apnea pls gn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Administration of respiratory syncytial virus_ monoclonal antibody_ seasonal dose by intramuscular injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96381","description":"Administration of respiratory syncytial virus_ monoclonal antibody_ seasonal dose by intramuscular injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTD0","description":"ICD-AHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTA0","description":"ICD-JDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77412","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILB1","description":"ICD-FILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pet image ltd area","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78811","description":"Pet image ltd area","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC43","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopic sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92614","description":"Laryngoscopic sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coombs test indirect titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86886","description":"Coombs test indirect titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Care coord at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9477","description":"Care coord at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0202","description":"HCPCS-B0202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYA1","description":"ICD-HEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trac stand free stand pelvic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0900","description":"Trac stand free stand pelvic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXE1","description":"ICD-CEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX2B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSB0","description":"ICD-PHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQC1","description":"ICD-LAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXF0","description":"ICD-CEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD24D","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28660","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRE1","description":"ICD-HHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETC0","description":"ICD-BETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC2D","description":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVC0","description":"ICD-JCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2115","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICD0","description":"ICD-OICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIC1","description":"ICD-BFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIA1","description":"ICD-MHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJF0","description":"ICD-GBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOE0","description":"ICD-HGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44100","description":"Biopsy of bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pm/icd remote tech serv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93296","description":"Pm/icd remote tech serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esrd home pt serv p mo 12-19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90965","description":"Esrd home pt serv p mo 12-19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHE0","description":"ICD-KEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace part denture teeth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5640","description":"Replace part denture teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD145","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ caplacizumab-yhdp_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9047","description":"Injection_ caplacizumab-yhdp_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1392","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","description":"HCPCS-M1392","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0546U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","description":"CPT-0546U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLF0","description":"ICD-NKLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWA0","description":"ICD-KFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUC0","description":"ICD-ICUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31781","description":"Reconstruct windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of sacroiliac joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27050","description":"Biopsy of sacroiliac joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCE0","description":"ICD-BDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy & polypectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45333","description":"Sigmoidoscopy & polypectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAD0","description":"ICD-JIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kt/v =/> 1.2 & <1.7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3083F","description":"Kt/v =/> 1.2 & <1.7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0692U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692U","description":"CPT-0692U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLC0","description":"ICD-BHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion_ bamlanivimab and etesevimab_ includes infusion and post administration monitoring in the home or residence; this includes a beneficiaryā€™s home.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0246","description":"Intravenous infusion_ bamlanivimab and etesevimab_ includes infusion and post administration monitoring in the home or residence; this includes a beneficiaryā€™s home.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pre-htn/htn_ no f/u_ not gvn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8952","description":"Pre-htn/htn_ no f/u_ not gvn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lymphocyte culture primed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86822","description":"Lymphocyte culture primed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1060","description":"Thoracic pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPE0","description":"ICD-BHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4IA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IA31","description":"ICD-4IA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQE1","description":"ICD-LGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ calaspargase pegol-mknl_ 10 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9118","description":"Injection_ calaspargase pegol-mknl_ 10 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVF0","description":"ICD-JAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVC0","description":"ICD-BIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","description":"HCPCS-E1803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAA1","description":"ICD-NCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDID1","description":"ICD-NDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC52","description":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAC1","description":"ICD-KAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cord blood harvesting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2140","description":"Cord blood harvesting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXA1","description":"ICD-CEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53661","description":"Dilation of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Absolute Quantitation Of Myocardial Blood Flow (Aqmbf)_ Positron Emission Tomography (Pet)_ Rest And Pharmacologic Stress (List Separately In Addition To Code For Primary Proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78434","description":"Absolute Quantitation Of Myocardial Blood Flow (Aqmbf)_ Positron Emission Tomography (Pet)_ Rest And Pharmacologic Stress (List Separately In Addition To Code For Primary Proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHC0","description":"ICD-BBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB115","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interstitial radiation source application; intermediate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77777","description":"Interstitial radiation source application; intermediate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDED1","description":"ICD-EDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCF1","description":"ICD-OFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB236","description":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Observ/hosp same date","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99236","description":"Observ/hosp same date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMD1","description":"ICD-GDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGF0","description":"ICD-NBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRA0","description":"ICD-LDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision graft neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35901","description":"Excision graft neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWC1","description":"ICD-CBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGB0","description":"ICD-BDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMB0","description":"ICD-IBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYD1","description":"ICD-PGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METB1","description":"ICD-METB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBE0","description":"ICD-KDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCA0","description":"ICD-CFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVF1","description":"ICD-NHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC160","description":"Reduced Physical Function _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44363","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIF0","description":"ICD-OFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97035","description":"Ultrasound therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGF0","description":"ICD-JHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heart/lung resuscitation cpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92950","description":"Heart/lung resuscitation cpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUC1","description":"ICD-BCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq tx malar fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21355","description":"Perq tx malar fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEE1","description":"ICD-AGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18D","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00124","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00124","description":"CPT-00124","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Recording of fetal magnetic cardiac signal using at least 3 channels; patient recording and storage_ data scanning with signal extraction_ technical analysis and result","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0475T","description":"Recording of fetal magnetic cardiac signal using at least 3 channels; patient recording and storage_ data scanning with signal extraction_ technical analysis and result","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit picc insert kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5520","description":"Hit picc insert kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection Factor V111 FC Fusion Protein (Recombinant) Per IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9975","description":"Injection Factor V111 FC Fusion Protein (Recombinant) Per IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain outer ear canal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69020","description":"Drain outer ear canal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infusion pump refill kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4220","description":"Infusion pump refill kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of sinuses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31090","description":"Exploration of sinuses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNF1","description":"ICD-OLNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76978","description":"Ultrasound_ targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUC0","description":"ICD-CEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMA0","description":"ICD-JIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove intestinal allograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44137","description":"Remove intestinal allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJB1","description":"ICD-KGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Corf related serv 15 mins ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0409","description":"Corf related serv 15 mins ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGF0","description":"ICD-KDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBC0","description":"ICD-MFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFF0","description":"ICD-BBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASB0","description":"ICD-GASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUD1","description":"ICD-OLUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Csit on pt any reas 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8962","description":"Csit on pt any reas 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHF1","description":"ICD-MBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBC1","description":"ICD-NLBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWF0","description":"ICD-GFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOA1","description":"ICD-CHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMB0","description":"ICD-KGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwr seat tilt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1002","description":"Pwr seat tilt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB3B","description":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEF1","description":"ICD-IDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Door to punc time <2hrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9580","description":"Door to punc time <2hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic analysis of vestibular implant_ unilateral; with initial programming","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0728T","description":"Diagnostic analysis of vestibular implant_ unilateral; with initial programming","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj midazolam hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2250","description":"Inj midazolam hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB24","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVF0","description":"ICD-NHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDC0","description":"ICD-MEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35372","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBED1","description":"ICD-MBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWF1","description":"ICD-LGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-81515","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","description":"CPT-81515","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ complete joint (ie_ joint space and peri-articular soft tissue structures) real-time with image documentation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76881","description":"Ultrasound_ complete joint (ie_ joint space and peri-articular soft tissue structures) real-time with image documentation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis equipment noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1699","description":"Dialysis equipment noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNA0","description":"ICD-BBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEE0","description":"ICD-BHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Retinal prosth int/ext comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1841","description":"Retinal prosth int/ext comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens lenticular bifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2115","description":"Lens lenticular bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infect disease (bact)_ DNA_ 27 resistance genes_ PCR amplification and probe hybridization in microarray format (molecular detection and identification of AmpC_ carbapenemas)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0004U","description":"Infect disease (bact)_ DNA_ 27 resistance genes_ PCR amplification and probe hybridization in microarray format (molecular detection and identification of AmpC_ carbapenemas)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTD1","description":"ICD-IBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUF0","description":"ICD-IAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ob us limited fetus(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76815","description":"Ob us limited fetus(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove hip pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15945","description":"Remove hip pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic Removal Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0679T","description":"Laparoscopic Removal Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQE1","description":"ICD-CCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVB1","description":"ICD-OBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Imm admin by intramusc inj of (SARS-CoV-2) (coronavirus disease [COVID-19]) vacc_ mRNA-LNP_ spike protein_ preserv free_ 30mcg/0.3 mL dose_ tris-sucrose formula_ booster dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0054A","description":"Imm admin by intramusc inj of (SARS-CoV-2) (coronavirus disease [COVID-19]) vacc_ mRNA-LNP_ spike protein_ preserv free_ 30mcg/0.3 mL dose_ tris-sucrose formula_ booster dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contact layer >16<= 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6207","description":"Contact layer >16<= 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Us exam abdo back wall lim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76775","description":"Us exam abdo back wall lim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFC0","description":"ICD-BGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Idet 1 or more levels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22527","description":"Idet 1 or more levels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGED0","description":"ICD-NGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cannabinoids synthetic 4-6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80351","description":"Cannabinoids synthetic 4-6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBME1","description":"ICD-KBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPB1","description":"ICD-CCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEB1","description":"ICD-OLEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALD1","description":"ICD-JALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJC0","description":"ICD-KFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMC1","description":"ICD-OJMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQF0","description":"ICD-CDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of bile ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47700","description":"Exploration of bile ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4BC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BC11","description":"ICD-4BC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBA0","description":"ICD-GEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extra ambulance attendant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0424","description":"Extra ambulance attendant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1034","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","description":"HCPCS-E1034","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHA0","description":"ICD-ABHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUE0","description":"ICD-ODUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBE1","description":"ICD-FCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"W/c dpth 22-25 in seat frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2343","description":"W/c dpth 22-25 in seat frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAE0","description":"ICD-AIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVD0","description":"ICD-FHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVA0","description":"ICD-GIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSA1","description":"ICD-GGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0103","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0103","description":"HCPCS-A0103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE260","description":"Reduced Physical Function _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXF0","description":"ICD-BEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No admit req surg rev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9413","description":"No admit req surg rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht leg splnt plstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4045","description":"Cast sup sht leg splnt plstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of nail bed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11762","description":"Reconstruction of nail bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4356","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","description":"HCPCS-Q4356","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTB1","description":"ICD-AGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILE0","description":"ICD-AILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUD0","description":"ICD-GEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKF0","description":"ICD-BHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rehabilitative support for musculoskeletal care mips value pathway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1370","description":"Rehabilitative support for musculoskeletal care mips value pathway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Test urine urobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84578","description":"Test urine urobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIB0","description":"ICD-KEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLB1","description":"ICD-JHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hep c scrng docd as done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3514F","description":"Hep c scrng docd as done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Limited ankle motion ea jnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2200","description":"Limited ankle motion ea jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOF0","description":"ICD-LCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auto test panel pricing code 13-16 test","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP16","description":"Auto test panel pricing code 13-16 test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAB1","description":"ICD-OJAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Qty act card prev mg perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9677","description":"Qty act card prev mg perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup body cast plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4001","description":"Cast sup body cast plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRF0","description":"ICD-PBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical_ esophageal sphincter augmentation procedure_ placement of sphincter augmentation device (ie_ magnetic band)_ including cruroplasty when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43284","description":"Laparoscopy_ surgical_ esophageal sphincter augmentation procedure_ placement of sphincter augmentation device (ie_ magnetic band)_ including cruroplasty when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFE1","description":"ICD-NLFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQD0","description":"ICD-GFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUA1","description":"ICD-ECUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0681","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","description":"HCPCS-G0681","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDE0","description":"ICD-KCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWD1","description":"ICD-DGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHB1","description":"ICD-NDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIC1","description":"ICD-JDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56640","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX22","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N block inj celiac pelus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64530","description":"N block inj celiac pelus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNF1","description":"ICD-FHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inhaled bronchodilator rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4025F","description":"Inhaled bronchodilator rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILE0","description":"ICD-GILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Measure kidney pressure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50396","description":"Measure kidney pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB43","description":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor viii reltd antgn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85244","description":"Clot factor viii reltd antgn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUA1","description":"ICD-KHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tissue culture lymphocyte","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88230","description":"Tissue culture lymphocyte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMD1","description":"ICD-MGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNC0","description":"ICD-BDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXC0","description":"ICD-BCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMC0","description":"ICD-NFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ganciclovir sodium (exela) not therapeutically equivalent to j1570_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1574","description":"Injection_ ganciclovir sodium (exela) not therapeutically equivalent to j1570_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30200","description":"Injection treatment of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0967T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","description":"CPT-0967T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB32","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITC1","description":"ICD-MITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE15D","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trb@ gene rearrange dirprobe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81341","description":"Trb@ gene rearrange dirprobe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB13D","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDED0","description":"ICD-FDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0301","description":"HCPCS-B0301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft hand/foot >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64896","description":"Nerve graft hand/foot >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINF1","description":"ICD-BINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopathology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88199","description":"Cytopathology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB117","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2IB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IB31","description":"ICD-2IB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pulm fx w/in 12 mon b/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3038F","description":"Pulm fx w/in 12 mon b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECF1","description":"ICD-NECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vendaje_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4252","description":"Vendaje_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Minimally invasive direct co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2208","description":"Minimally invasive direct co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96935","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed fx ht w/o rail w/o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0291","description":"Hosp bed fx ht w/o rail w/o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLF1","description":"ICD-BHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVA0","description":"ICD-CDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCD0","description":"ICD-CFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unscheduled dressing change","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4920","description":"Unscheduled dressing change","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCB0","description":"ICD-MDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA4B","description":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBB0","description":"ICD-NJBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYC0","description":"ICD-PKYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fresh frozen plasma_ high titer COVID-19 convalescent_ frozen within 8 hours of collection_ each unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9507","description":"Fresh frozen plasma_ high titer COVID-19 convalescent_ frozen within 8 hours of collection_ each unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTC0","description":"ICD-AFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert tray w/o bag/cath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4310","description":"Insert tray w/o bag/cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMD1","description":"ICD-MKMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infliximab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80230","description":"Infliximab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of g6pd enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82955","description":"Assay of g6pd enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98013","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","description":"CPT-98013","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tens two lead","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0720","description":"Tens two lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUE0","description":"ICD-GGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNB0","description":"ICD-KGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUB0","description":"ICD-KEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEA1","description":"ICD-OAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABA0","description":"ICD-MABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Birthing class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9442","description":"Birthing class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAB0","description":"ICD-BEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDC0","description":"ICD-FIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap remove rectum w/pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45397","description":"Lap remove rectum w/pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUB0","description":"ICD-NKUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anal stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46705","description":"Repair of anal stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/o coronary artery stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4562F","description":"Pt w/o coronary artery stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release of toe joint each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28272","description":"Release of toe joint each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMA0","description":"ICD-JEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWB0","description":"ICD-DEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXC0","description":"ICD-GFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOE1","description":"ICD-OCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJB0","description":"ICD-OJJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYA1","description":"ICD-OGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vbac delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59610","description":"Vbac delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML10","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMD0","description":"ICD-KEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPF0","description":"ICD-CIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANC0","description":"ICD-NANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYA0","description":"ICD-GBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL60","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD20D","description":"Clinically Complex _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0301","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0301","description":"CDT-D0301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prescribed anticoagulant medication during the performance period_ history of GI bleeding_ history of intracranial bleeding_ bl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1056","description":"Prescribed anticoagulant medication during the performance period_ history of GI bleeding_ history of intracranial bleeding_ bl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sps wrist device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1806","description":"Sps wrist device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L1557","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1557","description":"HCPCS-L1557","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26356","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTB0","description":"ICD-BHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduce testis torsion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54600","description":"Reduce testis torsion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQD0","description":"ICD-HDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct colonography screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74263","description":"Ct colonography screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCF0","description":"ICD-OLCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUF0","description":"ICD-ACUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient not eligible due to active diagnosis of hypertension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1290","description":"Patient not eligible due to active diagnosis of hypertension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBE1","description":"ICD-MFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHF1","description":"ICD-ADHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEF1","description":"ICD-FFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES33D","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ef spec metabolic noninherit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4154","description":"Ef spec metabolic noninherit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; Unmonitored","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95705","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; Unmonitored","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of bladder/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51800","description":"Revision of bladder/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHD1","description":"ICD-BAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heart muscle imaging (pet)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78459","description":"Heart muscle imaging (pet)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQC1","description":"ICD-PAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove radius bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24136","description":"Remove radius bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breast tomosynthesis uni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77061","description":"Breast tomosynthesis uni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUB1","description":"ICD-OCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJA0","description":"ICD-BEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNC1","description":"ICD-NJNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chct for mal hyperthermia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89049","description":"Chct for mal hyperthermia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIE1","description":"ICD-NFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHD1","description":"ICD-EIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAF1","description":"ICD-NJAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISE1","description":"ICD-HISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8D","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYA0","description":"ICD-HAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANB0","description":"ICD-BANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0404","description":"HCPCS-B0404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTD1","description":"ICD-CDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSD1","description":"ICD-OKSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBA1","description":"ICD-EIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPE1","description":"ICD-BIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUE0","description":"ICD-MEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE10D","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/sac fb remove","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32658","description":"Thoracoscopy w/sac fb remove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLF0","description":"ICD-NGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSD1","description":"ICD-LFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAF1","description":"ICD-EDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOF1","description":"ICD-OHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ureter endoscopy & biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50955","description":"Ureter endoscopy & biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1436","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","description":"HCPCS-M1436","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"G-esoph reflx tst w/electrod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91035","description":"G-esoph reflx tst w/electrod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fungus isolation culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87102","description":"Fungus isolation culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB145","description":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIA1","description":"ICD-CFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ sculptra_ 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2028","description":"Inj_ sculptra_ 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39000","description":"Exploration of chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXC1","description":"ICD-NGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Soft protect helmet prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A8000","description":"Soft protect helmet prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18C","description":"Special Care High _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPC1","description":"ICD-OBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE12B","description":"Special Care Low _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMC0","description":"ICD-OJMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00402","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00402","description":"CPT-00402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical exposure of root surface without apicoectomy or repair of root resorption - anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3501","description":"Surgical exposure of root surface without apicoectomy or repair of root resorption - anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"H pylori (c-13) blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83009","description":"H pylori (c-13) blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTF0","description":"ICD-EGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive surgery of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42844","description":"Extensive surgery of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANF0","description":"ICD-KANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of hip tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27006","description":"Incision of hip tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/thymus resect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32673","description":"Thoracoscopy w/thymus resect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC33","description":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEE1","description":"ICD-ACEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Custom grad glove med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8425","description":"Custom grad glove med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; intercalary_ complete (ie_ cylindrical) (List separately in addition to code for prim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20934","description":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; intercalary_ complete (ie_ cylindrical) (List separately in addition to code for prim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFC1","description":"ICD-GFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB14A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Influenza imm order/admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4037F","description":"Influenza imm order/admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYF1","description":"ICD-PIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMA1","description":"ICD-GGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/o 3+ post-opnausea&vom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4557F","description":"Pt w/o 3+ post-opnausea&vom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amphotericin b lipid complex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0287","description":"Amphotericin b lipid complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITE0","description":"ICD-MITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Work related disability exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99455","description":"Work related disability exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXF0","description":"ICD-GDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHA0","description":"ICD-JDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE25C","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJA1","description":"ICD-BGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ bin_ ite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5260","description":"Hearing aid_ digit_ bin_ ite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nail plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11730","description":"Removal of nail plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYB1","description":"ICD-GHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAND1","description":"ICD-KAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Us guide intraop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76998","description":"Us guide intraop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCD1","description":"ICD-MBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prev visit est age 18-39","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99395","description":"Prev visit est age 18-39","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBA1","description":"ICD-IHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSA0","description":"ICD-OGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trim nail(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0127","description":"Trim nail(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intravascular ultrasound (non-coronary vessel)_ radiological supervision and interpretation; each additional non-coronary vessel (list separately in addition to c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75946","description":"Intravascular ultrasound (non-coronary vessel)_ radiological supervision and interpretation; each additional non-coronary vessel (list separately in addition to c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA02","description":"Very High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Debridement_ bone (includes epidermis_ dermis_ subcutaneous tissue_ muscle and/or fascia_ if performed); first 20 sq cm or less with manual preparation and insertion of drug-d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7561","description":"Debridement_ bone (includes epidermis_ dermis_ subcutaneous tissue_ muscle and/or fascia_ if performed); first 20 sq cm or less with manual preparation and insertion of drug-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0513U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","description":"CPT-0513U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eye surgery follow-up add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67331","description":"Eye surgery follow-up add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTF1","description":"ICD-CBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of toes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28280","description":"Fusion of toes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAC0","description":"ICD-EFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1155","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35471","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRC1","description":"ICD-OKRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plasma_ frz between 8-24hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9059","description":"Plasma_ frz between 8-24hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat chest lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32215","description":"Treat chest lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection Nusinersen 0.1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9489","description":"Injection Nusinersen 0.1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ther behav svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2020","description":"Ther behav svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD21C","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMB0","description":"ICD-CCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIB0","description":"ICD-JCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUA0","description":"ICD-JAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB31","description":"Low Rehab_ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB4A","description":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excursion amplifier lever ty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6642","description":"Excursion amplifier lever ty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDC0","description":"ICD-KHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC235","description":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urinalysis glass test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81020","description":"Urinalysis glass test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHED1","description":"ICD-NHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HB11","description":"ICD-4HB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXF1","description":"ICD-GAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIC0","description":"ICD-CFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUD0","description":"ICD-OIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA26","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEA0","description":"ICD-EAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKD0","description":"ICD-FBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Polarization_ any lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2762","description":"Polarization_ any lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX36","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB214","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Certified translation or sign-language services per visit.","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9990","description":"Certified translation or sign-language services per visit.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of fluoride","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82735","description":"Assay of fluoride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPE0","description":"ICD-BIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPE1","description":"ICD-KFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBD1","description":"ICD-GIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit device repair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5036","description":"Hit device repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXC0","description":"ICD-NFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVA1","description":"ICD-NKVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPA1","description":"ICD-KGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap ing hernia repair init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49650","description":"Lap ing hernia repair init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKB1","description":"ICD-CFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mohs 1 stage t/a/l","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17313","description":"Mohs 1 stage t/a/l","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endo below knee alignable sy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5910","description":"Endo below knee alignable sy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALB1","description":"ICD-KALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDC0","description":"ICD-KBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEF0","description":"ICD-MCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eeg over 1 hour","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95813","description":"Eeg over 1 hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28G","description":"Special Care Low _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA and RNA)_ respiratory tract infection_ 17 bacteria_ 8 fungus_ 13 virus_ and 16 antibiotic-resistance genes_ multiplex amplified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0373U","description":"Infectious agent detection by nucleic acid (DNA and RNA)_ respiratory tract infection_ 17 bacteria_ 8 fungus_ 13 virus_ and 16 antibiotic-resistance genes_ multiplex amplified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKD1","description":"ICD-FEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRB1","description":"ICD-KBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSD1","description":"ICD-KFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open axillary/subclavian artery exposure for delivery of endovascular prosthesis by infraclavicular or supraclavicular incision_ unilateral (List separately in addition to cod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34715","description":"Open axillary/subclavian artery exposure for delivery of endovascular prosthesis by infraclavicular or supraclavicular incision_ unilateral (List separately in addition to cod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug test def 22+ classes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0483","description":"Drug test def 22+ classes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETA0","description":"ICD-NETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls repos perph cnula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33957","description":"Ecmo/ecls repos perph cnula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ infliximab-qbtx_ biosimilar_ (Ixifi)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5109","description":"Injection_ infliximab-qbtx_ biosimilar_ (Ixifi)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HEPATITIS BE ANTIGEN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87350","description":"IAAD IA HEPATITIS BE ANTIGEN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJA1","description":"ICD-FHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Brain Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1079","description":"Radiation Therapy For Brain Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cesarean birth class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9438","description":"Cesarean birth class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays lungs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75743","description":"Artery x-rays lungs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heroin metabolite","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80356","description":"Heroin metabolite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATC1","description":"ICD-MATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hyperthermia treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77620","description":"Hyperthermia treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous rf 1st vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36475","description":"Endovenous rf 1st vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKB0","description":"ICD-KGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMA0","description":"ICD-EIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCE1","description":"ICD-EBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21610","description":"Partial removal of rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIID0","description":"ICD-MIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYE0","description":"ICD-HDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"C-1 esterase_ berinert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0597","description":"C-1 esterase_ berinert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Speech therapy_ re-eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9152","description":"Speech therapy_ re-eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUA1","description":"ICD-EHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB206","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18F","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFC0","description":"ICD-KDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDE0","description":"ICD-OKDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPB1","description":"ICD-GFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on salivary glands_ including biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0113U","description":"Anesthesia for procedures on salivary glands_ including biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vinblastine sulfate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9360","description":"Vinblastine sulfate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1428","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","description":"HCPCS-M1428","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX5A","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFB1","description":"ICD-NJFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTA1","description":"ICD-MGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIB1","description":"ICD-CBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEC1","description":"ICD-JEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX24","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA GIARDIA","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87329","description":"IAAD IA GIARDIA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair bladder-vagina lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57330","description":"Repair bladder-vagina lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB12C","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCC0","description":"ICD-OFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOA0","description":"ICD-PJOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg 3.1-4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11604","description":"Exc tr-ext mal+marg 3.1-4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLE0","description":"ICD-ADLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJA1","description":"ICD-NJJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWA1","description":"ICD-KAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTE1","description":"ICD-NKTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCED0","description":"ICD-CCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDD0","description":"ICD-BEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAA1","description":"ICD-IBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCC0","description":"ICD-JDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNE0","description":"ICD-JDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt referral for ect docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4067F","description":"Pt referral for ect docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal monitor/interpret only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59051","description":"Fetal monitor/interpret only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHA1","description":"ICD-MDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBA0","description":"ICD-OCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKC1","description":"ICD-FEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Most recent tobacco status is not tobacco free","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9792","description":"Most recent tobacco status is not tobacco free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSD0","description":"ICD-OCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nursing facility care init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99304","description":"Nursing facility care init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Re-exploration of chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32120","description":"Re-exploration of chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious Disease_ Bacterial Vaginosis And Vaginitis_ Quantitative Real-Time Amplification Of Dna Markers For Gardnerella Vaginalis_ Atopobium Vaginae_ Megasphaera Type 1_ Ba","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81514","description":"Infectious Disease_ Bacterial Vaginosis And Vaginitis_ Quantitative Real-Time Amplification Of Dna Markers For Gardnerella Vaginalis_ Atopobium Vaginae_ Megasphaera Type 1_ Ba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAID0","description":"ICD-NAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of gastrostomy tube_ percutaneous_ includes removal_ when performed_ without imaging or endoscopic guidance; requiring revision of gastrostomy tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43763","description":"Replacement of gastrostomy tube_ percutaneous_ includes removal_ when performed_ without imaging or endoscopic guidance; requiring revision of gastrostomy tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTA0","description":"ICD-MFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fluorescein angiography and indocyanine-green angiography (includes multiframe imaging) performed at the same patient encounter with interpretation and report_ unilateral or b","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92242","description":"Fluorescein angiography and indocyanine-green angiography (includes multiframe imaging) performed at the same patient encounter with interpretation and report_ unilateral or b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal surg congen hernia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2400","description":"Fetal surg congen hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE14B","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKA1","description":"ICD-FCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay cyclosporine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80158","description":"Drug assay cyclosporine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYC1","description":"ICD-GCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIF1","description":"ICD-ICIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct angio abdominal arteries","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75635","description":"Ct angio abdominal arteries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLA1","description":"ICD-OHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWA0","description":"ICD-DCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29894","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal cancer)_ image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (CD3 and CD8 within tumor-stroma border","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0261U","description":"Oncology (colorectal cancer)_ image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (CD3 and CD8 within tumor-stroma border","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ammonia test strips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4774","description":"Ammonia test strips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of corneal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65450","description":"Treatment of corneal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap ablat uterine fibroids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0336T","description":"Lap ablat uterine fibroids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHE1","description":"ICD-ECHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBC1","description":"ICD-MKBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRA0","description":"ICD-GFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSF1","description":"ICD-DDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVF0","description":"ICD-CDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tofersen_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1304","description":"Injection_ tofersen_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Frozen ivf case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4016","description":"Frozen ivf case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAD0","description":"ICD-FCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPC0","description":"ICD-NAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLA0","description":"ICD-IFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSF1","description":"ICD-HGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMC0","description":"ICD-NEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSD0","description":"ICD-LBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMF0","description":"ICD-FHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVD0","description":"ICD-GIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise finger joint each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26135","description":"Revise finger joint each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lung transplant single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32851","description":"Lung transplant single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ovulation tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84830","description":"Ovulation tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1AA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AA31","description":"ICD-1AA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq vertebral augmentation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22513","description":"Perq vertebral augmentation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFE0","description":"ICD-CIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMA0","description":"ICD-EAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Frequency Ultrasonic Diathermy Treatment Device For Home Use_ Includes All Components And Accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1004","description":"Low Frequency Ultrasonic Diathermy Treatment Device For Home Use_ Includes All Components And Accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHA1","description":"ICD-BCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDE0","description":"ICD-BFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"3d-crt/imrt received","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4165F","description":"3d-crt/imrt received","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gingivectomy/plasty per toot","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4211","description":"Gingivectomy/plasty per toot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBC1","description":"ICD-KFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE115","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6199","description":"Implant procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHB0","description":"ICD-OJHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cranial cervical torticollis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0113","description":"Cranial cervical torticollis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB224","description":"Special Care Low _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery translocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33506","description":"Repair artery translocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1503","description":"HCPCS-B1503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDA0","description":"ICD-CGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCE0","description":"ICD-JHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic retrograde cholangiopancreatography (ercp) with biopsy_ single or multiple_ with endoscopic cannulation of papilla with direct visualization of pancreatic/common bi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7542","description":"Endoscopic retrograde cholangiopancreatography (ercp) with biopsy_ single or multiple_ with endoscopic cannulation of papilla with direct visualization of pancreatic/common bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-sterile gauze>16<=48 sq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6217","description":"Non-sterile gauze>16<=48 sq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDA0","description":"ICD-NGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQA0","description":"ICD-CGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIC0","description":"ICD-ABIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCF0","description":"ICD-ODCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bath tub rail floor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0242","description":"Bath tub rail floor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of cervix radical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57531","description":"Removal of cervix radical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKB0","description":"ICD-OFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Fluoroscopic Guidance_ Lumbar; First Le","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0627T","description":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Fluoroscopic Guidance_ Lumbar; First Le","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVA0","description":"ICD-GBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBB0","description":"ICD-KGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anti rheum drugthxpyrxd/gvn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4187F","description":"Anti rheum drugthxpyrxd/gvn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEE0","description":"ICD-FGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heparin neutralization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85525","description":"Heparin neutralization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special eye exam subsequent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92226","description":"Special eye exam subsequent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCME1","description":"ICD-KCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac rehab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93797","description":"Cardiac rehab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Graft hand or finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26416","description":"Graft hand or finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUD1","description":"ICD-EDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQC0","description":"ICD-KAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"O2 contents gas cubic ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8120","description":"O2 contents gas cubic ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIB0","description":"ICD-BIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18I","description":"Clinically Complex _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKD0","description":"ICD-OCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Self care goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8988","description":"Self care goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHE1","description":"ICD-FEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat metatarsal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28476","description":"Treat metatarsal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJE0","description":"ICD-GEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUB0","description":"ICD-JAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWD0","description":"ICD-GGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEA1","description":"ICD-BFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHC1","description":"ICD-AHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB256","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCB1","description":"ICD-IFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUF0","description":"ICD-NJUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35188","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62325","description":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBF1","description":"ICD-OIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTF0","description":"ICD-OJTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thermal Destruction Of Intraosseous Basivertebral Nerve_ Including All Imaging Guidance; Each Additional Vertebral Body_ Lumbar Or Sacral (List Separately In Addition To Code","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64629","description":"Thermal Destruction Of Intraosseous Basivertebral Nerve_ Including All Imaging Guidance; Each Additional Vertebral Body_ Lumbar Or Sacral (List Separately In Addition To Code","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARD1","description":"ICD-HARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1AB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AB11","description":"ICD-1AB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFF1","description":"ICD-NKFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI brain w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70558","description":"MRI brain w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYD1","description":"ICD-HHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flotufolastat f 18_ diagnostic_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9608","description":"Flotufolastat f 18_ diagnostic_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRA0","description":"ICD-LHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJID1","description":"ICD-OJID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIA1","description":"ICD-NGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hla i typing 1 antigen lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81374","description":"Hla i typing 1 antigen lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth blood vessel repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77051","description":"Anesth blood vessel repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAD0","description":"ICD-GCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHE1","description":"ICD-GHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJE0","description":"ICD-GBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI joint upr extr w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73223","description":"MRI joint upr extr w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove muti-comp penis pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54406","description":"Remove muti-comp penis pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tilt table locking hip sing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5270","description":"Tilt table locking hip sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Genital surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58999","description":"Genital surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exam of cervix w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57452","description":"Exam of cervix w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOF1","description":"ICD-OGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKD0","description":"ICD-NDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefotetan disodiu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0074","description":"Injection_ cefotetan disodiu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMD0","description":"ICD-MFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYB1","description":"ICD-KFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug Screen_ Other Than Chromatographic; Any Number Of Drug Classes_ By Clia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0434","description":"Drug Screen_ Other Than Chromatographic; Any Number Of Drug Classes_ By Clia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Visualization adjunct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9968","description":"Visualization adjunct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUC0","description":"ICD-IIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0549","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","description":"HCPCS-G0549","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy for aspiration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31515","description":"Laryngoscopy for aspiration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Njx tfrml eprl w/us cer/thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0228T","description":"Njx tfrml eprl w/us cer/thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC105","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMC1","description":"ICD-BCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ selective-cellular enhancement technique with interpretation (eg_ liquid-based slide preparation method)_ except cer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0830T","description":"Digitization of glass microscope slides for cytopathology_ selective-cellular enhancement technique with interpretation (eg_ liquid-based slide preparation method)_ except cer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray arms/legs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75822","description":"Vein x-ray arms/legs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25125","description":"Remove/graft forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVC0","description":"ICD-GDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUD1","description":"ICD-AFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATE1","description":"ICD-AATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove rectum w/reservoir","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45119","description":"Remove rectum w/reservoir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC154","description":"Special Care High _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTF0","description":"ICD-KFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX0B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASE0","description":"ICD-CASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAF1","description":"ICD-GBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUF1","description":"ICD-KHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBD0","description":"ICD-GFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA15B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGD0","description":"ICD-GBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCA1","description":"ICD-JBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar spine process addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0172T","description":"Lumbar spine process addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disease progn ra poor docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3475F","description":"Disease progn ra poor docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOC0","description":"ICD-HGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKF1","description":"ICD-JCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAC1","description":"ICD-JDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/balloon dilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45386","description":"Colonoscopy w/balloon dilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAF1","description":"ICD-IAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMC0","description":"ICD-MAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQC0","description":"ICD-GAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX15","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPC1","description":"ICD-OGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vitamin b12 injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3420","description":"Vitamin b12 injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICE1","description":"ICD-JICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNF1","description":"ICD-GFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0634U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0634U","description":"CPT-0634U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJB1","description":"ICD-GBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal)_ microRNA_ RT-PCR expression profiling of miR-31-3p_ formalin-fixed paraffin-embedded tissue_ algorithm reported as an expression score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0069U","description":"Oncology (colorectal)_ microRNA_ RT-PCR expression profiling of miR-31-3p_ formalin-fixed paraffin-embedded tissue_ algorithm reported as an expression score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood typing serologic abo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86900","description":"Blood typing serologic abo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair ing hernia sliding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49525","description":"Repair ing hernia sliding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fo pip dip no jt spr pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3927","description":"Fo pip dip no jt spr pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wc planar back cush wd>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2621","description":"Wc planar back cush wd>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hiv combination assay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0475","description":"Hiv combination assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ziprasidone mesylate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3486","description":"Ziprasidone mesylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHF0","description":"ICD-OFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct hrt w/3d image congen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75573","description":"Ct hrt w/3d image congen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMC0","description":"ICD-OIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVB0","description":"ICD-KFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mmr vaccine sc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90707","description":"Mmr vaccine sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBA1","description":"ICD-BFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFE0","description":"ICD-GFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rev artific disc addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0098T","description":"Rev artific disc addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0586T","description":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIF1","description":"ICD-BDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXE0","description":"ICD-CDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFE0","description":"ICD-BCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc med rsn no scr etoh use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9623","description":"Doc med rsn no scr etoh use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneumoc vac/admin/rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4040F","description":"Pneumoc vac/admin/rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGE1","description":"ICD-ODGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUF1","description":"ICD-OBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment with protocol modification administered by physician or other qualified health care professional with one patient; first 30 minutes of patient face","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0368T","description":"Adaptive behavior treatment with protocol modification administered by physician or other qualified health care professional with one patient; first 30 minutes of patient face","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dstrj neurofibromata xtnsv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0419T","description":"Dstrj neurofibromata xtnsv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEB0","description":"ICD-CFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00500","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00500","description":"CPT-00500","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRD0","description":"ICD-CBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEA1","description":"ICD-JGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBC1","description":"ICD-FCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUA0","description":"ICD-NKUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepb vacc 2 dose adolesc im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90743","description":"Hepb vacc 2 dose adolesc im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTF1","description":"ICD-GBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNE1","description":"ICD-OFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVD0","description":"ICD-NAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX53","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation; wit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7553","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation; wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth iridectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14751","description":"Anesth iridectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98972","description":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLE0","description":"ICD-ECLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDC1","description":"ICD-GHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Asthma mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8646","description":"Asthma mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rozanolixizumab-noli_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9333","description":"Injection_ rozanolixizumab-noli_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychoanalysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90845","description":"Psychoanalysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHE1","description":"ICD-IIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICD1","description":"ICD-FICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy prostatic imp 1-3","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9739","description":"Cystoscopy prostatic imp 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00730","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00730","description":"CPT-00730","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOC0","description":"ICD-PEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUC1","description":"ICD-AIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9276","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","description":"HCPCS-J9276","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mech remov tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36595","description":"Mech remov tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEC0","description":"ICD-NAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection(S)_ Anesthetic Agent(S) And/Or Steroid; Genicular Nerve Branches_ Including Imaging Guidance_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64454","description":"Injection(S)_ Anesthetic Agent(S) And/Or Steroid; Genicular Nerve Branches_ Including Imaging Guidance_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBB0","description":"ICD-BEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIE0","description":"ICD-NGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEF1","description":"ICD-NGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCB0","description":"ICD-MCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHF0","description":"ICD-NDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adjustable chair for esrd pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1570","description":"Adjustable chair for esrd pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWD1","description":"ICD-OEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of surface (transcutaneous) neurostimulator (eg_ TENS unit)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64550","description":"Application of surface (transcutaneous) neurostimulator (eg_ TENS unit)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEE0","description":"ICD-NDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy hand joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26100","description":"Biopsy hand joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vit for macular hole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67042","description":"Vit for macular hole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3387","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","description":"HCPCS-J3387","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAC1","description":"ICD-JFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPA1","description":"ICD-GGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAA1","description":"ICD-EFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neisseria meningitidis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86741","description":"Neisseria meningitidis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay aminolevulinic acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82135","description":"Assay aminolevulinic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXF0","description":"ICD-KIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sermorelin acetate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0515","description":"Sermorelin acetate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIC0","description":"ICD-EFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLE1","description":"ICD-ODLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUC1","description":"ICD-BGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion/graft of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25810","description":"Fusion/graft of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-99445","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","description":"CPT-99445","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMA0","description":"ICD-OBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBF0","description":"ICD-ODBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of psa complexed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84152","description":"Assay of psa complexed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor <22.05._comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0207","description":"Traumatic brain injury with Motor <22.05._comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXB1","description":"ICD-GHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implnt/abut remov dent max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6110","description":"Implnt/abut remov dent max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEF1","description":"ICD-MLEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMB0","description":"ICD-AFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMB1","description":"ICD-OJMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYD0","description":"ICD-GGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75451","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKF1","description":"ICD-FBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"vaccine administration-human papillomavirus - Dose 2","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1782","description":"vaccine administration-human papillomavirus - Dose 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fx growth plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27517","description":"Treat thigh fx growth plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Corneal smear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65430","description":"Corneal smear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKB1","description":"ICD-NKKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Next Generation ACO model_ 10-20min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9869","description":"Next Generation ACO model_ 10-20min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIB0","description":"ICD-AFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Upper extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93930","description":"Upper extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISF0","description":"ICD-HISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE110","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Cyclophosphamide_ (Auromedics)_ 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9087","description":"Injection_ Cyclophosphamide_ (Auromedics)_ 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat forearm bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25035","description":"Treat forearm bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18I","description":"Special Care High _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUD1","description":"ICD-BHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Puncture drainage of lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10160","description":"Puncture drainage of lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo radical prostatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55866","description":"Laparo radical prostatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB111","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL35","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPA0","description":"ICD-NGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGF0","description":"ICD-KBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rituximab-abbs_ biosimilar_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5115","description":"Injection_ rituximab-abbs_ biosimilar_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECB1","description":"ICD-NECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEB1","description":"ICD-OHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrizalent (ccIIV4)_ derived from cell cultures_ subunit_ antibiotic free_ 0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90756","description":"Influenza virus vaccine_ quadrizalent (ccIIV4)_ derived from cell cultures_ subunit_ antibiotic free_ 0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX52","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy bleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45317","description":"Proctosigmoidoscopy bleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTF0","description":"ICD-JGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADC0","description":"ICD-MADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leuprolide acetate suspnsion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9217","description":"Leuprolide acetate suspnsion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ob us >/= 14 wks sngl fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76805","description":"Ob us >/= 14 wks sngl fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mastectomy sleeve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8010","description":"Mastectomy sleeve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUD1","description":"ICD-JEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECC0","description":"ICD-CECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29879","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilate urethra stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53621","description":"Dilate urethra stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ copy number variants_ common variants with reflex to targeted sequence anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0028U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ copy number variants_ common variants with reflex to targeted sequence anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQA0","description":"ICD-CDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admin on the same date of service_ 16-30 minutes time Medicaid only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0311","description":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admin on the same date of service_ 16-30 minutes time Medicaid only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVB0","description":"ICD-NCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHE1","description":"ICD-KEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4386","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","description":"HCPCS-Q4386","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTF1","description":"ICD-BHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECD1","description":"ICD-AECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal leg bone(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27360","description":"Partial removal leg bone(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEC0","description":"ICD-GIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"2vhpv vaccine 3 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90650","description":"2vhpv vaccine 3 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVF1","description":"ICD-CHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat scor nek/ts pt no e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8673","description":"Fun stat scor nek/ts pt no e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Th/wght bear quad-lat brim m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2510","description":"Th/wght bear quad-lat brim m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCF1","description":"ICD-EHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19366","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ a","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX1C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spinal Puncture_ Lumbar_ Diagnostic; With Fluoroscopic Or Ct Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62328","description":"Spinal Puncture_ Lumbar_ Diagnostic; With Fluoroscopic Or Ct Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Intra-Articular (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20704","description":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Intra-Articular (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPE0","description":"ICD-CDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX15","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HB21","description":"ICD-2HB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLA1","description":"ICD-GGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11463","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00322","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00322","description":"CPT-00322","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMF0","description":"ICD-AHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUA0","description":"ICD-JGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revitalon 1 square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4157","description":"Revitalon 1 square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOB0","description":"ICD-DHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUC0","description":"ICD-EIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOE1","description":"ICD-GIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8E","description":"Medium Rehab _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6061","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HER2/neu negative or undocumented/unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9825","description":"HER2/neu negative or undocumented/unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1LB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LB31","description":"ICD-1LB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDB1","description":"ICD-NEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine lamina >2 thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63016","description":"Remove spine lamina >2 thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNF0","description":"ICD-GDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGD1","description":"ICD-GIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDA0","description":"ICD-ADDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Temp anchorage dev w flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7293","description":"Temp anchorage dev w flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDF1","description":"ICD-IHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lpn/lvn services up to 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1003","description":"Lpn/lvn services up to 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWC0","description":"ICD-GEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"corticotomy - one to three teeth or tooth spaces_ per quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7296","description":"corticotomy - one to three teeth or tooth spaces_ per quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVB1","description":"ICD-NCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQE0","description":"ICD-CDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQE1","description":"ICD-DFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJED0","description":"ICD-OJED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMC1","description":"ICD-KBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (hematolymphoid neoplasm)_ genomic sequence analysis using multiplex (PCR) and next-generation sequencing with algorithm_ quantification of dominant clonal sequence(s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0364U","description":"Oncology (hematolymphoid neoplasm)_ genomic sequence analysis using multiplex (PCR) and next-generation sequencing with algorithm_ quantification of dominant clonal sequence(s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUE0","description":"ICD-BDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVE0","description":"ICD-NCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUA1","description":"ICD-NHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIA0","description":"ICD-BGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insulin (lyumjev) for administration through dme (i.e._ insulin pump) per 50 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1813","description":"Insulin (lyumjev) for administration through dme (i.e._ insulin pump) per 50 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; venovenous collaterals originating at or above the he","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93587","description":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; venovenous collaterals originating at or above the he","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUD1","description":"ICD-EFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIB0","description":"ICD-ICIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16378","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16378","description":"CPT-16378","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alpha 1 proteinase inhibitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0256","description":"Alpha 1 proteinase inhibitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQB1","description":"ICD-GDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXE1","description":"ICD-KGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Body mass index docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3008F","description":"Body mass index docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC255","description":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lactation class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9443","description":"Lactation class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29899","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERD1","description":"ICD-CERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYE0","description":"ICD-HAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 16-18 under the MDPP Expanded Model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9883","description":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 16-18 under the MDPP Expanded Model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endothelial function assessment_ using peripheral vascular response to reactive hyperemia_ non-invasive (eg_ brachial artery ultrasound_ peripheral artery tonometry)_ unilater","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0337T","description":"Endothelial function assessment_ using peripheral vascular response to reactive hyperemia_ non-invasive (eg_ brachial artery ultrasound_ peripheral artery tonometry)_ unilater","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rehab system with interactive interface providing active assistance in rehabilitation therapy_ includes all components and accessories_ motors_ microprocessors_ sensors","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0739","description":"Rehab system with interactive interface providing active assistance in rehabilitation therapy_ includes all components and accessories_ motors_ microprocessors_ sensors","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVB0","description":"ICD-CFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ins cath ren art 1st unilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36251","description":"Ins cath ren art 1st unilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0682","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","description":"HCPCS-G0682","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ casirivimab and imdevimab_ 1200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0244","description":"Injection_ casirivimab and imdevimab_ 1200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEF1","description":"ICD-NKEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCA1","description":"ICD-BBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epidurography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72275","description":"Epidurography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWE1","description":"ICD-OLWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55150","description":"Removal of scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDF1","description":"ICD-IFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLB1","description":"ICD-OFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient has metastatic disease at diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9838","description":"Patient has metastatic disease at diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLF1","description":"ICD-EHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin stability screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83068","description":"Hemoglobin stability screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCB1","description":"ICD-FDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75860","description":"Vein x-ray neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOB0","description":"ICD-HFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00800","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00800","description":"CPT-00800","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIA0","description":"ICD-ACIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36014","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNE1","description":"ICD-BHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTE0","description":"ICD-JDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0972T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","description":"CPT-0972T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPD0","description":"ICD-ODPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transperineal placement of biodegradable material_ peri-prostatic_ single or multiple injection(s)_ including image guidance_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55874","description":"Transperineal placement of biodegradable material_ peri-prostatic_ single or multiple injection(s)_ including image guidance_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEB0","description":"ICD-JDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVA0","description":"ICD-NIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous arteriovenous fistula creation (AVF)_ direct_ any site_ by tissue approximation using thermal resistance e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2170","description":"Percutaneous arteriovenous fistula creation (AVF)_ direct_ any site_ by tissue approximation using thermal resistance e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWC1","description":"ICD-PHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Map tachycardia add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93609","description":"Map tachycardia add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0505","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0505","description":"HCPCS-B0505","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALD0","description":"ICD-OALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOD0","description":"ICD-LFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPF1","description":"ICD-GDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATD1","description":"ICD-FATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPE1","description":"ICD-BEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interprof phone/online 31/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99449","description":"Interprof phone/online 31/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g._ pregnancy_ history of angioedema to ace-i_ oth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1201","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g._ pregnancy_ history of angioedema to ace-i_ oth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Periodontal scaling & root","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4341","description":"Periodontal scaling & root","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOD0","description":"ICD-CAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB22A","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVB1","description":"ICD-OIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA241","description":"Clinically Complex _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXF0","description":"ICD-FFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX05","description":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPA1","description":"ICD-FEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPF0","description":"ICD-KDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HC31","description":"ICD-4HC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD12A","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUA1","description":"ICD-FEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWE1","description":"ICD-HIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGB0","description":"ICD-GCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICF0","description":"ICD-KICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1131","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28F","description":"Special Care High _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUF0","description":"ICD-GFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDE0","description":"ICD-ADDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exercise Test For Bronchospasm_ Including Pre- And Post-Spirometry And Pulse Oximetry; Without Electrocardiographic Recording(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94619","description":"Exercise Test For Bronchospasm_ Including Pre- And Post-Spirometry And Pulse Oximetry; Without Electrocardiographic Recording(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMF1","description":"ICD-JEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ corticotropin (Acthar Gel)_ up to 40 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0801","description":"Injection_ corticotropin (Acthar Gel)_ up to 40 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sub pt/ot current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8993","description":"Sub pt/ot current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cycler dialysis machine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1594","description":"Cycler dialysis machine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemorrhoidopexy by stapling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46947","description":"Hemorrhoidopexy by stapling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCF0","description":"ICD-NCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHA1","description":"ICD-GBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compounded drug not otherwise classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9977","description":"Compounded drug not otherwise classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ von Willebrand factor (recombinant)_ (Vonvendi)_ 1 IU VWF:RCo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7179","description":"Injection_ von Willebrand factor (recombinant)_ (Vonvendi)_ 1 IU VWF:RCo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIF0","description":"ICD-MBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Frenulotomy of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54164","description":"Frenulotomy of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRE0","description":"ICD-PBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood clot lysis time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85175","description":"Blood clot lysis time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKA0","description":"ICD-JBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ dinutuximab_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1246","description":"Injection_ dinutuximab_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOB0","description":"ICD-HEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETD0","description":"ICD-CETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Microsurgery add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69990","description":"Microsurgery add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No beta-lactam abx ther_ rng","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9560","description":"No beta-lactam abx ther_ rng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQB1","description":"ICD-GIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"In morphine preservativ free","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2274","description":"In morphine preservativ free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder_ each additional 15 minutes_ provided remotely by hospital staff who are licensed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7902","description":"Service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder_ each additional 15 minutes_ provided remotely by hospital staff who are licensed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Methotrexate oral 2.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8610","description":"Methotrexate oral 2.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJB0","description":"ICD-CEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Close bladder-uterus fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51920","description":"Close bladder-uterus fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDD0","description":"ICD-KGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUB0","description":"ICD-MEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYE0","description":"ICD-CEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJE1","description":"ICD-CEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair vagina/perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57210","description":"Repair vagina/perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy salpingostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58673","description":"Laparoscopy salpingostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Limited dental tx primary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8010","description":"Limited dental tx primary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical exposure of root surface without apicoectomy or repair of root resorption - premolar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3502","description":"Surgical exposure of root surface without apicoectomy or repair of root resorption - premolar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUA1","description":"ICD-ICUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIF1","description":"ICD-JIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Maternity care procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59899","description":"Maternity care procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC101","description":"Clinically Complex _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of tobramycin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80200","description":"Assay of tobramycin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACF1","description":"ICD-NACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx colon extent unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9089","description":"Onc dx colon extent unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intens cardiac rehab no exer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0423","description":"Intens cardiac rehab no exer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ondansetron oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0162","description":"Ondansetron oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBF0","description":"ICD-FGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"W/c medial thigh support","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0957","description":"W/c medial thigh support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVF0","description":"ICD-CFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kyphosis pad floating","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1025","description":"Kyphosis pad floating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcyl trifocal over 12","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2314","description":"Lens sphcyl trifocal over 12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sincalide (maia) not therapeutically equivalent to j2805_ 5 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2806","description":"Injection_ sincalide (maia) not therapeutically equivalent to j2805_ 5 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA0A","description":"Medium Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEA0","description":"ICD-EGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXD1","description":"ICD-OIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUD1","description":"ICD-NFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBE0","description":"ICD-GHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cyclophosphamide oral 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8530","description":"Cyclophosphamide oral 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilate biliary duct/ampulla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47542","description":"Dilate biliary duct/ampulla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee Ankle Foot Device_ Any Material_ Single Or Double Upright_ Swing And/Or Stance Phase Microprocessor Control With Adjustability_ Includes All Components (E.G._ Sensors_ Ba","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2006","description":"Knee Ankle Foot Device_ Any Material_ Single Or Double Upright_ Swing And/Or Stance Phase Microprocessor Control With Adjustability_ Includes All Components (E.G._ Sensors_ Ba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental sealant per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1351","description":"Dental sealant per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv trunk musc 6/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64647","description":"Chemodenerv trunk musc 6/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWE0","description":"ICD-PKWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct scan for therapy guide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77014","description":"Ct scan for therapy guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Family adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0370T","description":"Family adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAME1","description":"ICD-EAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat vaginal bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57180","description":"Treat vaginal bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSB1","description":"ICD-GFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLA1","description":"ICD-GCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Other power whlchr base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0014","description":"Other power whlchr base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEA0","description":"ICD-MDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUA0","description":"ICD-IHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDC0","description":"ICD-MLDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ranitidine hydrochloride inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2780","description":"Ranitidine hydrochloride inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUE1","description":"ICD-OLUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKE0","description":"ICD-JFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIF1","description":"ICD-CCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAA1","description":"ICD-FFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic mammography_ including computer-aided detection (CAD) when performed; bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77066","description":"Diagnostic mammography_ including computer-aided detection (CAD) when performed; bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00320","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00320","description":"CPT-00320","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDA0","description":"ICD-MGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit enteral grav diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9341","description":"Hit enteral grav diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repl bat t.e.n.s. own by pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4630","description":"Repl bat t.e.n.s. own by pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78499","description":"Cardiovascular nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documented medical reasons for not performing intraoperative cystoscopy (e.g._ urethral pathology precluding cystoscopy_ any patient who has a congenital or acquired absence o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9607","description":"Documented medical reasons for not performing intraoperative cystoscopy (e.g._ urethral pathology precluding cystoscopy_ any patient who has a congenital or acquired absence o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28E","description":"Special Care Low _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGA0","description":"ICD-BFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEA1","description":"ICD-KCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Follow-up recommendations according to recommended guidelines for incidentally detected pulmonary nodules not documented due to medical reasons (eg_patients with malignant)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9346","description":"Follow-up recommendations according to recommended guidelines for incidentally detected pulmonary nodules not documented due to medical reasons (eg_patients with malignant)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKE1","description":"ICD-JDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJC1","description":"ICD-OLJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGE1","description":"ICD-GEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice refer visit nonmd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0255","description":"Hospice refer visit nonmd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB114","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4372","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","description":"HCPCS-Q4372","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of stomach and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43820","description":"Fusion of stomach and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent leadless pacemaker_ right ventricular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33275","description":"Transcatheter removal of permanent leadless pacemaker_ right ventricular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Virtual reality (VR) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic servi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0772T","description":"Virtual reality (VR) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic servi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC246","description":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ra measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8490","description":"Ra measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Pan Tumor)_ Whole Genome Optical Genome Mapping Of Paired Malignant And Normal Dna Specimens_ Fresh Frozen Tissue_ Blood_ Or Bone Marrow_ Comparative Structural Vari","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0299U","description":"Oncology (Pan Tumor)_ Whole Genome Optical Genome Mapping Of Paired Malignant And Normal Dna Specimens_ Fresh Frozen Tissue_ Blood_ Or Bone Marrow_ Comparative Structural Vari","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTE1","description":"ICD-ODTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEID1","description":"ICD-IEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFB1","description":"ICD-FGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJB0","description":"ICD-NDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHA1","description":"ICD-KEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGF1","description":"ICD-BIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Copd measures group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8898","description":"Copd measures group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUD0","description":"ICD-EAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFC1","description":"ICD-NDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJA1","description":"ICD-NHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJF0","description":"ICD-KAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYB1","description":"ICD-HBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4GB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GB11","description":"ICD-4GB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLE0","description":"ICD-ACLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31365","description":"Removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMD0","description":"ICD-GDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 19-21 under the MDPP Expanded Model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9884","description":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 19-21 under the MDPP Expanded Model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOA1","description":"ICD-LEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHID1","description":"ICD-JHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62322","description":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ casimersen_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9075","description":"Injection_ casimersen_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBD0","description":"ICD-MEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQD0","description":"ICD-DHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYB0","description":"ICD-PJYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27514","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDA0","description":"ICD-CDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNB1","description":"ICD-OCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lefamulin_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0691","description":"Injection_ lefamulin_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pessary_ disposable_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4564","description":"Pessary_ disposable_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4FC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FC31","description":"ICD-4FC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGC1","description":"ICD-NBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJB1","description":"ICD-KFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOB1","description":"ICD-HIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUF1","description":"ICD-JHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATF0","description":"ICD-BATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Add joint upper ext orthosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3956","description":"Add joint upper ext orthosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leuprolide acetate implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9219","description":"Leuprolide acetate implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prosthesis_ penile_ inflatab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1813","description":"Prosthesis_ penile_ inflatab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFF1","description":"ICD-JCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Initial psychiatric collaborative care management_ first 70 minutes in the first calendar month of behavioral health care manager activities_ in consultation with a psychiatri","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99492","description":"Initial psychiatric collaborative care management_ first 70 minutes in the first calendar month of behavioral health care manager activities_ in consultation with a psychiatri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foot insert silicone gel eac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3003","description":"Foot insert silicone gel eac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITB0","description":"ICD-FITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVB1","description":"ICD-OJVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0407","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0407","description":"HCPCS-A0407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Toe joint transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26556","description":"Toe joint transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDC0","description":"ICD-OHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemotherapy into cns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96450","description":"Chemotherapy into cns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC03","description":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC124","description":"Clinically Complex _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ef hydrolyzed/amino acids","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4153","description":"Ef hydrolyzed/amino acids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36800","description":"Insertion of cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXC0","description":"ICD-NJXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interferential stim 2 chan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8130","description":"Interferential stim 2 chan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD23C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spacer bag/reservoir","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4627","description":"Spacer bag/reservoir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fremanezumab-vfrm_ 1 mg (code may be used for Medicare when drug administered under the direct supervision of a physician_ not for use when drug is self-administere","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3031","description":"Injection_ fremanezumab-vfrm_ 1 mg (code may be used for Medicare when drug administered under the direct supervision of a physician_ not for use when drug is self-administere","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFC1","description":"ICD-OAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Manipulation of spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22505","description":"Manipulation of spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAD0","description":"ICD-CGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHF0","description":"ICD-AIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33781","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0934T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","description":"CPT-0934T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHF0","description":"ICD-GIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31075","description":"Exploration of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coronary artery bypass/reop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33530","description":"Coronary artery bypass/reop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOE1","description":"ICD-PGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pancreas surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48999","description":"Pancreas surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWC1","description":"ICD-CDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMB0","description":"ICD-FFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8C","description":"High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ACApatch_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4325","description":"ACApatch_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOE1","description":"ICD-KIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEC0","description":"ICD-GGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHA0","description":"ICD-OGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKA0","description":"ICD-CEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLC1","description":"ICD-KHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKE1","description":"ICD-CFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQE1","description":"ICD-DEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2361","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2361","description":"HCPCS-J2361","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVA0","description":"ICD-KFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPD1","description":"ICD-BGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBB1","description":"ICD-MLBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFB0","description":"ICD-CHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLC1","description":"ICD-MDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSE0","description":"ICD-GCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGF0","description":"ICD-NEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDA1","description":"ICD-GCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRD0","description":"ICD-KBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD112","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sbsq nb em per day hosp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99462","description":"Sbsq nb em per day hosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of diaphragm hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39540","description":"Repair of diaphragm hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQF0","description":"ICD-HAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); duplication/deletion variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81363","description":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); duplication/deletion variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYF0","description":"ICD-KCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Management of a new patient with dementia_ moderate to high complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0523","description":"Management of a new patient with dementia_ moderate to high complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0933T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","description":"CPT-0933T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDED1","description":"ICD-NDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTE1","description":"ICD-ABTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGF1","description":"ICD-OHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAD1","description":"ICD-OJAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Furnsh initial orthosis only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1200","description":"Furnsh initial orthosis only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOE1","description":"ICD-ODOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDC1","description":"ICD-BBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPD1","description":"ICD-FIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral periapical first f","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0220","description":"Intraoral periapical first f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Imp/abut fixed dent part max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6116","description":"Imp/abut fixed dent part max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB14C","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTB0","description":"ICD-MGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat fx radial 3+ frag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25609","description":"Treat fx radial 3+ frag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skilled Nursing Facility Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4033","description":"Skilled Nursing Facility Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Toe loop/holder_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0952","description":"Toe loop/holder_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD154","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Below elbow myoelectronic ct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6935","description":"Below elbow myoelectronic ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUF0","description":"ICD-MLUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEC0","description":"ICD-CGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXD1","description":"ICD-NLXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Water circ cold pad w pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0218","description":"Water circ cold pad w pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Self-Measured Blood Pressure Using A Device Validated For Clinical Accuracy; Separate Self-Measurements Of Two Readings One Minute Apart_ Twice Daily Over A 30-Day Period (Min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99474","description":"Self-Measured Blood Pressure Using A Device Validated For Clinical Accuracy; Separate Self-Measurements Of Two Readings One Minute Apart_ Twice Daily Over A 30-Day Period (Min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Upper gi endo shows barrtts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3140F","description":"Upper gi endo shows barrtts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45346","description":"Sigmoidoscopy w/ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGE1","description":"ICD-CGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor >26.15 & Motor <30.05._without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0107","description":"Stroke with Motor >26.15 & Motor <30.05._without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlso 2mod symphis-xipho pre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0458","description":"Tlso 2mod symphis-xipho pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB46","description":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIB0","description":"ICD-MDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAF1","description":"ICD-OAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX0A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOC1","description":"ICD-PDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKD0","description":"ICD-OKKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKC1","description":"ICD-OBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEC0","description":"ICD-BDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJC1","description":"ICD-BBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAE0","description":"ICD-EDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB0A","description":"Medium Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59856","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUE1","description":"ICD-OGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove pharynx foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42809","description":"Remove pharynx foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXD0","description":"ICD-FHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1946","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1946","description":"HCPCS-J1946","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt tlk psych & rx opd addic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4306F","description":"Pt tlk psych & rx opd addic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Whlchr special size/constrc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1220","description":"Whlchr special size/constrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBED1","description":"ICD-KBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt/caregiver queried falls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6080F","description":"Pt/caregiver queried falls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA11C","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Duplicate/copy patient_s records","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9961","description":"Duplicate/copy patient_s records","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPF1","description":"ICD-NBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28E","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67923","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIB0","description":"ICD-EHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood collection tube/vacuum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4770","description":"Blood collection tube/vacuum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLB1","description":"ICD-BDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB45","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTB0","description":"ICD-MJTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWB1","description":"ICD-GIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBD1","description":"ICD-FHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct abd & pelv w/contrast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74177","description":"Ct abd & pelv w/contrast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLC1","description":"ICD-FHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Balloon dilate urtrl strix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50706","description":"Balloon dilate urtrl strix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABE1","description":"ICD-GABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRE0","description":"ICD-OFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNE0","description":"ICD-FBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUE0","description":"ICD-CIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LB21","description":"ICD-4LB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJE1","description":"ICD-BBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVD0","description":"ICD-CIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0676","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0676","description":"HCPCS-G0676","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1448","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","description":"HCPCS-M1448","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGC1","description":"ICD-CDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter tricuspid valve annulus reconstruction with implantation of adjustable annulus reconstruction device_ percutaneous approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0545T","description":"Transcatheter tricuspid valve annulus reconstruction with implantation of adjustable annulus reconstruction device_ percutaneous approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneumococcal Vaccine Administered On Or After Patient_S 60Th Birthday And Before The End Of The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9991","description":"Pneumococcal Vaccine Administered On Or After Patient_S 60Th Birthday And Before The End Of The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEED0","description":"ICD-CEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX52","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPA1","description":"ICD-KFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plating chrome/nickel pr bar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2750","description":"Plating chrome/nickel pr bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lenticular lens_ single","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2121","description":"Lenticular lens_ single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient not screened for unhealthy alcohol use using a systematic screening method_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2199","description":"Patient not screened for unhealthy alcohol use using a systematic screening method_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chest surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32999","description":"Chest surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRA1","description":"ICD-LGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Care management services for behavioral health conditions_ at least 20 minutes of clinical staff time_ directed by a physician or other qualified health care professional_ per","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99484","description":"Care management services for behavioral health conditions_ at least 20 minutes of clinical staff time_ directed by a physician or other qualified health care professional_ per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBD0","description":"ICD-ODBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter_ intraspinal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1755","description":"Catheter_ intraspinal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERA0","description":"ICD-KERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ost skn barrier sld ext wear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4385","description":"Ost skn barrier sld ext wear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQA0","description":"ICD-LHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore inner ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69805","description":"Explore inner ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin sys hydraul stance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5848","description":"Knee-shin sys hydraul stance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATE1","description":"ICD-EATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Osteot hum xtrnl lngth dev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0594T","description":"Osteot hum xtrnl lngth dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tx gastro intub w/asp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43753","description":"Tx gastro intub w/asp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI upper extremity w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73218","description":"MRI upper extremity w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIE1","description":"ICD-EIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01480","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01480","description":"CPT-01480","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUD0","description":"ICD-AFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54120","description":"Partial removal of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIB0","description":"ICD-CBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0482U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","description":"CPT-0482U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lincomycin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2010","description":"Lincomycin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDE0","description":"ICD-IDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX44","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQF0","description":"ICD-OGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPF1","description":"ICD-OBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair bearings","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2210","description":"Wheelchair bearings","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dent anesthesia w/o surgery","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9210","description":"Dent anesthesia w/o surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSA1","description":"ICD-DDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEE0","description":"ICD-GCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYC0","description":"ICD-OCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDF0","description":"ICD-FIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACA1","description":"ICD-IACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCE1","description":"ICD-NBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMF1","description":"ICD-OJMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRD1","description":"ICD-GBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93621","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEA1","description":"ICD-JCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTF1","description":"ICD-GGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of anterior segment aqueous drainage device_ with creation of intraocular reservoir_ internal approach_ into the supraciliary space","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0474T","description":"Insertion of anterior segment aqueous drainage device_ with creation of intraocular reservoir_ internal approach_ into the supraciliary space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytotoxic antibody screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86807","description":"Cytotoxic antibody screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pontic titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6214","description":"Pontic titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAB1","description":"ICD-JAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOE1","description":"ICD-CCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostoma hmes filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7504","description":"Tracheostoma hmes filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDB1","description":"ICD-FIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23525","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAD0","description":"ICD-FHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (asceniv)_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9072","description":"Injection_ immune globulin (asceniv)_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ evaluation of fine needle aspirate; interpretation and report (List separately in addition to code for primary proce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0837T","description":"Digitization of glass microscope slides for cytopathology_ evaluation of fine needle aspirate; interpretation and report (List separately in addition to code for primary proce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUF1","description":"ICD-EIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA14A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICB0","description":"ICD-EICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUF1","description":"ICD-NEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hep a/hep b vacc adult im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90636","description":"Hep a/hep b vacc adult im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVB0","description":"ICD-KGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQC0","description":"ICD-PGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laser inc for pkp/lkp donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0289T","description":"Laser inc for pkp/lkp donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHC0","description":"ICD-NLHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove part thorax vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22101","description":"Remove part thorax vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00147","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00147","description":"CPT-00147","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5278","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Physical Medicine Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4025","description":"Physical Medicine Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUF1","description":"ICD-AEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOB1","description":"ICD-DBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esrd serv 4 vsts p mo 2-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90954","description":"Esrd serv 4 vsts p mo 2-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCA0","description":"ICD-FHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHA1","description":"ICD-EGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCA0","description":"ICD-MHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood typing patient serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86904","description":"Blood typing patient serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAC0","description":"ICD-EIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWE0","description":"ICD-CEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWC0","description":"ICD-CAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUB1","description":"ICD-NDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEE1","description":"ICD-NCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDB0","description":"ICD-MKDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0168","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","description":"HCPCS-J0168","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICD0","description":"ICD-JICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLD0","description":"ICD-JHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pegademase bovine_ 25 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2504","description":"Pegademase bovine_ 25 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0901","description":"HCPCS-B0901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28F","description":"Special Care Low _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQE0","description":"ICD-LCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIC0","description":"ICD-MBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oseltamivir phosp_ brand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9035","description":"Oseltamivir phosp_ brand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWB0","description":"ICD-OGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRA0","description":"ICD-LFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFD0","description":"ICD-CFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAB1","description":"ICD-CDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg 1.1-2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11442","description":"Exc face-mm b9+marg 1.1-2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26720","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj levocarnitine per 1 gm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1955","description":"Inj levocarnitine per 1 gm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOD1","description":"ICD-PAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL01","description":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis procedure with single evaluation by a physician or other qualified health care professional for acute kidney injury without ESRD","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0492","description":"Dialysis procedure with single evaluation by a physician or other qualified health care professional for acute kidney injury without ESRD","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIC1","description":"ICD-AHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implantable tissue marker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4648","description":"Implantable tissue marker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0628U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","description":"CPT-0628U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Establish access to aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36160","description":"Establish access to aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHB0","description":"ICD-MIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MSH6 (mutS homolog 6) (eg_ hereditary colon cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0160U","description":"MSH6 (mutS homolog 6) (eg_ hereditary colon cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVF0","description":"ICD-FIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFA0","description":"ICD-JEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTB1","description":"ICD-IGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCF1","description":"ICD-BDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQB1","description":"ICD-GHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVB1","description":"ICD-FDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2428","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","description":"HCPCS-J2428","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc pos elder mal scrn plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8733","description":"Doc pos elder mal scrn plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKE1","description":"ICD-NLKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc back les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21930","description":"Exc back les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93979","description":"Vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mobile arm support supinator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2633","description":"Mobile arm support supinator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33660","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABE0","description":"ICD-GABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIB0","description":"ICD-KFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBB1","description":"ICD-ODBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert abdomen-venous drain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49425","description":"Insert abdomen-venous drain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tx atrial fib pulm vein isol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93656","description":"Tx atrial fib pulm vein isol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXF1","description":"ICD-OEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Addition_ endoskeletal knee-shin system_ 4 bar linkage or multiaxial_ fluid swing and stance phase control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1014","description":"Addition_ endoskeletal knee-shin system_ 4 bar linkage or multiaxial_ fluid swing and stance phase control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Derma-Gide_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4203","description":"Derma-Gide_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSF0","description":"ICD-CBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFC0","description":"ICD-KGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQF0","description":"ICD-CAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRE0","description":"ICD-HIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXF0","description":"ICD-OBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB13B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Txmnts 2 phys/qhp by 1 mon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5020F","description":"Txmnts 2 phys/qhp by 1 mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLA1","description":"ICD-OLLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of free thyroxine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84439","description":"Assay of free thyroxine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMD1","description":"ICD-ADMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDB0","description":"ICD-JFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJD1","description":"ICD-FHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGC1","description":"ICD-OFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of thigh/knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27499","description":"Decompression of thigh/knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0502","description":"HCPCS-C0502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incobotulinumtoxin a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0588","description":"Incobotulinumtoxin a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bile acids total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82239","description":"Bile acids total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score neck/ts < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8672","description":"Fun stat score neck/ts < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINB1","description":"ICD-CINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal finger bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26236","description":"Partial removal finger bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Augmentative AI-based facial phenotype analysis with report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0731T","description":"Augmentative AI-based facial phenotype analysis with report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBC0","description":"ICD-BGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair liver wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47362","description":"Repair liver wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIA0","description":"ICD-MFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain breast lesion add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19001","description":"Drain breast lesion add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSE1","description":"ICD-HGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADB0","description":"ICD-AADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELE0","description":"ICD-BELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx ovarian stg1a-b no pr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9113","description":"Onc dx ovarian stg1a-b no pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVE0","description":"ICD-KAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXB1","description":"ICD-OEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXC0","description":"ICD-JEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFD1","description":"ICD-FGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Limit oral eval problm focus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0140","description":"Limit oral eval problm focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Screeningmammographydigital","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0202","description":"Screeningmammographydigital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen one/mult class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80303","description":"Drug screen one/mult class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTA1","description":"ICD-AGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLF1","description":"ICD-GFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLC0","description":"ICD-EBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEB0","description":"ICD-JGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tmj arthroscopy lysis adhesn","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7873","description":"Tmj arthroscopy lysis adhesn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSB0","description":"ICD-OFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fuse upper gi structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47721","description":"Fuse upper gi structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1BA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BA31","description":"ICD-1BA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEF1","description":"ICD-CDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1240","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITE0","description":"ICD-AITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL5A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ftl cgen abnor three anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81510","description":"Ftl cgen abnor three anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYD1","description":"ICD-GEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92636","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","description":"CPT-92636","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANF0","description":"ICD-FANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Torsion mechanism wrist/elbo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3891","description":"Torsion mechanism wrist/elbo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRF0","description":"ICD-OGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0535U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","description":"CPT-0535U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKF1","description":"ICD-BAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ omacetaxine mep_ 0.01mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9262","description":"Inj_ omacetaxine mep_ 0.01mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENF1","description":"ICD-FENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTA1","description":"ICD-BCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHB1","description":"ICD-OHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin pro/pos wc cus wd <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2607","description":"Skin pro/pos wc cus wd <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTE1","description":"ICD-GHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0680","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","description":"HCPCS-G0680","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGA1","description":"ICD-KBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAF0","description":"ICD-IDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC1C","description":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28H","description":"Special Care High _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0204","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0204","description":"HCPCS-B0204","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair_ any appr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49623","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair_ any appr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXC1","description":"ICD-NHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tib/per revasc w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37230","description":"Tib/per revasc w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enteral feed supp pump per d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4035","description":"Enteral feed supp pump per d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLME1","description":"ICD-MLME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86551","description":"Anesth removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBC0","description":"ICD-FEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-rays bone survey infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77076","description":"X-rays bone survey infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rocking bed w/ or w/o side r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0462","description":"Rocking bed w/ or w/o side r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit hydra over 3l diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9377","description":"Hit hydra over 3l diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Levonorgestrel iu 13.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7301","description":"Levonorgestrel iu 13.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBC1","description":"ICD-MCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQE0","description":"ICD-PLQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWA1","description":"ICD-CEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEC1","description":"ICD-OAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fixation of tongue_ mechanical_ other than suture (eg_ K-wire)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41500","description":"Fixation of tongue_ mechanical_ other than suture (eg_ K-wire)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chimeric antigen receptor T-cell (CAR-T) therapy; harvesting of blood-derived T lymphocytes for development of genetically modified autologous CAR-T cells_ per day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0537T","description":"Chimeric antigen receptor T-cell (CAR-T) therapy; harvesting of blood-derived T lymphocytes for development of genetically modified autologous CAR-T cells_ per day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITA1","description":"ICD-EITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC4D","description":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUA1","description":"ICD-OKUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIF1","description":"ICD-KBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repr of anal fistula w/glue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46706","description":"Repr of anal fistula w/glue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQB1","description":"ICD-DFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAE1","description":"ICD-OBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ argatroban (auromedics)_ not therapeutically equivalent to j0883_ 1 mg (for non-esrd use)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0898","description":"Injection_ argatroban (auromedics)_ not therapeutically equivalent to j0883_ 1 mg (for non-esrd use)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVA0","description":"ICD-GHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHF0","description":"ICD-IIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ mon_ ite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5246","description":"Hearing aid_ prog_ mon_ ite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMF1","description":"ICD-FIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBED0","description":"ICD-CBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEE1","description":"ICD-IGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC22A","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24545","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAA0","description":"ICD-AIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWA1","description":"ICD-HDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement Of Lost Or Broken Retainer - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8703","description":"Replacement Of Lost Or Broken Retainer - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITF1","description":"ICD-FITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diskectomy_ anterior_ with d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2350","description":"Diskectomy_ anterior_ with d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVF0","description":"ICD-BFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYA0","description":"ICD-GEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee fracture(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27538","description":"Treat knee fracture(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pure tone audiometry air","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92552","description":"Pure tone audiometry air","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAD1","description":"ICD-BHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fracture frame dual w cross","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0946","description":"Fracture frame dual w cross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9806","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9806","description":"HCPCS-C9806","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQF0","description":"ICD-GAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24470","description":"Revision of elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHB0","description":"ICD-KFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIC0","description":"ICD-GAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interferential stim 4 chan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8131","description":"Interferential stim 4 chan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJC0","description":"ICD-FAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC05","description":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPE1","description":"ICD-BGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXB0","description":"ICD-KAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJE1","description":"ICD-NBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFE1","description":"ICD-FBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23100","description":"Biopsy of shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ detection of 8 autoantibodies (ARF 6_ NKX3-1_ 5_-UTR-B","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0134U","description":"Oncology (prostate)_ detection of 8 autoantibodies (ARF 6_ NKX3-1_ 5_-UTR-B","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoe lift elev heel/sole neo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3310","description":"Shoe lift elev heel/sole neo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemo ia infuse each addl hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96423","description":"Chemo ia infuse each addl hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTD0","description":"ICD-NCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIE1","description":"ICD-AEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHE1","description":"ICD-OEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETA1","description":"ICD-AETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBA0","description":"ICD-JGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYF1","description":"ICD-CFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of jaw muscle/bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21296","description":"Revision of jaw muscle/bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJA0","description":"ICD-FDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prq card stent/ath/angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92933","description":"Prq card stent/ath/angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abduction bar-straight","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2310","description":"Abduction bar-straight","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair tear ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68700","description":"Repair tear ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPB0","description":"ICD-GDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28X","description":"Special Care Low _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABC1","description":"ICD-JABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Control of nosebleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30903","description":"Control of nosebleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRF1","description":"ICD-OJRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1015","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHC0","description":"ICD-CHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4295","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","description":"HCPCS-A4295","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINE0","description":"ICD-OINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise oral mucosa for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40818","description":"Excise oral mucosa for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPD0","description":"ICD-FBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEND1","description":"ICD-GEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXF1","description":"ICD-NKXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Above elbow prosth tiss shap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6500","description":"Above elbow prosth tiss shap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUB0","description":"ICD-MGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0975T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","description":"CPT-0975T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKC1","description":"ICD-OEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCE0","description":"ICD-FCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16371","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16371","description":"CPT-16371","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUC1","description":"ICD-OGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chest x-ray 2vw frontal&latl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71020","description":"Chest x-ray 2vw frontal&latl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA52","description":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAF0","description":"ICD-MHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBC1","description":"ICD-BDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral nutrition additiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4216","description":"Parenteral nutrition additiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDA0","description":"ICD-NKDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQC0","description":"ICD-GBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHE1","description":"ICD-GAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLD1","description":"ICD-OFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin advanced glycation endproducts (AGE) measurement by multi-wavelength fluorescent spectroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0233T","description":"Skin advanced glycation endproducts (AGE) measurement by multi-wavelength fluorescent spectroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1705","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1705","description":"HCPCS-B1705","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEE0","description":"ICD-JBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKC1","description":"ICD-JIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAC0","description":"ICD-NDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVB0","description":"ICD-OAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNB0","description":"ICD-NKNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPF0","description":"ICD-NEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Whfo electric custom fitted","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3904","description":"Whfo electric custom fitted","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOB0","description":"ICD-KFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01404","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01404","description":"CPT-01404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJF1","description":"ICD-BHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUB0","description":"ICD-AGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJF1","description":"ICD-FIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00176","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00176","description":"CPT-00176","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHC0","description":"ICD-CBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAB0","description":"ICD-MJAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXD0","description":"ICD-OHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML32","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE20B","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal shunt placement w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59076","description":"Fetal shunt placement w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMF1","description":"ICD-CHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDD0","description":"ICD-CBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion/graft of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25805","description":"Fusion/graft of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDB0","description":"ICD-KBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Face_ Eyelids_ Mouth_ Neck_ Ears_ Orbits_ Genitalia_ Hands_ And/Or Feet; 25 Cc Or Less Injectate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15773","description":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Face_ Eyelids_ Mouth_ Neck_ Ears_ Orbits_ Genitalia_ Hands_ And/Or Feet; 25 Cc Or Less Injectate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc viral load >=200","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9242","description":"Doc viral load >=200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICB1","description":"ICD-KICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of chest wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19271","description":"Revision of chest wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRD1","description":"ICD-CHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKA0","description":"ICD-CFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug test def 15-21 classes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0482","description":"Drug test def 15-21 classes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0461","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0461","description":"CDT-D0461","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sorbent cartridges per 10","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1636","description":"Sorbent cartridges per 10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Per pm reeval est pat 65+ yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99397","description":"Per pm reeval est pat 65+ yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXB0","description":"ICD-OHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open aortic tube prosth repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34830","description":"Open aortic tube prosth repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Occult blood other sources","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82271","description":"Occult blood other sources","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL44","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGA0","description":"ICD-NBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETF1","description":"ICD-FETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood culture for bacteria","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87040","description":"Blood culture for bacteria","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVD1","description":"ICD-FIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0515T","description":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient has a reactive hcv antibody test_ and has a follow up hcv viral test that does not detect hcv viremia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1234","description":"Patient has a reactive hcv antibody test_ and has a follow up hcv viral test that does not detect hcv viremia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anogenital exam child w imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99170","description":"Anogenital exam child w imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMD1","description":"ICD-EDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHB1","description":"ICD-GDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tap block bi by infusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64489","description":"Tap block bi by infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lso sagittal rigid panel cus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0636","description":"Lso sagittal rigid panel cus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo urethral suspension","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51990","description":"Laparo urethral suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0654","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","description":"HCPCS-J0654","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANC1","description":"ICD-GANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBC1","description":"ICD-ADBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGE0","description":"ICD-JDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tissue exam by pathologist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88304","description":"Tissue exam by pathologist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFE0","description":"ICD-KHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adjust finger ext/flex devc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1825","description":"Adjust finger ext/flex devc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psa/t/glsc docd b/4 txmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3268F","description":"Psa/t/glsc docd b/4 txmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1KA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KA21","description":"ICD-1KA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas biopsy not review","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8884","description":"Doc reas biopsy not review","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Methadone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6053","description":"Methadone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urinal male jug-type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0325","description":"Urinal male jug-type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLD0","description":"ICD-JGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYA1","description":"ICD-HCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPA1","description":"ICD-GHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD120","description":"Reduced Physical Function _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPD1","description":"ICD-KFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAD1","description":"ICD-MCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1904","description":"HCPCS-B1904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJC1","description":"ICD-GFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair bowel opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44626","description":"Repair bowel opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28G","description":"Special Care Low _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC05","description":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove shoulder blade lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23182","description":"Remove shoulder blade lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUF0","description":"ICD-IBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEC0","description":"ICD-OBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNA0","description":"ICD-FCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAD0","description":"ICD-GHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No reop req bld grft oth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8578","description":"No reop req bld grft oth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intro/sheath_fixed_peel-away","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1892","description":"Intro/sheath_fixed_peel-away","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNF0","description":"ICD-CGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANA1","description":"ICD-NANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8D","description":"Low Rehab_ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perc d-e cor revasc t cabg s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9604","description":"Perc d-e cor revasc t cabg s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCB1","description":"ICD-CHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVA1","description":"ICD-KFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole lauroxil_ (aristada)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1944","description":"Injection_ aripiprazole lauroxil_ (aristada)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAA1","description":"ICD-ECAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt not disch home day#2 evar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8833","description":"Pt not disch home day#2 evar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVF0","description":"ICD-CCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBD1","description":"ICD-KGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOA0","description":"ICD-HDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunotherapy 2/> injections","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95125","description":"Immunotherapy 2/> injections","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous catheter anchor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5200","description":"Percutaneous catheter anchor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Facial augmentation implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5925","description":"Facial augmentation implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLB1","description":"ICD-KFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML55","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00635","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00635","description":"CPT-00635","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQC0","description":"ICD-LFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA16","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ABO GNOTYP NEXT GNRJ SEQ ABO","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0221U","description":"ABO GNOTYP NEXT GNRJ SEQ ABO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTF1","description":"ICD-CGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMC1","description":"ICD-IFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE135","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thawing cryopresrved embryo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89352","description":"Thawing cryopresrved embryo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ampicillin sodium per 1.5 gm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0295","description":"Ampicillin sodium per 1.5 gm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00811","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00811","description":"CPT-00811","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI w/cont_ breast_ bi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8906","description":"MRI w/cont_ breast_ bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vagotomy & pylorus repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43641","description":"Vagotomy & pylorus repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGF1","description":"ICD-BCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAC1","description":"ICD-BAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC25","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYE0","description":"ICD-GAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52301","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGF1","description":"ICD-FFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N.gonorrhoeae dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87592","description":"N.gonorrhoeae dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Needle biopsy chest lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32400","description":"Needle biopsy chest lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVB1","description":"ICD-CGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECC1","description":"ICD-NECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDB1","description":"ICD-MEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens bifocal add over 3.25d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2220","description":"Lens bifocal add over 3.25d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD125","description":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAF0","description":"ICD-CAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIC1","description":"ICD-GCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBC1","description":"ICD-JCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aminophyllin 250 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0280","description":"Aminophyllin 250 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj menotropins 75 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0122","description":"Inj menotropins 75 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPD0","description":"ICD-KEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCE0","description":"ICD-AGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUE0","description":"ICD-ICUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pump uninterrupted infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0455","description":"Pump uninterrupted infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINE0","description":"ICD-NINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDME0","description":"ICD-GDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Us bone stimulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20979","description":"Us bone stimulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduction of forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21137","description":"Reduction of forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5170","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5170","description":"HCPCS-Q5170","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDE0","description":"ICD-EFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEC1","description":"ICD-BIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACA0","description":"ICD-EACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQD0","description":"ICD-KFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place gastrostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43830","description":"Place gastrostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7514","description":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSB0","description":"ICD-HDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOE0","description":"ICD-HDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXC0","description":"ICD-OHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Histrelin acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1675","description":"Histrelin acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA60","description":"Medium Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Support broker waiver/15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2041","description":"Support broker waiver/15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUE1","description":"ICD-EIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKE0","description":"ICD-BGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNE0","description":"ICD-FHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart septum defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33647","description":"Repair heart septum defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coronectomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7251","description":"Coronectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Test socket knee disarticula","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5622","description":"Test socket knee disarticula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOE0","description":"ICD-CCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILC0","description":"ICD-JILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dentures rebase part maxill","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5720","description":"Dentures rebase part maxill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUE0","description":"ICD-ACUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ent procedure/service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92700","description":"Ent procedure/service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBE0","description":"ICD-MHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXA0","description":"ICD-BGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWD1","description":"ICD-PLWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD236","description":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of citrate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82507","description":"Assay of citrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYE1","description":"ICD-OEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bk flex inner socket ext fra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5645","description":"Bk flex inner socket ext fra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dose optimization auc - 5fu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3722","description":"Dose optimization auc - 5fu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKD0","description":"ICD-OBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCA1","description":"ICD-ECCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQA1","description":"ICD-DAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-97008","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","description":"CPT-97008","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44364","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJC1","description":"ICD-KAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD24A","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wedge resect of lung diag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32507","description":"Wedge resect of lung diag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYB0","description":"ICD-PFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKC1","description":"ICD-NEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWE0","description":"ICD-OAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASB1","description":"ICD-OASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES10B","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIE1","description":"ICD-AIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disp wound suct_ drsg/access","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9272","description":"Disp wound suct_ drsg/access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance (eg_ vibration) elastography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76391","description":"Magnetic resonance (eg_ vibration) elastography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antistreptolysin o titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86060","description":"Antistreptolysin o titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce/graft eye wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67255","description":"Reinforce/graft eye wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Metabolic panel ionized ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80047","description":"Metabolic panel ionized ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFE1","description":"ICD-KFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apexification/recalc interim","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3352","description":"Apexification/recalc interim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB13A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1108","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"L hrt artery/ventricle angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93458","description":"L hrt artery/ventricle angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thigh/wght bear high roll cu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2550","description":"Thigh/wght bear high roll cu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEF1","description":"ICD-IGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTD0","description":"ICD-CFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQA0","description":"ICD-LEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dynamic fine wire emg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96003","description":"Dynamic fine wire emg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBE1","description":"ICD-GEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-15012","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","description":"CPT-15012","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCF1","description":"ICD-BFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL21","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasonic generator w svneb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0574","description":"Ultrasonic generator w svneb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGA1","description":"ICD-GAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mast simple complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19303","description":"Mast simple complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASA1","description":"ICD-PASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise wrist/forearm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25290","description":"Incise wrist/forearm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTC0","description":"ICD-CHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIF0","description":"ICD-FHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3FA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FA21","description":"ICD-3FA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA151","description":"Clinically Complex _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA14","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gait training therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97116","description":"Gait training therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc repair abdom aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75952","description":"Endovasc repair abdom aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEE0","description":"ICD-FAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0902","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0902","description":"CDT-D0902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEA1","description":"ICD-KEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAID0","description":"ICD-MAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBE1","description":"ICD-KDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELD1","description":"ICD-GELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIF0","description":"ICD-MCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBND1","description":"ICD-JBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ophthalmic biometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92136","description":"Ophthalmic biometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Genetic testing als","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3800","description":"Genetic testing als","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRA0","description":"ICD-OFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB2C","description":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38C","description":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXE1","description":"ICD-BAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA03","description":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LB31","description":"ICD-2LB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATA0","description":"ICD-EATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Absorp drg >48 suc pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0746","description":"Absorp drg >48 suc pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Scan proc spinal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61783","description":"Scan proc spinal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATB1","description":"ICD-EATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28606","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Statin not presc doc reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9442","description":"Statin not presc doc reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMC0","description":"ICD-GGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAC0","description":"ICD-NIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTE0","description":"ICD-ODTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ho bi thighcuffs w sprdr bar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1652","description":"Ho bi thighcuffs w sprdr bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rsk fx ref w/n 24 hrs xray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5100F","description":"Rsk fx ref w/n 24 hrs xray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAF1","description":"ICD-NHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFA0","description":"ICD-FAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit cont anticoag diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9336","description":"Hit cont anticoag diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular disease_ quantification of advanced serum or plasma lipoprotein profile_ by nuclear magnetic resonance (NMR) spectrometry with report of a lipoprotein profile (","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0377U","description":"Cardiovascular disease_ quantification of advanced serum or plasma lipoprotein profile_ by nuclear magnetic resonance (NMR) spectrometry with report of a lipoprotein profile (","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of neck/chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21550","description":"Biopsy of neck/chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWB1","description":"ICD-CEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42305","description":"Drainage of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIC0","description":"ICD-EBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrical stimulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97032","description":"Electrical stimulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36200","description":"Place catheter in aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8E","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUD0","description":"ICD-NAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adults who have not had at least 180 days of continuous pharmacotherapy with a medication prescribed for OUD without a gap of m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1036","description":"Adults who have not had at least 180 days of continuous pharmacotherapy with a medication prescribed for OUD without a gap of m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVE0","description":"ICD-NGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELE0","description":"ICD-GELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METC0","description":"ICD-METC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58540","description":"Revision of uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRF0","description":"ICD-OJRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc thigh/knee les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27327","description":"Exc thigh/knee les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair sciatic nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64858","description":"Repair sciatic nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXB0","description":"ICD-JCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYF1","description":"ICD-KDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE13C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKC0","description":"ICD-GIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1743","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1743","description":"HCPCS-C1743","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUF1","description":"ICD-JEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39010","description":"Exploration of chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARD1","description":"ICD-OARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rad w/o backup non-inv intfc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0470","description":"Rad w/o backup non-inv intfc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth chest wall repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47251","description":"Anesth chest wall repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Care management services for behavioral health conditions_ at least 20 minutes of clinical staff time_ directed by a physician or other qualified health care professional_ per","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0507","description":"Care management services for behavioral health conditions_ at least 20 minutes of clinical staff time_ directed by a physician or other qualified health care professional_ per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCME0","description":"ICD-JCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft of tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27724","description":"Repair/graft of tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endo hip ultra-light materia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5960","description":"Endo hip ultra-light materia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JA21","description":"ICD-3JA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKD1","description":"ICD-CEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBD1","description":"ICD-OJBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHA0","description":"ICD-NGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDA0","description":"ICD-OCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTD1","description":"ICD-BBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of angiotensin ii","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82163","description":"Assay of angiotensin ii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCF1","description":"ICD-IGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pancreatorrhaphy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48545","description":"Pancreatorrhaphy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair bronchus add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32501","description":"Repair bronchus add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECE1","description":"ICD-MECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCF1","description":"ICD-MGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIED1","description":"ICD-FIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECB0","description":"ICD-IECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ ultra-rapid sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0426U","description":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ ultra-rapid sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enclosed walker w rear seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0144","description":"Enclosed walker w rear seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2JC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JC21","description":"ICD-2JC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Deb subq tissue add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11045","description":"Deb subq tissue add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJE1","description":"ICD-JHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBF1","description":"ICD-GFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Init nb em per day hosp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99460","description":"Init nb em per day hosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Node neg inv brst cncr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8879","description":"Node neg inv brst cncr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJF0","description":"ICD-KEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Use of speech device service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92609","description":"Use of speech device service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27881","description":"Amputation of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLB0","description":"ICD-MLLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIC0","description":"ICD-MGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQB0","description":"ICD-PLQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPD1","description":"ICD-OAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of prolactin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84146","description":"Assay of prolactin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCE0","description":"ICD-MLCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise/graft midfoot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28305","description":"Incise/graft midfoot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAD1","description":"ICD-IAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Band stabilization - per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2976","description":"Band stabilization - per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove by ligat int hem grps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46946","description":"Remove by ligat int hem grps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKD1","description":"ICD-OCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral solution hepatic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B5100","description":"Parenteral solution hepatic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE221","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFC1","description":"ICD-OGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid tumor)_ next-generation sequencing (NGS) of DNA from formalin-fixed paraffin-embedded (FFPE) tissue with comparative sequence analysis from a matched normal sp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0473U","description":"Oncology (solid tumor)_ next-generation sequencing (NGS) of DNA from formalin-fixed paraffin-embedded (FFPE) tissue with comparative sequence analysis from a matched normal sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHB1","description":"ICD-JAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Evaluation of wheezing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94070","description":"Evaluation of wheezing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGA1","description":"ICD-NBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove electrode/thoracotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33238","description":"Remove electrode/thoracotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie_ caval valve implantation [CAVI]); percutaneous femoral vein approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0805T","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie_ caval valve implantation [CAVI]); percutaneous femoral vein approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIA1","description":"ICD-GBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABE0","description":"ICD-EABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAD0","description":"ICD-JAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBA1","description":"ICD-CIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC255","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCE0","description":"ICD-NFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMB1","description":"ICD-KDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAB1","description":"ICD-GDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93978","description":"Vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tricyclic & cyclicals 6/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80337","description":"Tricyclic & cyclicals 6/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCC1","description":"ICD-ACCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGB1","description":"ICD-GIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ nitroglycerin_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2305","description":"Injection_ nitroglycerin_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray bile ducts/pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74300","description":"X-ray bile ducts/pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYA0","description":"ICD-HBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEA1","description":"ICD-NHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSC1","description":"ICD-PFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pulm funct tst plethysmograp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94726","description":"Pulm funct tst plethysmograp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOF0","description":"ICD-KGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPF0","description":"ICD-NCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10120","description":"Remove foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTA1","description":"ICD-MHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC116","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1171","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETD1","description":"ICD-EETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOD0","description":"ICD-DIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBC0","description":"ICD-MBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4337","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","description":"HCPCS-Q4337","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disposable corrugated tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7010","description":"Disposable corrugated tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJC1","description":"ICD-NIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKB1","description":"ICD-KGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHF0","description":"ICD-BFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELD1","description":"ICD-BELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVD0","description":"ICD-GEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIB1","description":"ICD-OJIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHA0","description":"ICD-BGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDF1","description":"ICD-EHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIB0","description":"ICD-BAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCF0","description":"ICD-MBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"1 bodytemp >=35.5cw/in 30min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4559F","description":"1 bodytemp >=35.5cw/in 30min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exchange biliary drg cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47536","description":"Exchange biliary drg cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rbc pretx incubatj w/enzymes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86971","description":"Rbc pretx incubatj w/enzymes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin sub graft trnk/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15271","description":"Skin sub graft trnk/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE221","description":"Clinically Complex _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACB0","description":"ICD-BACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPE0","description":"ICD-KIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWC1","description":"ICD-LHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair communication device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5336","description":"Repair communication device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tmj reshaping components","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7865","description":"Tmj reshaping components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin full graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15221","description":"Skin full graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYB1","description":"ICD-CAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1439","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","description":"HCPCS-M1439","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder abduction joint pai","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6640","description":"Shoulder abduction joint pai","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unclassified drug or biological used for ESRD on dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3591","description":"Unclassified drug or biological used for ESRD on dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHD1","description":"ICD-NDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"5%dextrose/0.45%saline1000ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5013","description":"5%dextrose/0.45%saline1000ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSB0","description":"ICD-GBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIF0","description":"ICD-OCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hm postpar hyper per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9212","description":"Hm postpar hyper per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary pan cancer (eg_ hereditary breast and ovarian cancer_ hereditary endometrial cancer_ hereditary colorectal cancer)_ genomic sequence analysis panel utilizing a comb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0104U","description":"Hereditary pan cancer (eg_ hereditary breast and ovarian cancer_ hereditary endometrial cancer_ hereditary colorectal cancer)_ genomic sequence analysis panel utilizing a comb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAC1","description":"ICD-MHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXA1","description":"ICD-FFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDF1","description":"ICD-FIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGB1","description":"ICD-OCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARC0","description":"ICD-OARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esrd serv 4 visits p mo <2yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90951","description":"Esrd serv 4 visits p mo <2yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYF0","description":"ICD-DIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct capt & interp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0364","description":"Cone beam ct capt & interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYC0","description":"ICD-LAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home visit new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99341","description":"Home visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA4B","description":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVA1","description":"ICD-CEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transect pulmonary artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33922","description":"Transect pulmonary artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX3A","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8C","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Modify speech aid prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5960","description":"Modify speech aid prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAA0","description":"ICD-CGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSC1","description":"ICD-OLSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory virus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86756","description":"Respiratory virus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18E","description":"Special Care High _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIC1","description":"ICD-JCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m sestamibi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9500","description":"Tc99m sestamibi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXA1","description":"ICD-OBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYF0","description":"ICD-DBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX02","description":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93641","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Allgrft implnt knee w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29867","description":"Allgrft implnt knee w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNC1","description":"ICD-OJNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of infusion pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36262","description":"Removal of infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGB0","description":"ICD-CGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTA0","description":"ICD-KGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 3RD DOSE MODERNA","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0013A","description":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 3RD DOSE MODERNA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX24","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIF0","description":"ICD-FEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lefort i-3/> piece w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21143","description":"Lefort i-3/> piece w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJD0","description":"ICD-JCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transplt allo lymphocytes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38242","description":"Transplt allo lymphocytes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKA1","description":"ICD-OHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATA1","description":"ICD-OATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had a suicide safety plan initiated_ reviewed_ or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1351","description":"Patients who had a suicide safety plan initiated_ reviewed_ or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Irrigation Supply; Sleeve_ Reusable_ Per Month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4436","description":"Irrigation Supply; Sleeve_ Reusable_ Per Month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSA1","description":"ICD-HCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urine flow measurement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51736","description":"Urine flow measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter therapy_ infusion other than for thrombolysis_ any type (eg_ spasmolytic_ vasoconstrictive)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37202","description":"Transcatheter therapy_ infusion other than for thrombolysis_ any type (eg_ spasmolytic_ vasoconstrictive)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUD0","description":"ICD-BAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75825","description":"Vein x-ray trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kelch-like protein 11 (KLHL11) antibody_ serum or cerebrospinal fluid (CSF)_ cell-binding assay_ qualitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0432U","description":"Kelch-like protein 11 (KLHL11) antibody_ serum or cerebrospinal fluid (CSF)_ cell-binding assay_ qualitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABE0","description":"ICD-KABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKA0","description":"ICD-FDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBA0","description":"ICD-MDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIF1","description":"ICD-FIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBB1","description":"ICD-OHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPD0","description":"ICD-FIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fld ped wc tltnspc w/o seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1234","description":"Fld ped wc tltnspc w/o seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34051","description":"Removal of artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vascular graft_ synthetic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8670","description":"Vascular graft_ synthetic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC41","description":"Medium Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noncontact near-infrared spectroscopy (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation)_ other than for screening for peripheral arteria","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0859T","description":"Noncontact near-infrared spectroscopy (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation)_ other than for screening for peripheral arteria","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITB1","description":"ICD-JITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ benralizumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0517","description":"Injection_ benralizumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBE0","description":"ICD-JBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49618","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of donor heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33940","description":"Removal of donor heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOF0","description":"ICD-KBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rem nonodonto cyst > 1.25 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7461","description":"Rem nonodonto cyst > 1.25 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPF0","description":"ICD-FDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHD1","description":"ICD-BCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1289","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1289","description":"HCPCS-J1289","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ hymovis_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7322","description":"Hyaluronan or derivative_ hymovis_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWA1","description":"ICD-PAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDF0","description":"ICD-OEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ic lbw inf < 1500 gm subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99478","description":"Ic lbw inf < 1500 gm subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA15A","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt re-evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97002","description":"Pt re-evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat mouth roof fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21422","description":"Treat mouth roof fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open reduct compd mandble fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7730","description":"Open reduct compd mandble fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair mngment training","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97542","description":"Wheelchair mngment training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUA0","description":"ICD-GFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Daunorubicin citrate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9151","description":"Daunorubicin citrate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC215","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOE1","description":"ICD-KEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who screened positive for at least 1 of the 5 hrsns","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1320","description":"Patients who screened positive for at least 1 of the 5 hrsns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYE0","description":"ICD-LEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLA1","description":"ICD-MHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNC0","description":"ICD-NLNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWA1","description":"ICD-ODWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAC0","description":"ICD-OIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67924","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFME1","description":"ICD-GFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trans shoe solid stirrup new","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3630","description":"Trans shoe solid stirrup new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTA1","description":"ICD-NBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOC1","description":"ICD-KAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNF0","description":"ICD-JCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJB1","description":"ICD-KAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRA1","description":"ICD-GBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITA1","description":"ICD-AITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDF0","description":"ICD-AGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMD1","description":"ICD-NGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLA0","description":"ICD-FFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Distal shoe space maintainer - fixed - unilateral","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1575","description":"Distal shoe space maintainer - fixed - unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01830","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01830","description":"CPT-01830","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIC0","description":"ICD-OHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKB1","description":"ICD-KBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDD1","description":"ICD-GHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aripiprazole injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0400","description":"Aripiprazole injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMA0","description":"ICD-FIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE255","description":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Novosorb Synpath Dermal Matrix_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2006","description":"Novosorb Synpath Dermal Matrix_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine eltrd plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63662","description":"Remove spine eltrd plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC210","description":"Special Care High _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUE1","description":"ICD-JIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRF1","description":"ICD-GGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tract frame attach footboard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0870","description":"Tract frame attach footboard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24530","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assert comm tx pgm per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0040","description":"Assert comm tx pgm per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBC0","description":"ICD-CEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAA1","description":"ICD-JIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4371","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","description":"HCPCS-Q4371","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27703","description":"Reconstruction ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOB0","description":"ICD-LIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1805","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1805","description":"CDT-D1805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dress/debrid p-thick burn m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16025","description":"Dress/debrid p-thick burn m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extrnl bleaching per arch","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9972","description":"Extrnl bleaching per arch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQC0","description":"ICD-PDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (multiple myeloma)_ liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ monoclonal paraprotein sequencing analysis_ serum_ results reported as baseline pr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0450U","description":"Oncology (multiple myeloma)_ liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ monoclonal paraprotein sequencing analysis_ serum_ results reported as baseline pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm_ false aneurysm_ dissection_ endoleak_ or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34711","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm_ false aneurysm_ dissection_ endoleak_ or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ evaluation of drugs present by LC-MS/MS_ using oral fluid_ reported as a comparison to an estimated steady-state range_ per date of service inclu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0011U","description":"Prescription drug monitoring_ evaluation of drugs present by LC-MS/MS_ using oral fluid_ reported as a comparison to an estimated steady-state range_ per date of service inclu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Scope plantar fasciotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29893","description":"Scope plantar fasciotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9750","description":"Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen quant zonisamide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80203","description":"Drug screen quant zonisamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Topotecan injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9351","description":"Topotecan injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLA1","description":"ICD-GDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Arm pad each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0019","description":"Arm pad each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQE1","description":"ICD-OKQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release middle ear bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69650","description":"Release middle ear bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion catheter artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36640","description":"Insertion catheter artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDA1","description":"ICD-IIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERF1","description":"ICD-KERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1168","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALA1","description":"ICD-JALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27535","description":"Treat knee fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAA1","description":"ICD-GFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYF0","description":"ICD-HCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ full length/chap style_ 30-40 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6560","description":"Gradient compression stocking_ full length/chap style_ 30-40 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBC1","description":"ICD-BCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVC0","description":"ICD-NIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJA1","description":"ICD-FIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33722","description":"Repair of heart defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBA0","description":"ICD-BCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rituximab 10 mg and hyaluronidase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9311","description":"Injection_ rituximab 10 mg and hyaluronidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDA0","description":"ICD-OIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEB0","description":"ICD-AIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair mouth laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40830","description":"Repair mouth laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJF1","description":"ICD-JGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01744","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01744","description":"CPT-01744","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture radius/ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25605","description":"Treat fracture radius/ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pos airway pressure filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7038","description":"Pos airway pressure filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVD1","description":"ICD-OKVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQB1","description":"ICD-CFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWE0","description":"ICD-CDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHB0","description":"ICD-CCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEC0","description":"ICD-EHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rapid desensitization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95180","description":"Rapid desensitization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Below knee cuff suspension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5666","description":"Below knee cuff suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFA1","description":"ICD-OEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEC0","description":"ICD-JEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYC1","description":"ICD-GHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAB0","description":"ICD-ICAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIF1","description":"ICD-KHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUC1","description":"ICD-KHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX4A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42180","description":"Repair palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGA1","description":"ICD-NEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urine ost pouch w bltinconv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4429","description":"Urine ost pouch w bltinconv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHB0","description":"ICD-EEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUA1","description":"ICD-GEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNF1","description":"ICD-KCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINE0","description":"ICD-KINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ clevidipine butyrate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9248","description":"Inj_ clevidipine butyrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECE0","description":"ICD-IECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMC0","description":"ICD-NGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQF0","description":"ICD-OFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETF0","description":"ICD-CETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCME0","description":"ICD-OCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFD1","description":"ICD-BEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Osseous surgl-3teethperquad","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4261","description":"Osseous surgl-3teethperquad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt queried symp resp insuff","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1503F","description":"Pt queried symp resp insuff","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lateral thoracic extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1210","description":"Lateral thoracic extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPC1","description":"ICD-KAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor viii vw antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85246","description":"Clot factor viii vw antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prolong serv w/o contact add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99359","description":"Prolong serv w/o contact add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous Visible Light Hyperspectral Imaging Measurement Of Oxyhemoglobin_ Deoxyhemoglobin_ And Tissue Oxygenation_ With Interpretation And Report_ Per Extremity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0631T","description":"Transcutaneous Visible Light Hyperspectral Imaging Measurement Of Oxyhemoglobin_ Deoxyhemoglobin_ And Tissue Oxygenation_ With Interpretation And Report_ Per Extremity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALA1","description":"ICD-OALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77401","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18B","description":"Special Care High _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJA1","description":"ICD-FAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/revise wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25320","description":"Repair/revise wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Warfrn or othr antcog no rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8971","description":"Warfrn or othr antcog no rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prosthetic implant nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8699","description":"Prosthetic implant nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray bend only l-s spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72120","description":"X-ray bend only l-s spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBE1","description":"ICD-ICBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFD0","description":"ICD-OJFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1109T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1109T","description":"CPT-1109T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUD1","description":"ICD-MDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26410","description":"Repair hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPC0","description":"ICD-NIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDC1","description":"ICD-GCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL0D","description":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepb vacc 3 dose immunsup im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90740","description":"Hepb vacc 3 dose immunsup im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVF0","description":"ICD-CAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/reline occlusal guard","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9942","description":"Repair/reline occlusal guard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB260","description":"Reduced Physical Function _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWA1","description":"ICD-PCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percut allergy skin tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95004","description":"Percut allergy skin tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDB1","description":"ICD-NBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKE1","description":"ICD-JEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction anal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46910","description":"Destruction anal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDC0","description":"ICD-GCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adjst forearm pro/sup device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1802","description":"Adjst forearm pro/sup device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAF1","description":"ICD-OHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICA0","description":"ICD-NICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8B","description":"Medium Rehab _ ADL Index 0-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE111","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPD0","description":"ICD-GIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Air elevator for heel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0370","description":"Air elevator for heel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRD1","description":"ICD-CBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX51","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHD1","description":"ICD-EHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18F","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQD0","description":"ICD-LCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ methotrexate (accord) not therapeutically equivalent to j9250 and j9260_ 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9255","description":"Injection_ methotrexate (accord) not therapeutically equivalent to j9250 and j9260_ 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAF1","description":"ICD-EEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAD1","description":"ICD-CDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Standard control cable extra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6655","description":"Standard control cable extra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESE0","description":"ICD-CESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95977","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Correct skn color 6.1-20.0cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11921","description":"Correct skn color 6.1-20.0cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA3B","description":"Default_ /PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"W/c wdth 24-27 in seat frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2341","description":"W/c wdth 24-27 in seat frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPB1","description":"ICD-KEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open wedge/bx lung nodule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32097","description":"Open wedge/bx lung nodule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Type location activityassess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1052F","description":"Type location activityassess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4421","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","description":"HCPCS-Q4421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lat thorax spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22532","description":"Lat thorax spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCB0","description":"ICD-OKCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Screening for sleep related breathing disorders","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9957","description":"Screening for sleep related breathing disorders","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCF0","description":"ICD-GCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Supported employ_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2024","description":"Supported employ_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Virus antibody nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86790","description":"Virus antibody nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMA0","description":"ICD-NIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC15C","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1302","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1302","description":"HCPCS-A1302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23472","description":"Reconstruct shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLC0","description":"ICD-FBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHC1","description":"ICD-OAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr e/n/e/l 2.6-7.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13152","description":"Cmplx rpr e/n/e/l 2.6-7.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient Has Any Emergency Department Encounter During The Performance Period With Place Of Service Indicator 23","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0035","description":"Patient Has Any Emergency Department Encounter During The Performance Period With Place Of Service Indicator 23","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJC0","description":"ICD-FHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28E","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESA1","description":"ICD-KESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAA0","description":"ICD-ICAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJND1","description":"ICD-OJND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQC1","description":"ICD-PEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAF0","description":"ICD-IIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAE0","description":"ICD-JGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQD1","description":"ICD-KCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0049","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of foot joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28052","description":"Biopsy of foot joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special eye evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92060","description":"Special eye evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVD1","description":"ICD-CEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLD0","description":"ICD-NFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPD1","description":"ICD-OBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUF0","description":"ICD-GIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome karyotype study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88280","description":"Chromosome karyotype study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGA1","description":"ICD-OAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWE0","description":"ICD-LEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRB1","description":"ICD-PDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB215","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTB1","description":"ICD-CHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl car modulj tranvns elt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0413T","description":"Rmvl car modulj tranvns elt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGB0","description":"ICD-OLGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx mult myeloma stg2 hig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9129","description":"Onc dx mult myeloma stg2 hig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA255","description":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct lip with flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40525","description":"Reconstruct lip with flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of neck muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21725","description":"Revision of neck muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHD0","description":"ICD-GDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic radiology simulation-aided field setting; complex_ including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy tre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9794","description":"Therapeutic radiology simulation-aided field setting; complex_ including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy tre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIC1","description":"ICD-EFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Throat x-ray & fluoroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70370","description":"Throat x-ray & fluoroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB20","description":"Medium Rehab _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted reprod med lab proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89398","description":"Unlisted reprod med lab proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPD1","description":"ICD-GFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSF1","description":"ICD-GGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNF1","description":"ICD-CBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFA1","description":"ICD-GEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUB1","description":"ICD-EEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASC0","description":"ICD-LASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIC1","description":"ICD-OKIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise inferior turbinate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30130","description":"Excise inferior turbinate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq vertebral augmentation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22514","description":"Perq vertebral augmentation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDB1","description":"ICD-JEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2IA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IA31","description":"ICD-2IA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEB1","description":"ICD-AGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA24C","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove wrist/forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25116","description":"Remove wrist/forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL20","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNB1","description":"ICD-FGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Targeted case mgmt per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2023","description":"Targeted case mgmt per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC135","description":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stem cells total count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86367","description":"Stem cells total count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1151","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28G","description":"Special Care Low _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of digoxin total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80162","description":"Assay of digoxin total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of finger splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29130","description":"Application of finger splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERB1","description":"ICD-DERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Pasireotide Long Acting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9454","description":"Injection_ Pasireotide Long Acting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wet-dry dressings rx recmd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4265F","description":"Wet-dry dressings rx recmd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKA0","description":"ICD-GBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWA1","description":"ICD-OGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGA1","description":"ICD-OGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Serv part of phase i trial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9988","description":"Serv part of phase i trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient was a permanent nursing home resident at any time during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1058","description":"Patient was a permanent nursing home resident at any time during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal collar bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23120","description":"Partial removal collar bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIB1","description":"ICD-EAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9342","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","description":"HCPCS-J9342","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXF1","description":"ICD-CCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB02","description":"Ultra High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGA0","description":"ICD-GCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tumor immunohistochem/manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88360","description":"Tumor immunohistochem/manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth blepharoplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10351","description":"Anesth blepharoplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLF1","description":"ICD-NFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of ruptured uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58520","description":"Repair of ruptured uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA244","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEB1","description":"ICD-FDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat big toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28495","description":"Treat big toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARD0","description":"ICD-KARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHA0","description":"ICD-EBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no 30 day f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9403","description":"Doc reas no 30 day f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDE0","description":"ICD-OCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB145","description":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOF0","description":"ICD-CFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Paranasal sinus ultrasound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9024","description":"Paranasal sinus ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cranial Electrotherapy Stimulation (Ces) System_ Includes All Supplies And Accessories_ Any Type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1002","description":"Cranial Electrotherapy Stimulation (Ces) System_ Includes All Supplies And Accessories_ Any Type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alginate drsg >16 <=48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6197","description":"Alginate drsg >16 <=48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEA1","description":"ICD-BDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDD0","description":"ICD-FGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDA0","description":"ICD-FDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTB1","description":"ICD-GDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/pleurectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32656","description":"Thoracoscopy w/pleurectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTA1","description":"ICD-OCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Correct metacarpal flaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26565","description":"Correct metacarpal flaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assist living waiver/diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2031","description":"Assist living waiver/diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC13B","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroretinography with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92275","description":"Electroretinography with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUA0","description":"ICD-CDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elbow molded w/ expand inter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6205","description":"Elbow molded w/ expand inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Njx tfrml eprl w/us lumb/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0230T","description":"Njx tfrml eprl w/us lumb/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIC0","description":"ICD-KIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ped dynamic seating frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2295","description":"Ped dynamic seating frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCD0","description":"ICD-NGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYD0","description":"ICD-CFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (acute myelogenous leukemia)_ DNA_ genotyping of internal tandem duplication_ p.D835_ p.I836_ using mononuclear cells_ reported as detection or non-detection of FLT3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0023U","description":"Oncology (acute myelogenous leukemia)_ DNA_ genotyping of internal tandem duplication_ p.D835_ p.I836_ using mononuclear cells_ reported as detection or non-detection of FLT3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIB0","description":"ICD-KCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDE0","description":"ICD-NIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGA1","description":"ICD-JFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33779","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nutrition class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9452","description":"Nutrition class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWE0","description":"ICD-KHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAF1","description":"ICD-ABAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Initial observation care_ per day_ for the evaluation and management of a patient_ which requires these 3 key components: A comprehensive history; A comprehensive examination;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99220","description":"Initial observation care_ per day_ for the evaluation and management of a patient_ which requires these 3 key components: A comprehensive history; A comprehensive examination;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Influenza imm rec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4035F","description":"Influenza imm rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87484","description":"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSB1","description":"ICD-PCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBC1","description":"ICD-BEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETA0","description":"ICD-CETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61863","description":"Implant neuroelectrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMD1","description":"ICD-CAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAC1","description":"ICD-BEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGC0","description":"ICD-OLGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBC1","description":"ICD-EHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8D","description":"High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITD1","description":"ICD-GITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUD0","description":"ICD-AAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"H&p for surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0260","description":"H&p for surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNA1","description":"ICD-KCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADB0","description":"ICD-GADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOF0","description":"ICD-GFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Scan proc cranial intra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61781","description":"Scan proc cranial intra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18X","description":"Clinically Complex _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMC0","description":"ICD-BAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUD1","description":"ICD-OBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDB0","description":"ICD-GHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHF0","description":"ICD-IGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMD0","description":"ICD-NEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYE1","description":"ICD-GIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surgery of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86053","description":"Anesth surgery of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB10A","description":"Clinically Complex _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth spine cord surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62051","description":"Anesth spine cord surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"W/c manual swingaway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1028","description":"W/c manual swingaway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stimulation of spinal cord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63610","description":"Stimulation of spinal cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neonate crit care initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99468","description":"Neonate crit care initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTF1","description":"ICD-JGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJF0","description":"ICD-FEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWC0","description":"ICD-OEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1225","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radical resect abd tumor<5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22904","description":"Radical resect abd tumor<5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21080","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAD1","description":"ICD-ICAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FA21","description":"ICD-1FA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7515","description":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQF1","description":"ICD-KIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg_ electrode array and receiver)_ including contact group(s)_ amplitude_ pulse w","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0789T","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg_ electrode array and receiver)_ including contact group(s)_ amplitude_ pulse w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Singl prscrp lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0504","description":"Singl prscrp lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC3D","description":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Init pm e/m new pat 1-4 yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99382","description":"Init pm e/m new pat 1-4 yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMC0","description":"ICD-GFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC22","description":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aflibercept injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0178","description":"Aflibercept injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACC1","description":"ICD-FACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWD1","description":"ICD-KAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"APOL1 (apolipoprotein L1) (eg_ chronic kidney disease)_ risk variants (G1_ G2)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0355U","description":"APOL1 (apolipoprotein L1) (eg_ chronic kidney disease)_ risk variants (G1_ G2)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOD1","description":"ICD-LFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOF0","description":"ICD-KAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0651U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0651U","description":"CPT-0651U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVF1","description":"ICD-GEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC135","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24361","description":"Reconstruct elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVF0","description":"ICD-GCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66225","description":"Repair/graft eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAME1","description":"ICD-MAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMC1","description":"ICD-BBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABA1","description":"ICD-GABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6700","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","description":"HCPCS-L6700","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLE1","description":"ICD-ICLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXF0","description":"ICD-BHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rerepair ventrl hern reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49565","description":"Rerepair ventrl hern reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ald fm/dm ear level receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5284","description":"Ald fm/dm ear level receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDB0","description":"ICD-MJDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAC0","description":"ICD-FBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAC1","description":"ICD-CDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92993","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ho abduction hip adjustable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1650","description":"Ho abduction hip adjustable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLC1","description":"ICD-EDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMF0","description":"ICD-OJMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCA1","description":"ICD-ABCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMF1","description":"ICD-GGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYB1","description":"ICD-DFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anterior swing band","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2335","description":"Anterior swing band","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQE1","description":"ICD-OLQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITF1","description":"ICD-OITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Battery charger_ port conc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1357","description":"Battery charger_ port conc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ext amb insulin delivery sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9274","description":"Ext amb insulin delivery sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKED0","description":"ICD-OKED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"I&d p-spine c/t/cerv-thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22010","description":"I&d p-spine c/t/cerv-thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLD1","description":"ICD-KCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMF0","description":"ICD-AEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML0C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resp virus 3-5 targets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87631","description":"Resp virus 3-5 targets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVF1","description":"ICD-BGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwr wc dr wh motor/gear comb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2370","description":"Pwr wc dr wh motor/gear comb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLA1","description":"ICD-FCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRF1","description":"ICD-OGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ Durolane_ for intra-articular injection_ per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9465","description":"Hyaluronan or derivative_ Durolane_ for intra-articular injection_ per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone marrow interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85097","description":"Bone marrow interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Detect agnt mult dna ampli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87801","description":"Detect agnt mult dna ampli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAC1","description":"ICD-OLAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDME0","description":"ICD-EDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSD1","description":"ICD-OLSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMD0","description":"ICD-GEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 15 genotyping (HPA-15)_ CD109 (CD109 molecule) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post-transfusion purpura)_ gene analysis_ common varian","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81112","description":"Human Platelet Antigen 15 genotyping (HPA-15)_ CD109 (CD109 molecule) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post-transfusion purpura)_ gene analysis_ common varian","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOA0","description":"ICD-OGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEA0","description":"ICD-MJEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDD0","description":"ICD-IFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1JB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JB11","description":"ICD-1JB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ inotuzumab ozogamicin_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9229","description":"Injection_ inotuzumab ozogamicin_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Port_ indwelling_ imp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1788","description":"Port_ indwelling_ imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18X","description":"Special Care High _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dent sutur recent wnd to 5cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7910","description":"Dent sutur recent wnd to 5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIF0","description":"ICD-CGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIID0","description":"ICD-NIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Modification diabetic shoe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5507","description":"Modification diabetic shoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61526","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repl trach puncture dilator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8514","description":"Repl trach puncture dilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision benign lesion compl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7412","description":"Excision benign lesion compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ mon_ ite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5256","description":"Hearing aid_ digit_ mon_ ite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01850","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01850","description":"CPT-01850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Opto-acoustic imaging_ breast (including axilla when performed)_ unilateral_ with image documentation_ analysis and report_obtained with ultrasound examination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9788","description":"Opto-acoustic imaging_ breast (including axilla when performed)_ unilateral_ with image documentation_ analysis and report_obtained with ultrasound examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILC1","description":"ICD-MILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHB1","description":"ICD-BHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dexamethasone_ lacrimal ophthalmic insert_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1096","description":"Dexamethasone_ lacrimal ophthalmic insert_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGE0","description":"ICD-NBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXE0","description":"ICD-JEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neostim tl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4265","description":"Neostim tl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNC0","description":"ICD-JDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Root surgery molar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3425","description":"Root surgery molar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gi/renal risk assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1008F","description":"Gi/renal risk assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDA1","description":"ICD-OEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBD0","description":"ICD-BGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBC0","description":"ICD-GIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCD1","description":"ICD-GBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIB1","description":"ICD-ACIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTB1","description":"ICD-AHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of circumcision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54163","description":"Repair of circumcision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVC1","description":"ICD-GGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Services provided as part of","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9990","description":"Services provided as part of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACD1","description":"ICD-KACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUF1","description":"ICD-EAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of only pulse generator component(s) (battery and/or transmitter) of wireless cardiac stimulator for left ventricular pacing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0518T","description":"Removal of only pulse generator component(s) (battery and/or transmitter) of wireless cardiac stimulator for left ventricular pacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diet counsel at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9474","description":"Diet counsel at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cryosurgery penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54056","description":"Cryosurgery penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDF1","description":"ICD-FGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hep c rna 4to12 wk after med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9209","description":"Hep c rna 4to12 wk after med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1469","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","description":"HCPCS-M1469","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADE1","description":"ICD-JADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKD1","description":"ICD-KFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg 0.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11440","description":"Exc face-mm b9+marg 0.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB260","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatric symptoms assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9742","description":"Psychiatric symptoms assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX50","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62121","description":"Incise skull repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oxymorphone hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2410","description":"Oxymorphone hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLB1","description":"ICD-IHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAD1","description":"ICD-KGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interferon alfacon-1 inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9212","description":"Interferon alfacon-1 inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace aortic valve perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33361","description":"Replace aortic valve perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59130","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefiderocol_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0693","description":"Injection_ cefiderocol_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB204","description":"Special Care High _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GB31","description":"ICD-3GB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKED1","description":"ICD-NKED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ nivolumab and relatlimab-rmbw_ 3 mg/1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9298","description":"Injection_ nivolumab and relatlimab-rmbw_ 3 mg/1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWF0","description":"ICD-HIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fixed bilat space maintainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1515","description":"Fixed bilat space maintainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFE1","description":"ICD-FEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCB1","description":"ICD-MDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35082","description":"Repair artery rupture aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITA0","description":"ICD-MITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ epoetin alfa_ biosimilar_ (Retacrit) (for non ESRD use)_ 1000 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5106","description":"Injection_ epoetin alfa_ biosimilar_ (Retacrit) (for non ESRD use)_ 1000 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJA0","description":"ICD-KCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBC0","description":"ICD-BFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTD0","description":"ICD-BGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTB0","description":"ICD-NJTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx dprsd malar fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21360","description":"Opn tx dprsd malar fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44405","description":"Colonoscopy w/dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of humeral externally controlled intramedullary device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0595T","description":"Removal of humeral externally controlled intramedullary device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compres burn garment jacket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6509","description":"Compres burn garment jacket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQF0","description":"ICD-HGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHD1","description":"ICD-NIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFB0","description":"ICD-CGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKE0","description":"ICD-NIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic Repositioning Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including Connec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0678T","description":"Laparoscopic Repositioning Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including Connec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYC0","description":"ICD-DCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX30","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYC1","description":"ICD-LFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAC1","description":"ICD-IDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLB0","description":"ICD-FHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4IA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IA21","description":"ICD-4IA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destroy vag lesions complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57065","description":"Destroy vag lesions complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decitabine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0894","description":"Decitabine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10051","description":"Anesth salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGA0","description":"ICD-JBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA POLYV MLT ORGANISMS EA POLYV ANTISERUM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87451","description":"IAAD IA POLYV MLT ORGANISMS EA POLYV ANTISERUM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Precision attachment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5862","description":"Precision attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHD0","description":"ICD-JEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLB0","description":"ICD-OJLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX33","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAF1","description":"ICD-OEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQD0","description":"ICD-CCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cryo-Cord_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4237","description":"Cryo-Cord_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx vert fx w/manj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22315","description":"Closed tx vert fx w/manj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLB1","description":"ICD-MJLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Improving care for lower extremity joint repair mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0058","description":"Improving care for lower extremity joint repair mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01712","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01712","description":"CPT-01712","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36810","description":"Insertion of cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice routine home care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2042","description":"Hospice routine home care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTB1","description":"ICD-OFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2FC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FC11","description":"ICD-2FC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFB0","description":"ICD-KCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise low back nerve(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64714","description":"Revise low back nerve(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLF0","description":"ICD-JCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Benzodiazepines 13 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80347","description":"Benzodiazepines 13 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUA1","description":"ICD-GFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Multisys ther/juvenile 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2033","description":"Multisys ther/juvenile 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXC0","description":"ICD-CAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOE0","description":"ICD-DHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid exam one ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92590","description":"Hearing aid exam one ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Keroxx (2.5 g/cc)_ 1 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4202","description":"Keroxx (2.5 g/cc)_ 1 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDC0","description":"ICD-OEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOA0","description":"ICD-PFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8X","description":"Low Rehab_ ADL Index 0-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ ep_ diag/abl_ 3d/vect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1732","description":"Cath_ ep_ diag/abl_ 3d/vect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGD1","description":"ICD-NFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWC1","description":"ICD-CAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJA0","description":"ICD-CAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD114","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Add pwr joystick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0983","description":"Add pwr joystick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDD1","description":"ICD-OHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE217","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Phenytoin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1165","description":"Phenytoin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Predominantly Base Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6086","description":"Implant Supported Crown - Predominantly Base Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMB0","description":"ICD-MKMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device_ replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8618","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device_ replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD14D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00810","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00810","description":"CPT-00810","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWF0","description":"ICD-OBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQD0","description":"ICD-CEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace tissue expander","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11970","description":"Replace tissue expander","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJE1","description":"ICD-FHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Outrigger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1080","description":"Outrigger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB226","description":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVF1","description":"ICD-OBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELE0","description":"ICD-NELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXA1","description":"ICD-BDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAF0","description":"ICD-NIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL52","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Symes type medial opening so","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5636","description":"Symes type medial opening so","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of on-body injector (includes cannula insertion) for timed subcutaneous injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96377","description":"Application of on-body injector (includes cannula insertion) for timed subcutaneous injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair nasal septum defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30630","description":"Repair nasal septum defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sewhfo cap desgn w/jnt(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3977","description":"Sewhfo cap desgn w/jnt(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx spine process fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22305","description":"Closed tx spine process fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth neck vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35051","description":"Anesth neck vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTD1","description":"ICD-NGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrogastrography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91132","description":"Electrogastrography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIC1","description":"ICD-OFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQC0","description":"ICD-LBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy lymph node biop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38570","description":"Laparoscopy lymph node biop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVA1","description":"ICD-BGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAD1","description":"ICD-IEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of phenylketones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84035","description":"Assay of phenylketones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Functional status measurement with score was not obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient re","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1043","description":"Functional status measurement with score was not obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAF1","description":"ICD-NLAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFA1","description":"ICD-GAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJD0","description":"ICD-NIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sio flex pelvic/sacr pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0621","description":"Sio flex pelvic/sacr pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg_ diffuse large B-cell lymphoma) gene analysis_ common variant(s) (eg_ codon 646)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81237","description":"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg_ diffuse large B-cell lymphoma) gene analysis_ common variant(s) (eg_ codon 646)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVA1","description":"ICD-JFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX23","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bld glucose monitor w voice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2100","description":"Bld glucose monitor w voice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUE1","description":"ICD-GEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of larynx & pharynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31390","description":"Removal of larynx & pharynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEC0","description":"ICD-JBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBA1","description":"ICD-EHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27788","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ rapid sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0094U","description":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ rapid sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Genetic counseling 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96040","description":"Genetic counseling 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis repeated eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90937","description":"Hemodialysis repeated eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exposure behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by physician or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0363T","description":"Exposure behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by physician or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2031","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","description":"HCPCS-A2031","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69540","description":"Remove ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Car seat/bed test + 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94781","description":"Car seat/bed test + 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"In vivo lab service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88749","description":"In vivo lab service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJB1","description":"ICD-CFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB101","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE231","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ins cath abd/l-ext art 3rd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36247","description":"Ins cath abd/l-ext art 3rd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Jak2 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81270","description":"Jak2 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNF0","description":"ICD-FDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Basiliximab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0480","description":"Basiliximab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"U2Af1 (U2 Small Nuclear Rna Auxiliary Factor 1) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ S34F_ S34Y_ Q157R_ Q157P)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81357","description":"U2Af1 (U2 Small Nuclear Rna Auxiliary Factor 1) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ S34F_ S34Y_ Q157R_ Q157P)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Levalbuterol non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7612","description":"Levalbuterol non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23630","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX02","description":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy inject material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52327","description":"Cystoscopy inject material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATD0","description":"ICD-NATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTD1","description":"ICD-NJTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXB1","description":"ICD-JEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAC0","description":"ICD-IEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPE1","description":"ICD-NCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA41","description":"Low Rehab_ ADL Index 0-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB113","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of finger jnt add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26861","description":"Fusion of finger jnt add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Malaria antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86750","description":"Malaria antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1601","description":"HCPCS-C1601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPA0","description":"ICD-OIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychophysiological therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90875","description":"Psychophysiological therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit with ureteral stricture balloon dilation_ including imaging guidance (eg_ ultrasound and/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7549","description":"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit with ureteral stricture balloon dilation_ including imaging guidance (eg_ ultrasound and/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPA0","description":"ICD-OCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOF1","description":"ICD-CIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSE1","description":"ICD-KHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC5C","description":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alefacept","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0215","description":"Alefacept","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mammo assess susp docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3344F","description":"Mammo assess susp docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rad exc lesion up to 1.25 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7410","description":"Rad exc lesion up to 1.25 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mitomycin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9280","description":"Mitomycin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEME1","description":"ICD-FEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28I","description":"Clinically Complex _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIA0","description":"ICD-EGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fibrin degrade semiquant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85378","description":"Fibrin degrade semiquant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDB0","description":"ICD-ODDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDB1","description":"ICD-EBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMA0","description":"ICD-BIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ clindamycin phosp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0077","description":"Injection_ clindamycin phosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring Of A Standardized Online Digital Cognitive Behavioral Therapy Program Ordered By A Physician Or Other Qualified Health Care Professional; Supply","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0702T","description":"Remote Therapeutic Monitoring Of A Standardized Online Digital Cognitive Behavioral Therapy Program Ordered By A Physician Or Other Qualified Health Care Professional; Supply","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shunt accessory","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4740","description":"Shunt accessory","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRC1","description":"ICD-GGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43123","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tte w/doppler complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93306","description":"Tte w/doppler complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES111","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITF1","description":"ICD-GITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKC0","description":"ICD-ODKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVF1","description":"ICD-CGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHF0","description":"ICD-NHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Atomic absorption","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82190","description":"Atomic absorption","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0204","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0204","description":"HCPCS-A0204","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac output measurement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93561","description":"Cardiac output measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDE1","description":"ICD-GBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHB1","description":"ICD-JGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8B","description":"Very High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37271","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","description":"CPT-37271","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGF1","description":"ICD-GHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYF1","description":"ICD-GEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHE1","description":"ICD-EFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx ovarian unknown nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9117","description":"Onc dx ovarian unknown nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Periodontal medicament carrier with peripheral seal - laboratory processed - mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5996","description":"Periodontal medicament carrier with peripheral seal - laboratory processed - mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimpanzee adenovirus Oxford 1 (ChAdOx1) vector_ pre","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91302","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimpanzee adenovirus Oxford 1 (ChAdOx1) vector_ pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Closure of split wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12021","description":"Closure of split wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44188","description":"Lap colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0511U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","description":"CPT-0511U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Telehealth consultation_ critical care_ subsequent_ physicians typically spend 50 minutes communicating with the patient and providers via telehealth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0509","description":"Telehealth consultation_ critical care_ subsequent_ physicians typically spend 50 minutes communicating with the patient and providers via telehealth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0405","description":"HCPCS-C0405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMF0","description":"ICD-MBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol carb > 50%","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4180","description":"Parenteral sol carb > 50%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nursing fac discharge day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99316","description":"Nursing fac discharge day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor <22.05._comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0207","description":"Traumatic brain injury with Motor <22.05._comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pm phone r-strip device eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93293","description":"Pm phone r-strip device eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXA0","description":"ICD-GDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB3A","description":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFA1","description":"ICD-NJFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mechlorethamine hcl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9230","description":"Mechlorethamine hcl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CT/MRI brain done 24 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3112F","description":"CT/MRI brain done 24 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTD0","description":"ICD-IBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD211","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short sta","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL03","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGC0","description":"ICD-CEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental saliography","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0310","description":"Dental saliography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01392","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01392","description":"CPT-01392","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUC1","description":"ICD-CFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTD0","description":"ICD-OJTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMC0","description":"ICD-KGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18E","description":"Clinically Complex _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pharmacotherapy for OUD initiated after June 30th of performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1033","description":"Pharmacotherapy for OUD initiated after June 30th of performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exfoliative cytolog collect","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7287","description":"Exfoliative cytolog collect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDA1","description":"ICD-EEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBB1","description":"ICD-KHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hla ii typing ag equiv lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81375","description":"Hla ii typing ag equiv lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of rbc galactokinase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82759","description":"Assay of rbc galactokinase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA3D","description":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWA1","description":"ICD-KCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sinus surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31299","description":"Sinus surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNB0","description":"ICD-NHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEF0","description":"ICD-MLEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lvef less than/equal to 35%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3055F","description":"Lvef less than/equal to 35%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58290","description":"Vag hyst complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC23C","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSB0","description":"ICD-KCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAF0","description":"ICD-CIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKF1","description":"ICD-KGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Deep muscle biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20205","description":"Deep muscle biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mycobacteric identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87118","description":"Mycobacteric identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDD1","description":"ICD-FCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBA1","description":"ICD-MBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Os pch urine w bar/fange/tap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4432","description":"Os pch urine w bar/fange/tap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB215","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECE1","description":"ICD-FECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ped term dev_ hook_ vol open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6711","description":"Ped term dev_ hook_ vol open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87564","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","description":"CPT-87564","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWD1","description":"ICD-CBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOF1","description":"ICD-OCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of anal fissure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46940","description":"Treatment of anal fissure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEF1","description":"ICD-EDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Final refract +/- 1.0 in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9519","description":"Final refract +/- 1.0 in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTB1","description":"ICD-ABTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Handgrip for cane etc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4636","description":"Handgrip for cane etc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTF0","description":"ICD-OFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBD1","description":"ICD-NIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL15","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Phenobarbital sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2560","description":"Phenobarbital sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKB0","description":"ICD-NGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUC0","description":"ICD-MGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHE0","description":"ICD-MEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIF0","description":"ICD-NIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKE1","description":"ICD-CCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEA0","description":"ICD-MGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stocking sup grips 4 pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0982","description":"Stocking sup grips 4 pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surgery of rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47451","description":"Anesth surgery of rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGD1","description":"ICD-BHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"12-24hr sealed lead acid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0733","description":"12-24hr sealed lead acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27030","description":"Drainage of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0502U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","description":"CPT-0502U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42320","description":"Drainage of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chronic Care Management Services_ Each Additional 20 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional_ Per Calendar Month (Li","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2058","description":"Chronic Care Management Services_ Each Additional 20 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional_ Per Calendar Month (Li","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHA1","description":"ICD-MCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDF0","description":"ICD-KHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8I","description":"High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Placement of intraocular radiation source applicator (List separately in addition to primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0190T","description":"Placement of intraocular radiation source applicator (List separately in addition to primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cmprsburngarment glove-elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6505","description":"Cmprsburngarment glove-elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0025","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHF0","description":"ICD-JDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAD0","description":"ICD-ODAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECF1","description":"ICD-MECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1453","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","description":"HCPCS-M1453","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shrinker above knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8460","description":"Shrinker above knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXE1","description":"ICD-OGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUC1","description":"ICD-EDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKF0","description":"ICD-CBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGD1","description":"ICD-BBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHF1","description":"ICD-BIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBE1","description":"ICD-JCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast)_ immunohistochemistry_ protein expression profiling of 4 biomarkers (matrix metalloproteinase-1 [MMP-1]_ carcinoembryonic antigen-related cell","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0067U","description":"Oncology (breast)_ immunohistochemistry_ protein expression profiling of 4 biomarkers (matrix metalloproteinase-1 [MMP-1]_ carcinoembryonic antigen-related cell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLE1","description":"ICD-BGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVF0","description":"ICD-BEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLC0","description":"ICD-ODLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urinary suspensory","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5105","description":"Urinary suspensory","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC21A","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Debride nail 1-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11720","description":"Debride nail 1-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70190","description":"X-ray exam of eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp aorsubcl/carot/innom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35626","description":"Art byp aorsubcl/carot/innom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome analysis 100","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88249","description":"Chromosome analysis 100","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWF0","description":"ICD-KHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPA1","description":"ICD-JDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYB0","description":"ICD-KBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound exam aaa screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0389","description":"Ultrasound exam aaa screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTD1","description":"ICD-FGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKF1","description":"ICD-KEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI brain w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70559","description":"MRI brain w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPD1","description":"ICD-KBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGB1","description":"ICD-JEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYB0","description":"ICD-HHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1742","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1742","description":"HCPCS-C1742","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGC0","description":"ICD-OJGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWD0","description":"ICD-CHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHA0","description":"ICD-EGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMC1","description":"ICD-MFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEA1","description":"ICD-FAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Synthetic sentence test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92576","description":"Synthetic sentence test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hip disart sach laminat mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5600","description":"Hip disart sach laminat mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reusable pull-on any size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4536","description":"Reusable pull-on any size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYD0","description":"ICD-KEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Venous m-thrombectomy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37188","description":"Venous m-thrombectomy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKD1","description":"ICD-CIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation with","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7557","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation with","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHF0","description":"ICD-EGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17276","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transhepatic biliary drainage with contrast monitoring_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75980","description":"Percutaneous transhepatic biliary drainage with contrast monitoring_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spinal disk surgery add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63035","description":"Spinal disk surgery add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHB1","description":"ICD-KBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (multiple myeloma)_ LC-MS/MS_ peptide ion quantification_ serum_ results compared with baseline to determine monoclonal paraprotein abundance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0451U","description":"Oncology (multiple myeloma)_ LC-MS/MS_ peptide ion quantification_ serum_ results compared with baseline to determine monoclonal paraprotein abundance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC2D","description":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPF1","description":"ICD-CDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHE0","description":"ICD-EDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMC0","description":"ICD-MLMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagectomy_ total or near total_ with laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy_ with laparoscopic pyloric drainage proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43286","description":"Esophagectomy_ total or near total_ with laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy_ with laparoscopic pyloric drainage proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esoph egd dilation <30 mm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43249","description":"Esoph egd dilation <30 mm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBB1","description":"ICD-IDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYF1","description":"ICD-OGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAB1","description":"ICD-OLAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dermabrasion other than face","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15782","description":"Dermabrasion other than face","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35355","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMB1","description":"ICD-EGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA3B","description":"High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGED1","description":"ICD-AGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth facial bone surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19251","description":"Anesth facial bone surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1834","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","description":"HCPCS-J1834","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pathology report diagnosing cutaneous basal cell carcinoma or squamous cell carcinoma (to include in situ disease) was not sent from the pathologist/dermatopathologist to the","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9786","description":"Pathology report diagnosing cutaneous basal cell carcinoma or squamous cell carcinoma (to include in situ disease) was not sent from the pathologist/dermatopathologist to the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDD0","description":"ICD-ABDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mr angio pelvis w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72198","description":"Mr angio pelvis w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Out of office emerg med serv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99060","description":"Out of office emerg med serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove esophagus obstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74235","description":"Remove esophagus obstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens spher single plano 4.00","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2100","description":"Lens spher single plano 4.00","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11300","description":"Shave skin lesion 0.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL31","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGC1","description":"ICD-JFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD13B","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL53","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHE0","description":"ICD-ACHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; With Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0634T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; With Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"General health panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80050","description":"General health panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Phenothiazine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6057","description":"Phenothiazine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27286","description":"Fusion of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44320","description":"Colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair nasal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30540","description":"Repair nasal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC13C","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA1A","description":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M0236","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","description":"HCPCS-M0236","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDE0","description":"ICD-MIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUF0","description":"ICD-CCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Press pad alternating w/ pum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0181","description":"Press pad alternating w/ pum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1430","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","description":"HCPCS-M1430","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair lightwt foot rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1260","description":"Wheelchair lightwt foot rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepc measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8545","description":"Hepc measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL50","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No neuropsych symptoms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8948","description":"No neuropsych symptoms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLC0","description":"ICD-NBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Augmentation lower jaw bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21127","description":"Augmentation lower jaw bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ CYP2D7-2D6 hybrid gene) (List separately in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0073U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ CYP2D7-2D6 hybrid gene) (List separately in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of cathepsin-d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82387","description":"Assay of cathepsin-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYE0","description":"ICD-DGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXC0","description":"ICD-FEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0106","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0106","description":"HCPCS-B0106","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hhc lpn/rn obs/asses ea 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0163","description":"Hhc lpn/rn obs/asses ea 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGD1","description":"ICD-NJGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone mineral dual photon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78351","description":"Bone mineral dual photon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise aqueous shunt eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66185","description":"Revise aqueous shunt eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0201","description":"HCPCS-C0201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC23D","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUD1","description":"ICD-IAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKF0","description":"ICD-OGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dementia mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8761","description":"Dementia mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECD0","description":"ICD-AECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSA0","description":"ICD-PKSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clsd reduct compd maxilla fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7720","description":"Clsd reduct compd maxilla fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGC0","description":"ICD-JIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC204","description":"Reduced Physical Function _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCC1","description":"ICD-GBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYC0","description":"ICD-PCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYC0","description":"ICD-KDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01740","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01740","description":"CPT-01740","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIC1","description":"ICD-MLIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc cln cncr stage 4 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3390F","description":"Ajcc cln cncr stage 4 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAF1","description":"ICD-CEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMA1","description":"ICD-JGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dimenhydrinate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1240","description":"Dimenhydrinate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise hip joint replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27134","description":"Revise hip joint replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Follow-up/reassessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0316","description":"Follow-up/reassessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cylinder tank carrier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2208","description":"Cylinder tank carrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pi volunteer ambulance co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0432","description":"Pi volunteer ambulance co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No postop ren fail","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8576","description":"No postop ren fail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruct premalg lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17000","description":"Destruct premalg lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDE1","description":"ICD-CBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMB1","description":"ICD-FHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise tendon forearm/wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25109","description":"Excise tendon forearm/wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB35","description":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diphenhydramine hcl injectio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1200","description":"Diphenhydramine hcl injectio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Indiv pdc not > 0.8","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9513","description":"Indiv pdc not > 0.8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXB1","description":"ICD-OCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMC0","description":"ICD-EDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOF1","description":"ICD-HIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJF1","description":"ICD-GGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28E","description":"Special Care High _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAE0","description":"ICD-ODAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perc d-e cor revasc w ami s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9606","description":"Perc d-e cor revasc w ami s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00752","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00752","description":"CPT-00752","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ Hyalgan_ Supartz or Visco-3_ for intra-articular injection_ per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7321","description":"Hyaluronan or derivative_ Hyalgan_ Supartz or Visco-3_ for intra-articular injection_ per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX17","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILA1","description":"ICD-MILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of foot bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28122","description":"Partial removal of foot bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIF1","description":"ICD-OJIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKA0","description":"ICD-NIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext b9+marg 3.1-4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11404","description":"Exc tr-ext b9+marg 3.1-4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGD0","description":"ICD-CIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGA0","description":"ICD-FAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Obstetrical care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59400","description":"Obstetrical care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr s/a/l 2.6-7.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13121","description":"Cmplx rpr s/a/l 2.6-7.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comp multidisipln evaluation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2000","description":"Comp multidisipln evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFB0","description":"ICD-BFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wireless pressure sensor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2624","description":"Wireless pressure sensor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQB0","description":"ICD-KEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB25C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 65 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0145U","description":"Drug assay_ definitive_ 65 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35271","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trac stand free stand extrem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0880","description":"Trac stand free stand extrem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove sutures diff surgeon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15851","description":"Remove sutures diff surgeon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lat thor/lumb addl seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22534","description":"Lat thor/lumb addl seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acetylcysteine comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7604","description":"Acetylcysteine comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFC0","description":"ICD-FEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDME1","description":"ICD-GDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug confirmation_ each procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6058","description":"Drug confirmation_ each procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of chin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21123","description":"Reconstruction of chin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYF0","description":"ICD-PEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLC0","description":"ICD-FDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIA1","description":"ICD-IDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMA0","description":"ICD-IIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"PuraPly XT_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4197","description":"PuraPly XT_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLE0","description":"ICD-EDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUD0","description":"ICD-CDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Frame depth 22 to 25 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2204","description":"Frame depth 22 to 25 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAF1","description":"ICD-AIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUE0","description":"ICD-GIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBD0","description":"ICD-JDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUE0","description":"ICD-CAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ pmkr_ transvenous vdd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1779","description":"Lead_ pmkr_ transvenous vdd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fit spectacles multifocal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92342","description":"Fit spectacles multifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKC0","description":"ICD-CFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEC1","description":"ICD-MJEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHB1","description":"ICD-KIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHC1","description":"ICD-CCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBF0","description":"ICD-ABBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD22B","description":"Special Care Low _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove elbow joint implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24160","description":"Remove elbow joint implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARA0","description":"ICD-LARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remov vert xdrl bdy lmbr/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63303","description":"Remov vert xdrl bdy lmbr/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUD1","description":"ICD-BGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHF0","description":"ICD-AHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFME0","description":"ICD-FFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of digoxin free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80163","description":"Assay of digoxin free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKE0","description":"ICD-GHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEF0","description":"ICD-MKEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOF1","description":"ICD-OAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gliadin (Deamidated) (Dgp) Antibody_ Each Immunoglobulin (Ig) Class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86258","description":"Gliadin (Deamidated) (Dgp) Antibody_ Each Immunoglobulin (Ig) Class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLF1","description":"ICD-OJLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKB1","description":"ICD-NGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27448","description":"Incision of thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTE0","description":"ICD-FGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIF0","description":"ICD-JBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTC1","description":"ICD-KFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4FC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FC11","description":"ICD-4FC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCD0","description":"ICD-JBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Conform band s w>=3in <5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6446","description":"Conform band s w>=3in <5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOF0","description":"ICD-LHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Riv3 vaccine no preserv im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90673","description":"Riv3 vaccine no preserv im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCD1","description":"ICD-GFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Employment - Job Coaching 1:1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1733","description":"Employment - Job Coaching 1:1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDA1","description":"ICD-MCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (eg_ Parkinson disease_ dementia with Lewy bodies)_ cerebrospinal fluid (CSF)_ detection of misfolded a-synuclein protein by seed amplification assay_ qualitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0393U","description":"Neurology (eg_ Parkinson disease_ dementia with Lewy bodies)_ cerebrospinal fluid (CSF)_ detection of misfolded a-synuclein protein by seed amplification assay_ qualitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Collagen skin test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q3031","description":"Collagen skin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93312","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAD1","description":"ICD-KHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L8697","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8697","description":"HCPCS-L8697","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disposable nebulizer sml vol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7004","description":"Disposable nebulizer sml vol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXC0","description":"ICD-KCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQA0","description":"ICD-CFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAB1","description":"ICD-JDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMF1","description":"ICD-JDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spine surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22899","description":"Spine surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of urethra gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53270","description":"Removal of urethra gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA113","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYC0","description":"ICD-OHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXB1","description":"ICD-OFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aurothioglucose injeciton","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2910","description":"Aurothioglucose injeciton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUD1","description":"ICD-AGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0130U","description":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Functional status measurement with score was not obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient re","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1049","description":"Functional status measurement with score was not obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYB1","description":"ICD-PBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIB0","description":"ICD-BBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"W/c lateral trunk/hip suppor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0956","description":"W/c lateral trunk/hip suppor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRF1","description":"ICD-PJRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rep perf anoper fistu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46715","description":"Rep perf anoper fistu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUA0","description":"ICD-NFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with bronchial alveolar lavage(s)_ with computer-assisted image-guided navigation_ including fluoroscopic guidance when performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7510","description":"Bronchoscopy_ rigid or flexible_ with bronchial alveolar lavage(s)_ with computer-assisted image-guided navigation_ including fluoroscopic guidance when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPC0","description":"ICD-CEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair rect/bladder fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45800","description":"Repair rect/bladder fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of nos vitamin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84591","description":"Assay of nos vitamin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dehydroepiandrosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82626","description":"Dehydroepiandrosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUF0","description":"ICD-CDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETD1","description":"ICD-CETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98005","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","description":"CPT-98005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGC1","description":"ICD-CHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFB0","description":"ICD-KAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient-specific_ assistive_ rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patient_s tumor-specific cancer marker information obtained fr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0794T","description":"Patient-specific_ assistive_ rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patient_s tumor-specific cancer marker information obtained fr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mycoplasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87109","description":"Mycoplasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPE0","description":"ICD-NGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFC0","description":"ICD-FFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARA0","description":"ICD-OARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUD1","description":"ICD-BCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXF0","description":"ICD-CBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYB0","description":"ICD-HCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Escharotomy addl incision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16036","description":"Escharotomy addl incision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMD1","description":"ICD-EIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair vessel defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33802","description":"Repair vessel defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"External recharging system for battery (internal) for use with implanted cardiac contractility modulation generator_ replacement only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1030","description":"External recharging system for battery (internal) for use with implanted cardiac contractility modulation generator_ replacement only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQA0","description":"ICD-HAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJD1","description":"ICD-GGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLF1","description":"ICD-OCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDA0","description":"ICD-MJDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMB1","description":"ICD-NGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVF1","description":"ICD-BEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise/repair mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40812","description":"Excise/repair mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUE0","description":"ICD-BAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNE0","description":"ICD-OFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHE1","description":"ICD-CCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"TBP (TATA box binding protein) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81344","description":"TBP (TATA box binding protein) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBD1","description":"ICD-NEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPC1","description":"ICD-JGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEC0","description":"ICD-JGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC160","description":"Special Care Low _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTA1","description":"ICD-BFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUD0","description":"ICD-OAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCB0","description":"ICD-OLCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGD0","description":"ICD-FCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOB1","description":"ICD-HCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAC0","description":"ICD-IIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAB0","description":"ICD-AIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Any patients who had no asthma controller medications dispensed during the measurement year","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9808","description":"Any patients who had no asthma controller medications dispensed during the measurement year","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy forearm soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25065","description":"Biopsy forearm soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0956T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","description":"CPT-0956T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4BC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BC21","description":"ICD-4BC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSB0","description":"ICD-CCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVC1","description":"ICD-OEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLB0","description":"ICD-NDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUE0","description":"ICD-BIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC20","description":"High Rehab _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAB1","description":"ICD-ACAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXC0","description":"ICD-OLXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No doc sinus ct 28d or dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9350","description":"No doc sinus ct 28d or dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHA1","description":"ICD-IIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lidocaine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2001","description":"Lidocaine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8F","description":"Very High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00222","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00222","description":"CPT-00222","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear rx intra-arterial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79445","description":"Nuclear rx intra-arterial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA12B","description":"Clinically Complex _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Procalcitonin (pct)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84145","description":"Procalcitonin (pct)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1280","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heterophile antibody titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86309","description":"Heterophile antibody titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28E","description":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHA0","description":"ICD-OHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA11B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood_ l/r_ froz/degly/wash","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9054","description":"Blood_ l/r_ froz/degly/wash","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0536U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","description":"CPT-0536U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYB0","description":"ICD-OAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blinded administration of convulsive therapy procedure_ either electroconvulsive therapy (ect_ current covered gold standard) or magnetic seizure therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2000","description":"Blinded administration of convulsive therapy procedure_ either electroconvulsive therapy (ect_ current covered gold standard) or magnetic seizure therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWB1","description":"ICD-PFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLC1","description":"ICD-MGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVF0","description":"ICD-OFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"intravenous moderate (conscious) sedation/analgesia- first 15 minutes","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9239","description":"intravenous moderate (conscious) sedation/analgesia- first 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVF1","description":"ICD-GAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Collect & appl blood product","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7921","description":"Collect & appl blood product","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLE1","description":"ICD-JCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERD1","description":"ICD-KERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stat lab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3600","description":"Stat lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC23","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01925","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01925","description":"CPT-01925","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC06","description":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50727","description":"Revise ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKB1","description":"ICD-OEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab-pkrb_ biosimilar_ (herzuma)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5113","description":"Injection_ trastuzumab-pkrb_ biosimilar_ (herzuma)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEC0","description":"ICD-ACEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01622","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01622","description":"CPT-01622","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXA1","description":"ICD-KDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of hand or foot nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64835","description":"Repair of hand or foot nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRF0","description":"ICD-HBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCA1","description":"ICD-NLCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1903","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1903","description":"CDT-D1903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove in/ex hem grps w/fist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46262","description":"Remove in/ex hem grps w/fist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEE1","description":"ICD-EEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUE1","description":"ICD-MGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKC1","description":"ICD-JCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJE0","description":"ICD-NIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC32","description":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIE0","description":"ICD-FCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD20C","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Born 1945-1965","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9448","description":"Born 1945-1965","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLB1","description":"ICD-NBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQB1","description":"ICD-CCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMF0","description":"ICD-MKMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blinded or nonblinded procedure for symptomatic New York Heart Association (NYHA) Class II_ III_ IVA heart failure; transcatheter implantation of left atrial to coronary sinus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9792","description":"Blinded or nonblinded procedure for symptomatic New York Heart Association (NYHA) Class II_ III_ IVA heart failure; transcatheter implantation of left atrial to coronary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray exam of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74270","description":"Contrast x-ray exam of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCC1","description":"ICD-MDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Who cock-up nonmolde pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3908","description":"Who cock-up nonmolde pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKF0","description":"ICD-GEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1291","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLF0","description":"ICD-EBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPE0","description":"ICD-NFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Two Or More Benzodiazepine Prescriptions Ordered For Patients Who Had A Diagnosis Of Seizure Disorders_ Rapid Eye Movement Sleep Behavior Disorder_ Benzodiazepine Withdrawal_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0033","description":"Two Or More Benzodiazepine Prescriptions Ordered For Patients Who Had A Diagnosis Of Seizure Disorders_ Rapid Eye Movement Sleep Behavior Disorder_ Benzodiazepine Withdrawal_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1089T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1089T","description":"CPT-1089T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWD1","description":"ICD-CHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oseltamivir phosphate 75mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9019","description":"Oseltamivir phosphate 75mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electro-oculography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92270","description":"Electro-oculography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSB1","description":"ICD-PJSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ with definitive confirmation of positive results_ any number of drug classes_ urine_ includes specimen verification including DNA authentication in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0007U","description":"Drug test(s)_ presumptive_ with definitive confirmation of positive results_ any number of drug classes_ urine_ includes specimen verification including DNA authentication in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNF1","description":"ICD-GCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostoma valve w diaphra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7501","description":"Tracheostoma valve w diaphra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTF0","description":"ICD-FHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHF1","description":"ICD-CHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHE0","description":"ICD-MLHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3EA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EA31","description":"ICD-3EA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIND0","description":"ICD-GIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL23","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLC1","description":"ICD-OCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHF0","description":"ICD-FGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDC1","description":"ICD-MCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome count additional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88285","description":"Chromosome count additional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITB0","description":"ICD-KITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANB0","description":"ICD-GANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAC0","description":"ICD-MCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENB0","description":"ICD-KENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWF1","description":"ICD-GHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Metacarp fx orthosis pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3917","description":"Metacarp fx orthosis pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDID1","description":"ICD-EDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQD1","description":"ICD-PGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLC0","description":"ICD-OBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLD0","description":"ICD-FDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hd hosp bed_ 350-600 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0301","description":"Hd hosp bed_ 350-600 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ glove_ padded_ for nighttime use_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6521","description":"Gradient compression garment_ glove_ padded_ for nighttime use_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Internal Medicine Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4011","description":"Internal Medicine Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0878T","description":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of facial/other nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64866","description":"Fusion of facial/other nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUC0","description":"ICD-NDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX05","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVF0","description":"ICD-OJVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFB0","description":"ICD-OJFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29720","description":"Repair of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Navigational bronchoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31627","description":"Navigational bronchoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0635U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0635U","description":"CPT-0635U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hhcp-svs of aide_ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0156","description":"Hhcp-svs of aide_ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of left heart vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33988","description":"Insertion of left heart vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pharmacologic mgmt w/psytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90863","description":"Pharmacologic mgmt w/psytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPF1","description":"ICD-CFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB4C","description":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUC1","description":"ICD-KIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECB1","description":"ICD-IECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALE1","description":"ICD-KALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBB0","description":"ICD-EHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65110","description":"Removal of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVF0","description":"ICD-KHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58180","description":"Partial hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair detachable arms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1060","description":"Wheelchair detachable arms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITD0","description":"ICD-FITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immune admin oral/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90473","description":"Immune admin oral/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0504","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0504","description":"CDT-D0504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Self-mgmt educ/train 2-4 pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98961","description":"Self-mgmt educ/train 2-4 pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87468","description":"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUF0","description":"ICD-EFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant neurostim arrays","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61886","description":"Implant neurostim arrays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cerv col sr foam 2pc pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0172","description":"Cerv col sr foam 2pc pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAID0","description":"ICD-FAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWA0","description":"ICD-PKWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDD1","description":"ICD-GEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ includes titer(s)_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0224U","description":"Antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ includes titer(s)_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHC0","description":"ICD-EHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWB0","description":"ICD-OAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunohisto antb addl slide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88341","description":"Immunohisto antb addl slide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICB0","description":"ICD-JICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal and replacement of wireless cardiac stimulator for left ventricular pacing; pulse generator component(s) (battery and/or transmitter)_ including placement of a new ele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0520T","description":"Removal and replacement of wireless cardiac stimulator for left ventricular pacing; pulse generator component(s) (battery and/or transmitter)_ including placement of a new ele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLA1","description":"ICD-EFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB45","description":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEA0","description":"ICD-GCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pulpal therapy anterior prim","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3230","description":"Pulpal therapy anterior prim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVF0","description":"ICD-GFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUC1","description":"ICD-EEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWD1","description":"ICD-PAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"American amnion ac tri-layer_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4305","description":"American amnion ac tri-layer_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKC1","description":"ICD-BIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Valvuloplasty open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33401","description":"Valvuloplasty open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKB1","description":"ICD-JEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25420","description":"Repair/graft radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQF0","description":"ICD-OHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAA1","description":"ICD-OFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFE0","description":"ICD-KIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVC1","description":"ICD-NIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJC1","description":"ICD-OFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE13B","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Imaging of the head (CT or MRI) was not obtained_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1029","description":"Imaging of the head (CT or MRI) was not obtained_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pancreatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48152","description":"Pancreatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJE1","description":"ICD-GBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPA0","description":"ICD-FCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytomeg dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87495","description":"Cytomeg dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Needle Insertion(S) Without Injection(S); 1 Or 2 Muscle(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20560","description":"Needle Insertion(S) Without Injection(S); 1 Or 2 Muscle(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIC0","description":"ICD-NJIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lens material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66850","description":"Removal of lens material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54312","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARB0","description":"ICD-KARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOE1","description":"ICD-CDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUD1","description":"ICD-KCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKF0","description":"ICD-CEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert cervical dilator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59200","description":"Insert cervical dilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSF1","description":"ICD-LFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLF0","description":"ICD-ECLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEF0","description":"ICD-JDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEB0","description":"ICD-IBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD24C","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thiamine hcl 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3411","description":"Thiamine hcl 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Office visit after hours","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9440","description":"Office visit after hours","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKE0","description":"ICD-NLKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHF1","description":"ICD-CBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neuromuscular electrical stimulator (nmes)_ disposable_ replacement only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4560","description":"Neuromuscular electrical stimulator (nmes)_ disposable_ replacement only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGE0","description":"ICD-JHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHED1","description":"ICD-GHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCF0","description":"ICD-KBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPF0","description":"ICD-NFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed total electr w/ mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0265","description":"Hosp bed total electr w/ mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2003","description":"HCPCS-A2003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC25D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8X","description":"Medium Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABF0","description":"ICD-MABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRC1","description":"ICD-LGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74742","description":"X-ray fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENC0","description":"ICD-KENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"marsupialization of odontogenic cyst","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7509","description":"marsupialization of odontogenic cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"T-cell depletion of harvest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38210","description":"T-cell depletion of harvest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD15D","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Collect & prep genetic samp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0422","description":"Collect & prep genetic samp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUF1","description":"ICD-FDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFA1","description":"ICD-CAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRC0","description":"ICD-LCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWB0","description":"ICD-HFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45116","description":"Partial removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGD0","description":"ICD-OIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic pneumothorax","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32960","description":"Therapeutic pneumothorax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKND0","description":"ICD-NKND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thorax spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22556","description":"Thorax spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECC0","description":"ICD-FECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCE0","description":"ICD-OBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insitu hybridization auto","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88367","description":"Insitu hybridization auto","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXD1","description":"ICD-BGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCF0","description":"ICD-KDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL53","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASE0","description":"ICD-LASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUE1","description":"ICD-GGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Limited dental tx adult","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8040","description":"Limited dental tx adult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ovrsght xtrcorp liv asst pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0405T","description":"Ovrsght xtrcorp liv asst pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Complete cbc w/auto diff wbc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85025","description":"Complete cbc w/auto diff wbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVD1","description":"ICD-GEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC236","description":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No hepc rna after med docrsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9210","description":"No hepc rna after med docrsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPB1","description":"ICD-BDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dentures rebase cmplt maxil","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5710","description":"Dentures rebase cmplt maxil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No reason for no hep c rna","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9204","description":"No reason for no hep c rna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX34","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55180","description":"Revision of scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFF0","description":"ICD-NEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGA1","description":"ICD-CEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNE1","description":"ICD-OBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Portable oxygen contents_ liquid_ 1 month_s supply = 1 unit_ prescribed amount at rest or nighttime exceeds 4 liters per minute","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0447","description":"Portable oxygen contents_ liquid_ 1 month_s supply = 1 unit_ prescribed amount at rest or nighttime exceeds 4 liters per minute","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBC0","description":"ICD-AFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIB0","description":"ICD-BFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADA1","description":"ICD-OADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIA1","description":"ICD-EAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt not eligible ace/arb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8936","description":"Pt not eligible ace/arb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHF0","description":"ICD-EFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD20C","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNF0","description":"ICD-OFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee joint cam lock each joi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2415","description":"Knee joint cam lock each joi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQF0","description":"ICD-PFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBC0","description":"ICD-EFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of rib fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21813","description":"Treatment of rib fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC11C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHB1","description":"ICD-NCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cabg arterial single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33533","description":"Cabg arterial single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAD0","description":"ICD-JFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAE1","description":"ICD-ODAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"TPMT (thiopurine S-methyltransferase) (eg_ drug metabolism)_ gene analysis_ common variants (eg_ *2_ *3)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81335","description":"TPMT (thiopurine S-methyltransferase) (eg_ drug metabolism)_ gene analysis_ common variants (eg_ *2_ *3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVA1","description":"ICD-FFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infus insulin pump non needl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4230","description":"Infus insulin pump non needl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQD1","description":"ICD-LEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0675U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675U","description":"CPT-0675U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-rad contrast materialnoc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9698","description":"Non-rad contrast materialnoc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEA0","description":"ICD-OIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFE1","description":"ICD-CCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit complex cath care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5501","description":"Hit complex cath care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUD1","description":"ICD-JIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA160","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No sleep apnea assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8841","description":"No sleep apnea assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAD1","description":"ICD-BDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Facial prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5919","description":"Facial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fosphenytoin sodi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0078","description":"Injection_ fosphenytoin sodi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKA0","description":"ICD-GEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure for percutaneous transhepatic cholangiography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47500","description":"Injection procedure for percutaneous transhepatic cholangiography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69644","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWC0","description":"ICD-CCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOD0","description":"ICD-CEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUC0","description":"ICD-BBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOF1","description":"ICD-KAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWA0","description":"ICD-DGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJC0","description":"ICD-GBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect apical lung tum/chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32504","description":"Resect apical lung tum/chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEB0","description":"ICD-GBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cur meds not document","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8428","description":"Cur meds not document","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLF0","description":"ICD-IGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1189","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLE1","description":"ICD-OCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bendamustine hydrochloride (baxter)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9059","description":"Injection_ bendamustine hydrochloride (baxter)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscp rig trnso biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43193","description":"Esophagoscp rig trnso biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDC1","description":"ICD-CDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"1high risk no ord","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9366","description":"1high risk no ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"W/in 2yr dxa not order","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9471","description":"W/in 2yr dxa not order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB13A","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA206","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Post fusion 7-12 vert seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22802","description":"Post fusion 7-12 vert seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWA1","description":"ICD-HCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBE0","description":"ICD-CGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Test feces for trypsin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84488","description":"Test feces for trypsin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEB0","description":"ICD-JCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC4A","description":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEF0","description":"ICD-MEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of transferrin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84466","description":"Assay of transferrin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA250","description":"Clinically Complex _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBB0","description":"ICD-OGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Capsaicin 8% patch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7336","description":"Capsaicin 8% patch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXD1","description":"ICD-CBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE241","description":"Special Care High _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33999","description":"Cardiac surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of metatarsals","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28309","description":"Incision of metatarsals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDF0","description":"ICD-IEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGA1","description":"ICD-KGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQF1","description":"ICD-PJQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open aortofemor prosth repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34832","description":"Open aortofemor prosth repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18D","description":"Special Care High _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0911T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","description":"CPT-0911T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD20D","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDA0","description":"ICD-EHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBE0","description":"ICD-KGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISB1","description":"ICD-LISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone replacement graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7953","description":"Bone replacement graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA0D","description":"Low Rehab_ ADL Index 0-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Smpd1 gene common variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81330","description":"Smpd1 gene common variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEE1","description":"ICD-OFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29805","description":"Shoulder arthroscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16373","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16373","description":"CPT-16373","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDB0","description":"ICD-NIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open bone biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20251","description":"Open bone biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE24C","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB205","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50650","description":"Removal of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cranial bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21183","description":"Reconstruct cranial bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft aortorenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35560","description":"Art byp grft aortorenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLC0","description":"ICD-EDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphere trifocal 4.00d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2300","description":"Lens sphere trifocal 4.00d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLD1","description":"ICD-EBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHD0","description":"ICD-MBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEC1","description":"ICD-CDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMD0","description":"ICD-OEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trans shoe solid stirrup exi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3620","description":"Trans shoe solid stirrup exi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28I","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALC1","description":"ICD-MALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01770","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01770","description":"CPT-01770","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPE0","description":"ICD-NCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ acetaminophen (fresenius kabi) not therapeutically equivalent to j0131_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0134","description":"Injection_ acetaminophen (fresenius kabi) not therapeutically equivalent to j0131_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Symphony_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2009","description":"Symphony_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD151","description":"Special Care High _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21085","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vestibuloplasty exten graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7350","description":"Vestibuloplasty exten graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEB1","description":"ICD-JIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTD0","description":"ICD-OGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD251","description":"Clinically Complex _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYF1","description":"ICD-GHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic activities","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97530","description":"Therapeutic activities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAD1","description":"ICD-FAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Death occurring during the index acute care hospitalization","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9814","description":"Death occurring during the index acute care hospitalization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of neck muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21700","description":"Revision of neck muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"KEL GNOTYP KEL EXON 8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0194U","description":"KEL GNOTYP KEL EXON 8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIB1","description":"ICD-BGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Addition to lower extremity prostheses_ osseointegrated external prosthetic connector","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5991","description":"Addition to lower extremity prostheses_ osseointegrated external prosthetic connector","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWF0","description":"ICD-OEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHC0","description":"ICD-BHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc med reas no scrn hcv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9452","description":"Doc med reas no scrn hcv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61536","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMF0","description":"ICD-NEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYD1","description":"ICD-CCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA45","description":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18C","description":"Clinically Complex _ ADL Index 0-1/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI uppr extremity w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73220","description":"MRI uppr extremity w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair liver wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47360","description":"Repair liver wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plastic mod low ext pad/line","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2275","description":"Plastic mod low ext pad/line","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trabeculostomy Ab Interno By Laser;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0621T","description":"Trabeculostomy Ab Interno By Laser;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDB0","description":"ICD-GGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ filgrastim-ayow_ biosimilar_ (Releuko)_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9096","description":"Injection_ filgrastim-ayow_ biosimilar_ (Releuko)_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAC1","description":"ICD-JIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNB1","description":"ICD-CBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFC1","description":"ICD-NEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace eye fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67025","description":"Replace eye fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB60","description":"High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD15C","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth trach-bronch reconst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53951","description":"Anesth trach-bronch reconst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAB1","description":"ICD-CAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncoprotein her-2/neu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83950","description":"Oncoprotein her-2/neu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rev/remvl crtd sns dev lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0270T","description":"Rev/remvl crtd sns dev lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27500","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37270","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","description":"CPT-37270","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cad cxr remote","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0175T","description":"Cad cxr remote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy with biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31510","description":"Laryngoscopy with biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASE1","description":"ICD-GASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTA1","description":"ICD-ADTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIB1","description":"ICD-EIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFA1","description":"ICD-FBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"PuraPly or PuraPly AM_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4172","description":"PuraPly or PuraPly AM_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWA1","description":"ICD-KDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive at least one well-child visit with PCP during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9965","description":"Patient did not receive at least one well-child visit with PCP during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJC1","description":"ICD-OKJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEF0","description":"ICD-BAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Continuous_ Real-Time Monitoring And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95710","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Continuous_ Real-Time Monitoring And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDC0","description":"ICD-JGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXA0","description":"ICD-FBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIC1","description":"ICD-CCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Loudness balance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92562","description":"Loudness balance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABC1","description":"ICD-CABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prfrmnc docd 2 wks b/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3328F","description":"Prfrmnc docd 2 wks b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD115","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1007T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","description":"CPT-1007T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUF1","description":"ICD-IFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASE0","description":"ICD-DASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1437","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","description":"HCPCS-M1437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSA1","description":"ICD-KDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy lower leg soft tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27614","description":"Biopsy lower leg soft tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYE1","description":"ICD-OLYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELB1","description":"ICD-IELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove/treat lung lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32141","description":"Remove/treat lung lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYB0","description":"ICD-GAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEB0","description":"ICD-JFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental gold foil two surface","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2420","description":"Dental gold foil two surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Section recurrent laryngeal nerve_ therapeutic (separate procedure)_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31595","description":"Section recurrent laryngeal nerve_ therapeutic (separate procedure)_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5948","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5948","description":"CDT-D5948","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSD0","description":"ICD-HBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antithrombin iii activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85300","description":"Antithrombin iii activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHB1","description":"ICD-EAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUE1","description":"ICD-IDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAME0","description":"ICD-JAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC11B","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRC1","description":"ICD-OBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJE0","description":"ICD-FFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMA0","description":"ICD-GCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wrist arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29844","description":"Wrist arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis_ including small sequence changes_ copy number variants_ deletions_ duplications_ mobile ele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0335U","description":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis_ including small sequence changes_ copy number variants_ deletions_ duplications_ mobile ele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect arm/elbow tum 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24079","description":"Resect arm/elbow tum 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3EB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EB21","description":"ICD-3EB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia)_ genomic sequence analysis panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0237U","description":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia)_ genomic sequence analysis panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEA1","description":"ICD-NFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explr/decompress eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67445","description":"Explr/decompress eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNF1","description":"ICD-GGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical boot each infant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3208","description":"Surgical boot each infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMB0","description":"ICD-FDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWF0","description":"ICD-HHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHA1","description":"ICD-AAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAA1","description":"ICD-ABAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWE0","description":"ICD-DCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Intramedullary (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20702","description":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Intramedullary (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bicarbonate conc pow per pac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4707","description":"Bicarbonate conc pow per pac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elbow orthosis (EO)_ with adjustable position locking joint(s)_ prefabricated_ off-the-shelf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3761","description":"Elbow orthosis (EO)_ with adjustable position locking joint(s)_ prefabricated_ off-the-shelf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGC1","description":"ICD-CBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ atezolizumab_ 10 mg (Tecentriq)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9483","description":"Injection_ atezolizumab_ 10 mg (Tecentriq)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRD0","description":"ICD-PLRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTC1","description":"ICD-JHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNE0","description":"ICD-GFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0452T","description":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1302","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1302","description":"HCPCS-B1302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye muscle add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67340","description":"Revise eye muscle add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFB1","description":"ICD-JBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLA1","description":"ICD-FDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0138","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","description":"HCPCS-J0138","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAC0","description":"ICD-NGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35182","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tx beta-lactam abx therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9558","description":"Tx beta-lactam abx therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEF0","description":"ICD-CAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD212","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin substitute_ synthetic_ resorbable_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1849","description":"Skin substitute_ synthetic_ resorbable_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prepare embryo for transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89255","description":"Prepare embryo for transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTE0","description":"ICD-NFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE210","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXC0","description":"ICD-OFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTC0","description":"ICD-BBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ocular dev_ intraop_ det ret","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1784","description":"Ocular dev_ intraop_ det ret","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAE1","description":"ICD-NEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aspirate pleura w/ imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32555","description":"Aspirate pleura w/ imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0752","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","description":"HCPCS-J0752","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient unable to complete the neck fs prom at initial evaluation and/or discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility_ and an a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1149","description":"Patient unable to complete the neck fs prom at initial evaluation and/or discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility_ and an a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPA0","description":"ICD-FDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc surveillance for disease","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9052","description":"Onc surveillance for disease","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRF1","description":"ICD-KIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavior identification-supporting assessment_ administered by one technician under the direction of a physician or other qualified health care professional_ face-to-face with","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97152","description":"Behavior identification-supporting assessment_ administered by one technician under the direction of a physician or other qualified health care professional_ face-to-face with","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"removal of non-resorbable barrier","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4286","description":"removal of non-resorbable barrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: positional headaches","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2191","description":"Patients with clinical indications for imaging of the head: positional headaches","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAA1","description":"ICD-JEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQC1","description":"ICD-DAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBB0","description":"ICD-CGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES31A","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFB0","description":"ICD-KDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUA0","description":"ICD-BGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVB1","description":"ICD-NFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ldl-c >/= 130 mg/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3050F","description":"Ldl-c >/= 130 mg/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPD1","description":"ICD-NKPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAE0","description":"ICD-IIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv trunk musc 1-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64646","description":"Chemodenerv trunk musc 1-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI low field","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8042","description":"MRI low field","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft hand/foot 2 crvcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63015","description":"Remove spine lamina >2 crvcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ risperidone_ (perseris)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2798","description":"Injection_ risperidone_ (perseris)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of bladder neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52500","description":"Revision of bladder neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVF1","description":"ICD-BHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIA0","description":"ICD-AIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESB1","description":"ICD-GESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFD1","description":"ICD-FEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vit for membrane dissect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67043","description":"Vit for membrane dissect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4376","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","description":"HCPCS-Q4376","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMA1","description":"ICD-OKMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nipple exploration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19110","description":"Nipple exploration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECF0","description":"ICD-BECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ArdeoGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4333","description":"ArdeoGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pinworm exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87172","description":"Pinworm exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx colon t1-3_n1-2_no pr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9084","description":"Onc dx colon t1-3_n1-2_no pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology (coronary heart disease [CHD])_ DNA_ analysis of 5 single-nucleotide polymorphisms (SNPs) (rs11716050 [LOC105376934]_ rs6560711 [WDR37]_ rs3735222 [SCIN/LOC10798676","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0439U","description":"Cardiology (coronary heart disease [CHD])_ DNA_ analysis of 5 single-nucleotide polymorphisms (SNPs) (rs11716050 [LOC105376934]_ rs6560711 [WDR37]_ rs3735222 [SCIN/LOC10798676","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Water pressure pad for mattr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0198","description":"Water pressure pad for mattr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTE1","description":"ICD-MHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQC0","description":"ICD-OAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apnea monitor w recorder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0619","description":"Apnea monitor w recorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA53","description":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lt compres band <3in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6448","description":"Lt compres band <3in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHE1","description":"ICD-NHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEC1","description":"ICD-NDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBE1","description":"ICD-BIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bl exchange/transfuse nb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36450","description":"Bl exchange/transfuse nb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARC0","description":"ICD-LARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAA0","description":"ICD-EGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enteral feeding supply kit; elastomeric control fed_ per day_ includes but not limited to feeding/flushing syringe_ administration set tubing_ dressings_ tape","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4148","description":"Enteral feeding supply kit; elastomeric control fed_ per day_ includes but not limited to feeding/flushing syringe_ administration set tubing_ dressings_ tape","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHF0","description":"ICD-GAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Granisetron hcl 1 mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0166","description":"Granisetron hcl 1 mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRC0","description":"ICD-OIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art trnsposj subclavian","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35693","description":"Art trnsposj subclavian","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis_ copy number variants_ and micros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81463","description":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis_ copy number variants_ and micros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITD0","description":"ICD-KITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLC1","description":"ICD-CDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"American amnion_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4307","description":"American amnion_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKD1","description":"ICD-OHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALC1","description":"ICD-AALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ko w/0 joint rigid molded to","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1834","description":"Ko w/0 joint rigid molded to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFF0","description":"ICD-KCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Arbutamine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0395","description":"Arbutamine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Angina present","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1011F","description":"Angina present","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKF1","description":"ICD-GGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMD1","description":"ICD-JFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dress/debrid p-thick burn s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16020","description":"Dress/debrid p-thick burn s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 4 std seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0868","description":"Pwc gp 4 std seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoplasty_ medialization_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31591","description":"Laryngoplasty_ medialization_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUC1","description":"ICD-GIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Probe nasolacrimal duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68815","description":"Probe nasolacrimal duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Prostate Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1101","description":"Radiation Therapy For Prostate Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of tongue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41100","description":"Biopsy of tongue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBD1","description":"ICD-BFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE13D","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD25C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCB0","description":"ICD-OCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFA1","description":"ICD-FFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Continuous ppi or h2ra rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4185F","description":"Continuous ppi or h2ra rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUD1","description":"ICD-IIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE114","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1738","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1738","description":"HCPCS-C1738","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1010T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","description":"CPT-1010T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUE0","description":"ICD-FIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unspecified periodontal proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4999","description":"Unspecified periodontal proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24410","description":"Revision of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17266","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTC0","description":"ICD-MJTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pos microalbuminuria rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3060F","description":"Pos microalbuminuria rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHB0","description":"ICD-BBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES33C","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXE1","description":"ICD-CGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB10A","description":"Special Care Low _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 16 central carbon metabolites (ie_a-ketoglutarate_ alanine_ lactate_ phenylalanine_ pyruvate_ succinat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0263U","description":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 16 central carbon metabolites (ie_a-ketoglutarate_ alanine_ lactate_ phenylalanine_ pyruvate_ succinat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adenoma detected screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3775F","description":"Adenoma detected screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMC1","description":"ICD-JGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJC1","description":"ICD-BCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place cath xtrnl carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36227","description":"Place cath xtrnl carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAE0","description":"ICD-ECAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPC1","description":"ICD-NCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATE0","description":"ICD-FATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair spec size w/ leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1222","description":"Wheelchair spec size w/ leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA226","description":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWF0","description":"ICD-GBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFB0","description":"ICD-FIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIC0","description":"ICD-MAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15950","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGA1","description":"ICD-OEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMD0","description":"ICD-NIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise eyelashes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67830","description":"Revise eyelashes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML4C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICME1","description":"ICD-ICME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Position wc cush wdth>=22 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2606","description":"Position wc cush wdth>=22 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMF0","description":"ICD-ACMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid tumor)_ circulating tumor cell selection_ identification_ morphological characterization_ detection and enumeration based on differential EpCAM_ cytokeratins 8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0338U","description":"Oncology (solid tumor)_ circulating tumor cell selection_ identification_ morphological characterization_ detection and enumeration based on differential EpCAM_ cytokeratins 8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Moderate (45 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished w/in a bene home)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0083","description":"Moderate (45 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished w/in a bene home)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76831","description":"Echo exam uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Analyze neurostim simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95971","description":"Analyze neurostim simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDB0","description":"ICD-BBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ace/arb not rxd; doc reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8474","description":"Ace/arb not rxd; doc reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ustekinumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3357","description":"Ustekinumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYF0","description":"ICD-LBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28107","description":"Remove/graft foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCC0","description":"ICD-IGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcyl bifo 7.25-12/2.2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2212","description":"Lens sphcyl bifo 7.25-12/2.2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOA0","description":"ICD-ODOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVC1","description":"ICD-KEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLA1","description":"ICD-MKLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATF0","description":"ICD-EATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mcp joint arthroscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29902","description":"Mcp joint arthroscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2CA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CA21","description":"ICD-2CA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert major vessel graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33330","description":"Insert major vessel graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1003T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","description":"CPT-1003T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablate heart dysrhythm focus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93650","description":"Ablate heart dysrhythm focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPA0","description":"ICD-ODPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ntiol category 5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q1005","description":"Ntiol category 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bk thigh lacer non-molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5680","description":"Bk thigh lacer non-molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0174A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ alemtuzumab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0202","description":"Injection_ alemtuzumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast cancer)_ ERBB2 (HER2) copy number by FISH_ tumor cells from formalin fixed paraffin embedded tissue isolated using image-based dielectrophoresis (DEP) sorting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0009U","description":"Oncology (breast cancer)_ ERBB2 (HER2) copy number by FISH_ tumor cells from formalin fixed paraffin embedded tissue isolated using image-based dielectrophoresis (DEP) sorting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEF1","description":"ICD-GHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTF1","description":"ICD-EBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comp comm supp svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2016","description":"Comp comm supp svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDA1","description":"ICD-AEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA46","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0405","description":"HCPCS-A0405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0645U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0645U","description":"CPT-0645U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASA1","description":"ICD-HASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adoptive immunotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2107","description":"Adoptive immunotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sex offend tx svc_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2028","description":"Sex offend tx svc_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; set-up_ patient training_ configuration of monitor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0534T","description":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; set-up_ patient training_ configuration of monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGED0","description":"ICD-OGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision and/or reinsertion of transhepatic tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47530","description":"Revision and/or reinsertion of transhepatic tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj streptokinase /250000 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2995","description":"Inj streptokinase /250000 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPA0","description":"ICD-NDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANC1","description":"ICD-JANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOF0","description":"ICD-OIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKC0","description":"ICD-KFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXA1","description":"ICD-NLXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of scrotum abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55100","description":"Drainage of scrotum abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOF0","description":"ICD-HAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00215","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00215","description":"CPT-00215","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin pedicle flap trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15570","description":"Skin pedicle flap trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ilr device eval progr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93285","description":"Ilr device eval progr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hla i typing complete lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81372","description":"Hla i typing complete lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXD1","description":"ICD-OKXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC56","description":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB155","description":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mycobacteria culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87116","description":"Mycobacteria culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKB1","description":"ICD-JAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release of lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32220","description":"Release of lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC44","description":"Very High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"D5w infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7070","description":"D5w infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Egd place gastrostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43246","description":"Egd place gastrostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGA1","description":"ICD-NLGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Seat upholstery_ replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0981","description":"Seat upholstery_ replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Testosterone undecanoate 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3145","description":"Testosterone undecanoate 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX07","description":"High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit >30.0cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12047","description":"Intmd rpr n-hf/genit >30.0cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRE0","description":"ICD-GGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDF0","description":"ICD-FEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISB1","description":"ICD-GISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMF0","description":"ICD-NFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Csf ventriculography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78635","description":"Csf ventriculography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Valvuloplasty w/cp bypass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33403","description":"Valvuloplasty w/cp bypass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enterectomy w/taper cong","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44127","description":"Enterectomy w/taper cong","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTA1","description":"ICD-FCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1458","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","description":"HCPCS-M1458","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Subtalar arthro w/fb rmvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29904","description":"Subtalar arthro w/fb rmvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRA0","description":"ICD-GDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRB0","description":"ICD-KGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00944","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00944","description":"CPT-00944","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0986T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","description":"CPT-0986T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUB0","description":"ICD-AAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair detached retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67105","description":"Repair detached retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kafo sng/dbl mechanical act","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2005","description":"Kafo sng/dbl mechanical act","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sinusoidal rotational test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92546","description":"Sinusoidal rotational test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revoshield + amniotic barrier_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4289","description":"Revoshield + amniotic barrier_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Conform band n/s w>=3in<5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6443","description":"Conform band n/s w>=3in<5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient Did Not Receive Both The 13-Valent Pneumococcal Conjugate Vaccine And The 23-Valent Pneumococcal Polysaccharide Vaccine At Least 12 Months Apart_ With The First Occurr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2159","description":"Patient Did Not Receive Both The 13-Valent Pneumococcal Conjugate Vaccine And The 23-Valent Pneumococcal Polysaccharide Vaccine At Least 12 Months Apart_ With The First Occurr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA4C","description":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEA1","description":"ICD-MIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urine ost pouch w faucet/tap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4428","description":"Urine ost pouch w faucet/tap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQC0","description":"ICD-OJQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise spine cord vsl thrlmb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63252","description":"Revise spine cord vsl thrlmb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31288","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDB0","description":"ICD-IEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD12C","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYC1","description":"ICD-PGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVA0","description":"ICD-NHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tear duct system surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68899","description":"Tear duct system surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDB1","description":"ICD-BBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ furosemide (furoscix)_ 20 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1941","description":"Injection_ furosemide (furoscix)_ 20 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bcr/abl1 gene other bp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81208","description":"Bcr/abl1 gene other bp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient Received At Least One Dose Of The Herpes Zoster Live Vaccine Or Two Doses Of The Herpes Zoster Recombinant Vaccine (At Least 28 Days Apart) Anytime On Or After The Pat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2160","description":"Patient Received At Least One Dose Of The Herpes Zoster Live Vaccine Or Two Doses Of The Herpes Zoster Recombinant Vaccine (At Least 28 Days Apart) Anytime On Or After The Pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRE0","description":"ICD-PJRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEC1","description":"ICD-NEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE22B","description":"Reduced Physical Function _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brca1 gene known fam variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81215","description":"Brca1 gene known fam variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1463","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","description":"HCPCS-M1463","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNE0","description":"ICD-JGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Quality care in mental health and substance use disorders mips value pathway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1369","description":"Quality care in mental health and substance use disorders mips value pathway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYB0","description":"ICD-CCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEC1","description":"ICD-JIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINC0","description":"ICD-FINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adjv hrmnl thxpy rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4164F","description":"Adjv hrmnl thxpy rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDB0","description":"ICD-FCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHD1","description":"ICD-AFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Secondary urethral surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54344","description":"Secondary urethral surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUF1","description":"ICD-EHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cerv col supp adj bar & thor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0200","description":"Cerv col supp adj bar & thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYC0","description":"ICD-CBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt no ther chg or contra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9650","description":"Doc pt no ther chg or contra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ infliximab-abda_ biosimilar_ (Renflexis)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5104","description":"Injection_ infliximab-abda_ biosimilar_ (Renflexis)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELC1","description":"ICD-OELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ vestronidase alfa-vjbk_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3397","description":"Injection_ vestronidase alfa-vjbk_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental inlay resin 3/mre sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2652","description":"Dental inlay resin 3/mre sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAD1","description":"ICD-CCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUB0","description":"ICD-BBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEA1","description":"ICD-JDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLA0","description":"ICD-GDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUC1","description":"ICD-NBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7521","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","description":"HCPCS-J7521","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22558","description":"Lumbar spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCE1","description":"ICD-FGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECC0","description":"ICD-EECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCV2 10MCG TRS-SUCR 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0072A","description":"ADM SARSCV2 10MCG TRS-SUCR 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemi-wheelchair fixed arms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1085","description":"Hemi-wheelchair fixed arms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLA1","description":"ICD-CFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYC1","description":"ICD-CIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX07","description":"Very High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18A","description":"Special Care Low _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGA1","description":"ICD-NDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWD1","description":"ICD-DIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYF1","description":"ICD-DGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSC1","description":"ICD-GCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFB0","description":"ICD-BCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKB1","description":"ICD-JHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin chromotography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83021","description":"Hemoglobin chromotography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTA1","description":"ICD-JDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onsite Ac Tx Nsg Fac Res W/Skn Inf Bill Sid-Bnef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9682","description":"Onsite Ac Tx Nsg Fac Res W/Skn Inf Bill Sid-Bnef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cryotherapy of skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17340","description":"Cryotherapy of skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Copd symptoms assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1015F","description":"Copd symptoms assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMF1","description":"ICD-AHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVC1","description":"ICD-CIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electronic salivary reflex s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0755","description":"Electronic salivary reflex s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCD0","description":"ICD-IGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGB0","description":"ICD-FFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy resect bullae","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32655","description":"Thoracoscopy resect bullae","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Circumcision neonate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54160","description":"Circumcision neonate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHA0","description":"ICD-JBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Local anesthesia","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9215","description":"Local anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC5D","description":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of hammertoe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28285","description":"Repair of hammertoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQF1","description":"ICD-CHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1301","description":"HCPCS-A1301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMA1","description":"ICD-EBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair corporeal tear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54437","description":"Repair corporeal tear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAA0","description":"ICD-MGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy flexible brush","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43200","description":"Esophagoscopy flexible brush","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1502","description":"HCPCS-C1502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYD0","description":"ICD-HGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shortening of thigh bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27465","description":"Shortening of thigh bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXA1","description":"ICD-FHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Recd f/u w/in 30d disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9402","description":"Recd f/u w/in 30d disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IV injection_ bebtelovimab_ include injection and post administration monitoring in the patientā€™s home","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0223","description":"IV injection_ bebtelovimab_ include injection and post administration monitoring in the patientā€™s home","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms) gene analysis_ full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81236","description":"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms) gene analysis_ full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNE1","description":"ICD-NLNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28A","description":"Clinically Complex _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0301","description":"HCPCS-A0301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUB1","description":"ICD-KAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transposition of vein valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34510","description":"Transposition of vein valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPD1","description":"ICD-FCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCE1","description":"ICD-EGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRF1","description":"ICD-DCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRC1","description":"ICD-OJRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD20B","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYC1","description":"ICD-HDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy accessory convex inse","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5093","description":"Ostomy accessory convex inse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGC1","description":"ICD-NJGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC23D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABB1","description":"ICD-OABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHA0","description":"ICD-KIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQE0","description":"ICD-KHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENC1","description":"ICD-GENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens_ >= 1.66 p/>=1.80 g","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2783","description":"Lens_ >= 1.66 p/>=1.80 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDED1","description":"ICD-IDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr e/n/e/l 1.1-2.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13151","description":"Cmplx rpr e/n/e/l 1.1-2.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transseptal fiberotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7291","description":"Transseptal fiberotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUA0","description":"ICD-NHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8692","description":"Replacement retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert xdrl body thrlmb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63302","description":"Remove vert xdrl body thrlmb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apply long leg cast brace","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29358","description":"Apply long leg cast brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1252","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88025","description":"Autopsy (necropsy) complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCA0","description":"ICD-IFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation therapy dose plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77300","description":"Radiation therapy dose plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLA1","description":"ICD-OCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWA0","description":"ICD-PHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARB0","description":"ICD-OARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pul art balloon repr percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92997","description":"Pul art balloon repr percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB121","description":"Clinically Complex _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPB1","description":"ICD-FFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam hips bi 3-4 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73522","description":"X-ray exam hips bi 3-4 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTA1","description":"ICD-KFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hypothermia ill neonate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99184","description":"Hypothermia ill neonate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0588U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","description":"CPT-0588U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair maxillofacial prosth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8049","description":"Repair maxillofacial prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28546","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFD0","description":"ICD-GFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJF0","description":"ICD-CBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD135","description":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28306","description":"Incision of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPB1","description":"ICD-KFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Retreat root canal bicuspid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3347","description":"Retreat root canal bicuspid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGE0","description":"ICD-KCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcvng anti r-viral thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4271F","description":"Pt rcvng anti r-viral thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insulin intermed 5 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5552","description":"Insulin intermed 5 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENE1","description":"ICD-NENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBA0","description":"ICD-IDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBB1","description":"ICD-NKBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFC1","description":"ICD-JGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPC1","description":"ICD-BDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcath closure of vsd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93581","description":"Transcath closure of vsd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA216","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXB0","description":"ICD-FFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUF1","description":"ICD-OJUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWC0","description":"ICD-LEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANC0","description":"ICD-GANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCF1","description":"ICD-OJCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prenatal vitamins 30 day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0197","description":"Prenatal vitamins 30 day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17283","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASA1","description":"ICD-GASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIC1","description":"ICD-GEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compres burngarment facehood","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6503","description":"Compres burngarment facehood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ercp duct stent placement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43274","description":"Ercp duct stent placement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coude tip urinary catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4352","description":"Coude tip urinary catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special childcare waiver/d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2026","description":"Special childcare waiver/d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANE0","description":"ICD-CANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Proton treatment complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77525","description":"Proton treatment complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHC0","description":"ICD-NIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCC0","description":"ICD-GGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSA1","description":"ICD-LDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pcp prophylax rxd 3mon low %","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4280F","description":"Pcp prophylax rxd 3mon low %","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ligate/strip short leg vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37718","description":"Ligate/strip short leg vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCD0","description":"ICD-MHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXD0","description":"ICD-BDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy surg colpopexy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57425","description":"Laparoscopy surg colpopexy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0795T","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ophth us b & quant a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76510","description":"Ophth us b & quant a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8F","description":"High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28E","description":"Special Care Low _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8977","description":"Oncology measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNB1","description":"ICD-JBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWE1","description":"ICD-GBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJA1","description":"ICD-GHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHF1","description":"ICD-FHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ascending aortic graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33860","description":"Ascending aortic graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVE0","description":"ICD-OIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJB1","description":"ICD-KHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0570","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","description":"HCPCS-G0570","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of total thyroxine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84436","description":"Assay of total thyroxine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-1 probe&reverse trnscrpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87535","description":"Hiv-1 probe&reverse trnscrpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMC0","description":"ICD-BFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBE1","description":"ICD-GIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KB11","description":"ICD-2KB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB1C","description":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB4C","description":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEF1","description":"ICD-OAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOB1","description":"ICD-LGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQA0","description":"ICD-HBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1166","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIID0","description":"ICD-KIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospital bed institutional t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0270","description":"Hospital bed institutional t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ranibizumab-eqrn (cimerli)_ biosimilar_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5128","description":"Injection_ ranibizumab-eqrn (cimerli)_ biosimilar_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inhalation solution for dme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7699","description":"Inhalation solution for dme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCF1","description":"ICD-EGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBB1","description":"ICD-OCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNC0","description":"ICD-FBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Op rad mg composite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9236","description":"Op rad mg composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXA0","description":"ICD-NLXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apc gene dup/delet variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81203","description":"Apc gene dup/delet variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDF0","description":"ICD-JHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy shoulder tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23065","description":"Biopsy shoulder tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIF0","description":"ICD-ODIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58210","description":"Extensive hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Professional services_ initial visit_ for the administration of anti-infective_ pain management_ chelation_ pulmonary hypertension_ inotropic_ or other intravenous infusion dr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0088","description":"Professional services_ initial visit_ for the administration of anti-infective_ pain management_ chelation_ pulmonary hypertension_ inotropic_ or other intravenous infusion dr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2CA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CA11","description":"ICD-2CA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25270","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTC0","description":"ICD-OKTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLA1","description":"ICD-IGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antineutrophil Cytoplasmic Antibody (Anca); Titer_ Each Antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86037","description":"Antineutrophil Cytoplasmic Antibody (Anca); Titer_ Each Antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFF0","description":"ICD-CHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMB0","description":"ICD-JDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEB1","description":"ICD-FBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Family assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1011","description":"Family assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunodiffusion nes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86329","description":"Immunodiffusion nes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVB1","description":"ICD-BEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCB1","description":"ICD-OFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBD1","description":"ICD-CGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMA1","description":"ICD-GDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINC1","description":"ICD-JINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft subclav-axilary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35516","description":"Art byp grft subclav-axilary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIE0","description":"ICD-NAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYF1","description":"ICD-PKYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGF1","description":"ICD-KCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25565","description":"Treat fracture radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXC1","description":"ICD-BBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tibper revasc w/ather add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37233","description":"Tibper revasc w/ather add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88028","description":"Autopsy (necropsy) complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEB0","description":"ICD-FCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA56","description":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8I","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEC1","description":"ICD-BEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth face/skull bone surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19051","description":"Anesth face/skull bone surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGE1","description":"ICD-BGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat mouth roof fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21423","description":"Treat mouth roof fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDC0","description":"ICD-ECDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSB0","description":"ICD-KBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITC0","description":"ICD-GITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0402","description":"HCPCS-C0402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"I125 iothalamate_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9554","description":"I125 iothalamate_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cygnus dual_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4282","description":"Cygnus dual_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49613","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Residential Habilitation 1-3 Supp 1:1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0101","description":"Residential Habilitation 1-3 Supp 1:1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOC1","description":"ICD-DAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gingivectomy/plasty per quad","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4210","description":"Gingivectomy/plasty per quad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDB0","description":"ICD-JCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVE0","description":"ICD-BGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging_ breast_ without and with contrast material(s)_ including computer-aided detection (CAD real-time lesion detection_ characterization and pharmacokin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77049","description":"Magnetic resonance imaging_ breast_ without and with contrast material(s)_ including computer-aided detection (CAD real-time lesion detection_ characterization and pharmacokin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOA0","description":"ICD-LCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC2D","description":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUE1","description":"ICD-OAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB3C","description":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release palm/finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26440","description":"Release palm/finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPD0","description":"ICD-KFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETD0","description":"ICD-JETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Range of motion measurements","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95851","description":"Range of motion measurements","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp aortobifemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35646","description":"Art byp aortobifemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVE1","description":"ICD-CHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial thyroid excision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60212","description":"Partial thyroid excision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ovarian cyst(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58925","description":"Removal of ovarian cyst(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco Screening Not Performed Or Tobacco Cessation Intervention Not Provided On The Date Of The Encounter Or Within The Previous 12 Months_ Reason Not Otherwise Specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0029","description":"Tobacco Screening Not Performed Or Tobacco Cessation Intervention Not Provided On The Date Of The Encounter Or Within The Previous 12 Months_ Reason Not Otherwise Specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYC0","description":"ICD-PJYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC1C","description":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUC0","description":"ICD-MKUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26755","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBF0","description":"ICD-ICBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair achilles tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27650","description":"Repair achilles tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANB0","description":"ICD-NANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt offered tx for pseudobulb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4541F","description":"Pt offered tx for pseudobulb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iiv4 vaccine 3 yrs plus im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90688","description":"Iiv4 vaccine 3 yrs plus im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy eyelid & lid margin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67810","description":"Biopsy eyelid & lid margin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESD0","description":"ICD-GESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-76019","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","description":"CPT-76019","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOA1","description":"ICD-DHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB150","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology_ Chemotherapeutic Drug Cytotoxicity Assay Of Cancer Stem Cells (Cscs)_ From Cultured Cscs And Primary Tumor Cells_ Categorical Drug Response Reported Based On Percent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0564T","description":"Oncology_ Chemotherapeutic Drug Cytotoxicity Assay Of Cancer Stem Cells (Cscs)_ From Cultured Cscs And Primary Tumor Cells_ Categorical Drug Response Reported Based On Percent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGB0","description":"ICD-BEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44369","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove bladder/create pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51596","description":"Remove bladder/create pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSE1","description":"ICD-DBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01832","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01832","description":"CPT-01832","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29826","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove sperm pouch lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55680","description":"Remove sperm pouch lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNF0","description":"ICD-OCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj octafluoropropane mic_ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9956","description":"Inj octafluoropropane mic_ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJF1","description":"ICD-JEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVB1","description":"ICD-NGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBA0","description":"ICD-GDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fqhc visit_ mh new pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0469","description":"Fqhc visit_ mh new pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL5A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACA0","description":"ICD-JACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDE0","description":"ICD-KBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration; with imaging guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10022","description":"Fine needle aspiration; with imaging guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc idrl imed lesn thrlmb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63287","description":"Bx/exc idrl imed lesn thrlmb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLE1","description":"ICD-JHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCV2 10MCG TRS-SUCR 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0071A","description":"ADM SARSCV2 10MCG TRS-SUCR 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMB1","description":"ICD-ICMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0302","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0302","description":"HCPCS-C0302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELD0","description":"ICD-MELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSB1","description":"ICD-KCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1602","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1602","description":"CDT-D1602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0964T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","description":"CPT-0964T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elect stim wound care not pd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0282","description":"Elect stim wound care not pd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWA0","description":"ICD-CGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDB0","description":"ICD-FBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWB1","description":"ICD-HCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAE0","description":"ICD-AEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB12D","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral place of fix dev","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7998","description":"Intraoral place of fix dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insulin antibodies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86337","description":"Insulin antibodies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKA0","description":"ICD-NFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2035","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","description":"HCPCS-A2035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACC0","description":"ICD-GACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28B","description":"Special Care High _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAC0","description":"ICD-FDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLD1","description":"ICD-KHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iris support intraoclr lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2631","description":"Iris support intraoclr lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB0B","description":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIC1","description":"ICD-IHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIB0","description":"ICD-OGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLE1","description":"ICD-MKLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Detect agent nos dna amp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87798","description":"Detect agent nos dna amp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct angiography head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70496","description":"Ct angiography head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40842","description":"Reconstruction of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diskectomy_ anterior_ with d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2351","description":"Diskectomy_ anterior_ with d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecg monit/reprt up to 48 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93225","description":"Ecg monit/reprt up to 48 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAB0","description":"ICD-JEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Caries susceptibility test","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0425","description":"Caries susceptibility test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC51","description":"Medium Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise reconst elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24370","description":"Revise reconst elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB136","description":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excis uppr jaw cyst w/repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21049","description":"Excis uppr jaw cyst w/repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETF0","description":"ICD-GETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKF1","description":"ICD-NGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oral med adm direct observe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0033","description":"Oral med adm direct observe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIB0","description":"ICD-NBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair nasal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30545","description":"Repair nasal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg_ drug metabolism)_ gene analysis_ common variants (eg_ *2_ *3_ *4_ *5_ *6_ *7)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81231","description":"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg_ drug metabolism)_ gene analysis_ common variants (eg_ *2_ *3_ *4_ *5_ *6_ *7)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9307","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9307","description":"HCPCS-C9307","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHB0","description":"ICD-CIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTD1","description":"ICD-BCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iron stain peripheral blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85536","description":"Iron stain peripheral blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB251","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Red blood cell antigen typing_ DNA_ genotyping of 10 blood groups with phenotype prediction of 37 red blood cell antigens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0084U","description":"Red blood cell antigen typing_ DNA_ genotyping of 10 blood groups with phenotype prediction of 37 red blood cell antigens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destroy premal lesions 15/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17004","description":"Destroy premal lesions 15/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOF0","description":"ICD-GGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKF0","description":"ICD-NAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Structured Day Habilitation Group 1:1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0105","description":"Structured Day Habilitation Group 1:1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient Was Provided Pallative Care Services Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9993","description":"Patient Was Provided Pallative Care Services Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQF0","description":"ICD-OIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYD0","description":"ICD-GDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVD1","description":"ICD-FEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLB0","description":"ICD-ACLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray eye for foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70030","description":"X-ray eye for foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA0C","description":"High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mometasone furoate sinus implant_ 10 mcg (Sinuva)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9122","description":"Mometasone furoate sinus implant_ 10 mcg (Sinuva)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTD1","description":"ICD-MJTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFE1","description":"ICD-NHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient received hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9707","description":"Patient received hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0774T","description":"Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTC0","description":"ICD-GCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB234","description":"Special Care High _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31603","description":"Incision of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFC1","description":"ICD-JDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKC1","description":"ICD-NFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFC0","description":"ICD-OKFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERC0","description":"ICD-GERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone graft time of implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6104","description":"Bone graft time of implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nose polyp(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30115","description":"Removal of nose polyp(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt asked re sleep disturb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4328F","description":"Pt asked re sleep disturb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Maple syrup urine disease monitoring by patient-collected blood card sample_ quantitative measurement of allo-isoleucine_ leucine_ isoleucine_ and valine_ liquid chromatograph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0381U","description":"Maple syrup urine disease monitoring by patient-collected blood card sample_ quantitative measurement of allo-isoleucine_ leucine_ isoleucine_ and valine_ liquid chromatograph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oth resp proc_ group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0239","description":"Oth resp proc_ group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEB1","description":"ICD-IFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient immunocompromised","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1062","description":"Patient immunocompromised","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41005","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rx ace or arb therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8935","description":"Rx ace or arb therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32940","description":"Revision of lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Njx paravert w/us lumb/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0216T","description":"Njx paravert w/us lumb/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAD1","description":"ICD-EAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDD1","description":"ICD-NIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood methemoglobin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83045","description":"Blood methemoglobin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Diffuse Large B-Cell Lymphoma [Dlbcl])_ Mrna_ Gene Expression Profiling By Fluorescent Probe Hybridization Of 20 Genes_ Formalin-Fixed Paraffin-Embedded Tissue_ Algo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0017M","description":"Oncology (Diffuse Large B-Cell Lymphoma [Dlbcl])_ Mrna_ Gene Expression Profiling By Fluorescent Probe Hybridization Of 20 Genes_ Formalin-Fixed Paraffin-Embedded Tissue_ Algo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGC0","description":"ICD-NEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cptr-asst dir ms px","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20985","description":"Cptr-asst dir ms px","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFE0","description":"ICD-NFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTB0","description":"ICD-JFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJA0","description":"ICD-NFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis c revrs trnscrpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87522","description":"Hepatitis c revrs trnscrpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insrt heart pm atrial & vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33208","description":"Insrt heart pm atrial & vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22612","description":"Lumbar spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWF1","description":"ICD-HFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJD0","description":"ICD-OBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDND1","description":"ICD-GDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stationary o2 contents_ liq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0442","description":"Stationary o2 contents_ liq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACF1","description":"ICD-EACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mopath procedure level 3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81402","description":"Mopath procedure level 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kt/v <1.2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3082F","description":"Kt/v <1.2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ neck/head_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6566","description":"Gradient compression garment_ neck/head_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHC1","description":"ICD-NBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt ref pulm fx test/peakflow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3758F","description":"Pt ref pulm fx test/peakflow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUC1","description":"ICD-GCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTA1","description":"ICD-JFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medical home level iii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9150","description":"Medical home level iii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEA1","description":"ICD-IBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69720","description":"Release facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous catheter directed chemical ablation with balloon isolation of incompetent extremity vein_ open or percutaneous_ including all vascular access_ catheter manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0524T","description":"Endovenous catheter directed chemical ablation with balloon isolation of incompetent extremity vein_ open or percutaneous_ including all vascular access_ catheter manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEE1","description":"ICD-JEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYB0","description":"ICD-OJYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWE0","description":"ICD-OIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSD1","description":"ICD-OJSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARB0","description":"ICD-GARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUE1","description":"ICD-KDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXE0","description":"ICD-KAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALE1","description":"ICD-FALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELA0","description":"ICD-IELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anti-phospholipid antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86148","description":"Anti-phospholipid antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMC1","description":"ICD-MGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1EA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EA21","description":"ICD-1EA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBB1","description":"ICD-BDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Impression casting ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0395","description":"Impression casting ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0677U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677U","description":"CPT-0677U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENE0","description":"ICD-NENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDD1","description":"ICD-MEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOC1","description":"ICD-CBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRC0","description":"ICD-CDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVF0","description":"ICD-GBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX14","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6058","description":"Abutment supported crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX1B","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQF1","description":"ICD-OCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC224","description":"Clinically Complex _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0683U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683U","description":"CPT-0683U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLD1","description":"ICD-CCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMF1","description":"ICD-JFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWD0","description":"ICD-OBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTA1","description":"ICD-FDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatry (Suicidal Ideation)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 54 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0293U","description":"Psychiatry (Suicidal Ideation)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 54 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ready gradient sleev/glov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8421","description":"Ready gradient sleev/glov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFD0","description":"ICD-OBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMF1","description":"ICD-IBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal_ entire osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside the mastoid and involving a bony defect greater t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69728","description":"Removal_ entire osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside the mastoid and involving a bony defect greater t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADC0","description":"ICD-FADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heavyduty walker no wheels","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0148","description":"Heavyduty walker no wheels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular Stent Repair Of Coarctation Of The Ascending_ Transverse_ Or Descending Thoracic Or Abdominal Aorta_ Involving Stent Placement; Not Crossing Major Side Branches","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33895","description":"Endovascular Stent Repair Of Coarctation Of The Ascending_ Transverse_ Or Descending Thoracic Or Abdominal Aorta_ Involving Stent Placement; Not Crossing Major Side Branches","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC2B","description":"Very High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Fixed Unilateral Space Maintainer - Per Quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1556","description":"Removal Of Fixed Unilateral Space Maintainer - Per Quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQD0","description":"ICD-GIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBD0","description":"ICD-KCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"AFF2 (AF4/FMR2 family_ member 2 [FMR2]) (eg_ fragile X mental retardation 2 [FRAXE]) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81171","description":"AFF2 (AF4/FMR2 family_ member 2 [FMR2]) (eg_ fragile X mental retardation 2 [FRAXE]) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEE0","description":"ICD-KFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ca screen;flexi sigmoidscope","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0104","description":"Ca screen;flexi sigmoidscope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp2 std mult pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0842","description":"Pwc gp2 std mult pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFD0","description":"ICD-JEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLA1","description":"ICD-MCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (urothelial carcinoma)_ DNA_ quantitative methylation-specific PCR of 2 genes (ONECUT2_ VIM)_ algorithmic analysis reported as positive or negative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0465U","description":"Oncology (urothelial carcinoma)_ DNA_ quantitative methylation-specific PCR of 2 genes (ONECUT2_ VIM)_ algorithmic analysis reported as positive or negative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE126","description":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEF0","description":"ICD-EGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47120","description":"Partial removal of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDA1","description":"ICD-KBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Arthroscopy of joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29999","description":"Arthroscopy of joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exercise class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9451","description":"Exercise class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/ th nrv exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32664","description":"Thoracoscopy w/ th nrv exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGC0","description":"ICD-OFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELE1","description":"ICD-AELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQB1","description":"ICD-DDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKD0","description":"ICD-JAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIA1","description":"ICD-MAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMB1","description":"ICD-NLMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4FB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FB11","description":"ICD-4FB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release forearm/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26449","description":"Release forearm/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA106","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove shoulder foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23330","description":"Remove shoulder foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Soft interface below knee se","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2820","description":"Soft interface below knee se","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVB0","description":"ICD-NFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLD0","description":"ICD-EFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41827","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGF0","description":"ICD-GAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Slitting of prepuce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54000","description":"Slitting of prepuce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2AC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AC31","description":"ICD-2AC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUC1","description":"ICD-GBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIC1","description":"ICD-OBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap inc hernia repair recur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49656","description":"Lap inc hernia repair recur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bevacizumab-adcd (vegzelma)_ biosimilar_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5129","description":"Injection_ bevacizumab-adcd (vegzelma)_ biosimilar_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXF0","description":"ICD-NLXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB11","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1176","description":"Patient did not receive at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHA1","description":"ICD-OIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAB1","description":"ICD-NHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYD1","description":"ICD-CDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66170","description":"Glaucoma surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHD0","description":"ICD-NJHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJD0","description":"ICD-KAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"TYMS (thymidylate synthetase) (eg_ 5-fluorouracil/5-FU drug metabolism)_ gene analysis_ common variant(s) (eg_ tandem repeat variant)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81346","description":"TYMS (thymidylate synthetase) (eg_ 5-fluorouracil/5-FU drug metabolism)_ gene analysis_ common variant(s) (eg_ tandem repeat variant)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prost cncr rsk not lw/md/hgh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3274F","description":"Prost cncr rsk not lw/md/hgh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMA1","description":"ICD-MLMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDF1","description":"ICD-KGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pad water circulating heat u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0249","description":"Pad water circulating heat u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESA1","description":"ICD-HESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBE1","description":"ICD-ACBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLC0","description":"ICD-MDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surg dx exam anorectal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45990","description":"Surg dx exam anorectal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHB1","description":"ICD-FBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNC0","description":"ICD-NGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXD0","description":"ICD-NBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGA0","description":"ICD-CDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLC0","description":"ICD-OCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLB0","description":"ICD-MHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Probe nasolacrimal duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68810","description":"Probe nasolacrimal duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33951","description":"Ecmo/ecls insj prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wedge biopsy of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47100","description":"Wedge biopsy of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/o fol w/cont_ lwr ext","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8914","description":"Mra w/o fol w/cont_ lwr ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB1A","description":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX24","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Msh6 gene full seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81298","description":"Msh6 gene full seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair stomach-bowel fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43880","description":"Repair stomach-bowel fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of a chlamydia screening test with proper follow-up","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9820","description":"Documentation of a chlamydia screening test with proper follow-up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACD0","description":"ICD-AACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBE1","description":"ICD-KHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9256","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","description":"HCPCS-J9256","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIE0","description":"ICD-GCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNE0","description":"ICD-NHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKB0","description":"ICD-BHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45390","description":"Colonoscopy w/resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAF1","description":"ICD-AGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of small bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74250","description":"X-ray exam of small bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCB0","description":"ICD-GBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18A","description":"Special Care High _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALF1","description":"ICD-EALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWD0","description":"ICD-OHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUB1","description":"ICD-BEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0902","description":"HCPCS-B0902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFA1","description":"ICD-JIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVD0","description":"ICD-GCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit routine device maint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5035","description":"Hit routine device maint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXD0","description":"ICD-KFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTF0","description":"ICD-CFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gadofosveset trisodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9583","description":"Gadofosveset trisodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove interim implant component","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6198","description":"Remove interim implant component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESB0","description":"ICD-LESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITF1","description":"ICD-BITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ non-stranded_i-125","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2639","description":"Brachytx_ non-stranded_i-125","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGE1","description":"ICD-OAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUA0","description":"ICD-BAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc med reas no abx therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9559","description":"Doc med reas no abx therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8F","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27240","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYB0","description":"ICD-CAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5139","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5139","description":"HCPCS-Q5139","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEC1","description":"ICD-KDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGA0","description":"ICD-KIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENA1","description":"ICD-OENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPD1","description":"ICD-FHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHE1","description":"ICD-IFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMF0","description":"ICD-NAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urinalysis auto w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81001","description":"Urinalysis auto w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAB1","description":"ICD-MIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUD0","description":"ICD-CCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMF1","description":"ICD-ACMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lsh w/t/o ut 250 g or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58542","description":"Lsh w/t/o ut 250 g or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skilled services of a licensed practical nurse (LPN)_ in the training and/or education of a patient or family member_ in the home health or hospice setting_ each 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0496","description":"Skilled services of a licensed practical nurse (LPN)_ in the training and/or education of a patient or family member_ in the home health or hospice setting_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPE1","description":"ICD-GBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of left heart vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33989","description":"Removal of left heart vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inject hrt congntl art/grft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93564","description":"Inject hrt congntl art/grft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTB0","description":"ICD-ECTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWF1","description":"ICD-LBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc md rsn no antipla/p2y12","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9610","description":"Doc md rsn no antipla/p2y12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blink reflex test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95933","description":"Blink reflex test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC25C","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBF1","description":"ICD-KCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRC0","description":"ICD-GCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUD0","description":"ICD-NBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1577","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1577","description":"HCPCS-J1577","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transthor cath for stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33621","description":"Transthor cath for stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ brachytx seed adm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1728","description":"Cath_ brachytx seed adm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHB0","description":"ICD-MHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ ocriplasmin_ 0.125 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7316","description":"Inj_ ocriplasmin_ 0.125 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of chest tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32551","description":"Insertion of chest tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECB0","description":"ICD-CECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYD1","description":"ICD-DEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1054T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1054T","description":"CPT-1054T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALE0","description":"ICD-MALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Post fusion 13/> vert seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22804","description":"Post fusion 13/> vert seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLA0","description":"ICD-EFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1EB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EB31","description":"ICD-1EB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVF0","description":"ICD-FCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEE1","description":"ICD-CFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bp scrn no perf at interval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8785","description":"Bp scrn no perf at interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEF1","description":"ICD-BEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Paraffin bath therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97018","description":"Paraffin bath therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQB1","description":"ICD-DIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69660","description":"Revise middle ear bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28B","description":"Special Care High _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Family/couple counseling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1006","description":"Family/couple counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fuse pancreas cyst and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48520","description":"Fuse pancreas cyst and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42505","description":"Repair salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXF1","description":"ICD-FHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRB1","description":"ICD-PBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEF1","description":"ICD-GBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMA1","description":"ICD-AHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXE0","description":"ICD-NIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFC1","description":"ICD-KIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBD1","description":"ICD-BBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anes spine tranthor w/o vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62551","description":"Anes spine tranthor w/o vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBID0","description":"ICD-OBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1336","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLD1","description":"ICD-KBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRB0","description":"ICD-OGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urea nitrogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84520","description":"Assay of urea nitrogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter Tricuspid Valve Repair_ Percutaneous Approach; Each Additional Prosthesis During Same Session (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0570T","description":"Transcatheter Tricuspid Valve Repair_ Percutaneous Approach; Each Additional Prosthesis During Same Session (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTF0","description":"ICD-GHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hip arthr0 w/debridement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29862","description":"Hip arthr0 w/debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repeat thyroid surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60260","description":"Repeat thyroid surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove hand bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26200","description":"Remove hand bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXB1","description":"ICD-NDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHC1","description":"ICD-GDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abd imag w/us_ ct or MRI","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9455","description":"Abd imag w/us_ ct or MRI","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGB1","description":"ICD-OJGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBD0","description":"ICD-BIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWF1","description":"ICD-HCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4GB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GB21","description":"ICD-4GB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSE1","description":"ICD-OBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWA0","description":"ICD-HDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc arm/elbow les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24075","description":"Exc arm/elbow les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28F","description":"Clinically Complex _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC151","description":"Special Care Low _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUA0","description":"ICD-ACUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01250","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01250","description":"CPT-01250","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEE0","description":"ICD-GFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc prac mgmt pt opt alterna","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9059","description":"Onc prac mgmt pt opt alterna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2DA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DA21","description":"ICD-2DA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of support implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20670","description":"Removal of support implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prev care mg qual act perfrm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8496","description":"Prev care mg qual act perfrm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18C","description":"Special Care Low _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEB1","description":"ICD-FFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMD1","description":"ICD-NIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hematopoietic nuclear tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79403","description":"Hematopoietic nuclear tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNA1","description":"ICD-JCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENC0","description":"ICD-FENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4223","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4223","description":"HCPCS-Q4223","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSC1","description":"ICD-DDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4CA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CA11","description":"ICD-4CA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOD0","description":"ICD-OAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJB1","description":"ICD-BFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVE1","description":"ICD-FFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diathermy eg microwave","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97024","description":"Diathermy eg microwave","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAB0","description":"ICD-EBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDD1","description":"ICD-ECDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair penis and bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54390","description":"Repair penis and bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAB0","description":"ICD-KGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRC1","description":"ICD-PFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Belatacept injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0485","description":"Belatacept injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ped term dev_ hook_ vol clos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6712","description":"Ped term dev_ hook_ vol clos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2212","description":"Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERC1","description":"ICD-OERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown porcelain w/ h noble m","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2750","description":"Crown porcelain w/ h noble m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transverse Aortic Arch Graft_ With Cardiopulmonary Bypass_ With Profound Hypothermia_ Total Circulatory Arrest And Isolated Cerebral Perfusion With Reimplantation Of Arch Vess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33871","description":"Transverse Aortic Arch Graft_ With Cardiopulmonary Bypass_ With Profound Hypothermia_ Total Circulatory Arrest And Isolated Cerebral Perfusion With Reimplantation Of Arch Vess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUE0","description":"ICD-IBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAD1","description":"ICD-JCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIC0","description":"ICD-KDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJE1","description":"ICD-KIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTB0","description":"ICD-IHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAED0","description":"ICD-BAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of thymus gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60522","description":"Removal of thymus gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ther/proph/diag iv inf init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96365","description":"Ther/proph/diag iv inf init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGF0","description":"ICD-KIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCE0","description":"ICD-IBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQA1","description":"ICD-KGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autologous Platelet Rich Plasma (Prp) For Diabetic Chronic Wounds/Ulcers_ Using An Fda-Cleared Device (Includes Administration_ Dressings_ Phlebotomy_ Centrifug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0465","description":"Autologous Platelet Rich Plasma (Prp) For Diabetic Chronic Wounds/Ulcers_ Using An Fda-Cleared Device (Includes Administration_ Dressings_ Phlebotomy_ Centrifug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLA0","description":"ICD-OJLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18B","description":"Clinically Complex _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Current tobacco smoker","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1034F","description":"Current tobacco smoker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged Office Or Other Outpatient Evaluation And Management Service(S) Beyond The Minimum Required Time Of The Primary Procedure Which Has Been Selected Using Total Time_ R","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99417","description":"Prolonged Office Or Other Outpatient Evaluation And Management Service(S) Beyond The Minimum Required Time Of The Primary Procedure Which Has Been Selected Using Total Time_ R","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ped critical care subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99472","description":"Ped critical care subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Voice goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9172","description":"Voice goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00921","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00921","description":"CPT-00921","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUF1","description":"ICD-EGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCF0","description":"ICD-GBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrical bone stimulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20974","description":"Electrical bone stimulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA20","description":"Very High Rehab _ ADL Index 0-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWE0","description":"ICD-KBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1014T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","description":"CPT-1014T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBF0","description":"ICD-GBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDA1","description":"ICD-JFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQE0","description":"ICD-PHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colon ca scrn; barium enema","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0122","description":"Colon ca scrn; barium enema","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUF1","description":"ICD-BBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWE1","description":"ICD-LEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFD1","description":"ICD-JEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair Accessory_ Dynamic Positioning Hardware For Back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2398","description":"Wheelchair Accessory_ Dynamic Positioning Hardware For Back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINE1","description":"ICD-BINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE204","description":"Special Care Low _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEA1","description":"ICD-GGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6008","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIA0","description":"ICD-JGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHB0","description":"ICD-ADHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA0D","description":"High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cocaine hydrochloride nasal solution for topical administration_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9046","description":"Cocaine hydrochloride nasal solution for topical administration_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Locm 200-299mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9966","description":"Locm 200-299mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGID1","description":"ICD-FGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECE0","description":"ICD-CECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHF1","description":"ICD-FGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQA0","description":"ICD-OJQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIB1","description":"ICD-EFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct elbow lat ligmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24344","description":"Reconstruct elbow lat ligmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vascular surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37799","description":"Vascular surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJC1","description":"ICD-KDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc gastro 51 gene nomogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0007M","description":"Onc gastro 51 gene nomogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenervation of abductor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2340","description":"Chemodenervation of abductor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Variable asphericity lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2499","description":"Variable asphericity lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic incision larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31320","description":"Diagnostic incision larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDB0","description":"ICD-FHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHA1","description":"ICD-MGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45308","description":"Proctosigmoidoscopy removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66761","description":"Revision of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJD1","description":"ICD-BGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Req ret or w/in 90d of surg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9514","description":"Req ret or w/in 90d of surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIA1","description":"ICD-CAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOD0","description":"ICD-LDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQA0","description":"ICD-KBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pituitary evaluation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80418","description":"Pituitary evaluation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage abdom abscess open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49020","description":"Drainage abdom abscess open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLD0","description":"ICD-IBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fuse hand bones with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25825","description":"Fuse hand bones with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXD1","description":"ICD-KIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cor artery disease mrna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81493","description":"Cor artery disease mrna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDF1","description":"ICD-JIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies)_ including lesion identification_ characterizatio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0865T","description":"Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies)_ including lesion identification_ characterizatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCE0","description":"ICD-EFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE25B","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNA1","description":"ICD-CGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCND0","description":"ICD-JCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28X","description":"Clinically Complex _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOA0","description":"ICD-HGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTE1","description":"ICD-AGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54200","description":"Treatment of penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKC1","description":"ICD-KFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood volume","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78122","description":"Blood volume","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHE1","description":"ICD-NCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXE1","description":"ICD-JDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Re-evaluation of athletic training established plan of care requiring these components: An assessment of patient_s current functional status when there is a documented change;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97172","description":"Re-evaluation of athletic training established plan of care requiring these components: An assessment of patient_s current functional status when there is a documented change;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8B","description":"Very High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vitamin B-12 absorption study (eg_ Schilling test); with intrinsic factor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78271","description":"Vitamin B-12 absorption study (eg_ Schilling test); with intrinsic factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E2513","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","description":"HCPCS-E2513","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD255","description":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of salivary stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42335","description":"Removal of salivary stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOF0","description":"ICD-GHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0615","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","description":"HCPCS-J0615","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA12A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dent appl desensitizing med","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9910","description":"Dent appl desensitizing med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXB1","description":"ICD-CAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUF0","description":"ICD-BBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMD0","description":"ICD-NBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Custom item","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1002","description":"Custom item","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0702","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0702","description":"HCPCS-C0702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology/Hematology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4019","description":"Oncology/Hematology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45130","description":"Excision of rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPD0","description":"ICD-KGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGE1","description":"ICD-NLGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAB1","description":"ICD-IGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter_ transluminal intravascular lesion preparation device_ bladed_ sheathed (insertable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1600","description":"Catheter_ transluminal intravascular lesion preparation device_ bladed_ sheathed (insertable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKC1","description":"ICD-CDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAE0","description":"ICD-KDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXE1","description":"ICD-KBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat metacarpal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26607","description":"Treat metacarpal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOE1","description":"ICD-PIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Walker w trunk support","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0140","description":"Walker w trunk support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52281","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Human epididymis protein 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86305","description":"Human epididymis protein 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPA1","description":"ICD-BAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEC1","description":"ICD-FIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMA1","description":"ICD-BBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB101","description":"Special Care Low _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No strk cabg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8574","description":"No strk cabg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Csi any other than pci 2 yr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8964","description":"Csi any other than pci 2 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61601","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB53","description":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC02","description":"Medium Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Total kt/v less than 1. 7 per week (total clearance of urea [kt] / volume [v])_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8720","description":"Total kt/v less than 1. 7 per week (total clearance of urea [kt] / volume [v])_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Seat lift incorp lift-chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0627","description":"Seat lift incorp lift-chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYA1","description":"ICD-KIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc perm/cont/parox atr fib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1060F","description":"Doc perm/cont/parox atr fib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9176","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9176","description":"HCPCS-C9176","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAB1","description":"ICD-FHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rare constitutional and other heritable disorders_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0267U","description":"Rare constitutional and other heritable disorders_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTE0","description":"ICD-GCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEA0","description":"ICD-FCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYD1","description":"ICD-DGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASA0","description":"ICD-GASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD15B","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHD1","description":"ICD-NBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECC1","description":"ICD-MECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35011","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNB1","description":"ICD-OBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional_ including physiological and labo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0496T","description":"Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional_ including physiological and labo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Current tobacco non-user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1316","description":"Current tobacco non-user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJB0","description":"ICD-GEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBF1","description":"ICD-BHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx rectal m1 w/mets prog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9094","description":"Onc dx rectal m1 w/mets prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHF0","description":"ICD-BCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUD0","description":"ICD-FCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRB0","description":"ICD-CHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylinder 4.25d/2.12-4d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2108","description":"Spherocylinder 4.25d/2.12-4d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXD1","description":"ICD-FAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21245","description":"Reconstruction of jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIB1","description":"ICD-MLIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVF1","description":"ICD-FDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMF0","description":"ICD-JDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJE0","description":"ICD-CCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEB1","description":"ICD-BIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking waistlngth 18-30","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6539","description":"Gc stocking waistlngth 18-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replcmnt breast pump bottle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4285","description":"Replcmnt breast pump bottle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24360","description":"Reconstruct elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTA1","description":"ICD-EDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture radius/ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25575","description":"Treat fracture radius/ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Retinal prosthesis_ includes all internal and external components; add-on to C1841","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1842","description":"Retinal prosthesis_ includes all internal and external components; add-on to C1841","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam entire spi 1 vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72081","description":"X-ray exam entire spi 1 vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDF1","description":"ICD-KEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amnt pain noted pain prsnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1125F","description":"Amnt pain noted pain prsnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQE0","description":"ICD-DGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51555","description":"Partial removal of bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVA1","description":"ICD-FIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDA1","description":"ICD-NFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breath tst attain/anal c-14","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78267","description":"Breath tst attain/anal c-14","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43045","description":"Incision of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDC0","description":"ICD-CFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILA1","description":"ICD-OILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eye exam&tx estab pt 1/>vst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92014","description":"Eye exam&tx estab pt 1/>vst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBF1","description":"ICD-KGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Io anal gast n-stim subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95981","description":"Io anal gast n-stim subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Methotrexate sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9250","description":"Methotrexate sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOF0","description":"ICD-CIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGA1","description":"ICD-KCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGD1","description":"ICD-CGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28B","description":"Special Care Low _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parotid duct diversion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42509","description":"Parotid duct diversion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBA0","description":"ICD-CCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIE0","description":"ICD-FAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCE0","description":"ICD-NBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of catheter vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36500","description":"Insertion of catheter vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPD0","description":"ICD-NAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIA1","description":"ICD-JCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIF1","description":"ICD-NAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1JB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JB31","description":"ICD-1JB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD251","description":"Special Care High _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 1 genotyping (HPA-1)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa]_ antigen CD61 [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ pos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81105","description":"Human Platelet Antigen 1 genotyping (HPA-1)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa]_ antigen CD61 [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ pos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hep c ab test confirm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86804","description":"Hep c ab test confirm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGD0","description":"ICD-KEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKE1","description":"ICD-OCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Each Additional 30 Minutes Of Counseling In A Week Of Medication Assisted Treatment_ (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2080","description":"Each Additional 30 Minutes Of Counseling In A Week Of Medication Assisted Treatment_ (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTF0","description":"ICD-NBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"FUT1 GNOTYP FUT1 EXON 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0185U","description":"FUT1 GNOTYP FUT1 EXON 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCF1","description":"ICD-MHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"A/d tx program_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2036","description":"A/d tx program_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 5 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP05","description":"Auto.test pane pricing code_ 5 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILE0","description":"ICD-IILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXC0","description":"ICD-NDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A5001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5001","description":"HCPCS-A5001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALC0","description":"ICD-EALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Deoxyribonuclease antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86215","description":"Deoxyribonuclease antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"M.pneumon dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87580","description":"M.pneumon dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNE1","description":"ICD-GGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSD0","description":"ICD-OJSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBA1","description":"ICD-KBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory syncytial virus vaccine_ preF_ recombinant subunit_ adjuvanted_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90679","description":"Respiratory syncytial virus vaccine_ preF_ recombinant subunit_ adjuvanted_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD146","description":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lymphocyte transformation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86353","description":"Lymphocyte transformation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUA1","description":"ICD-NIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA12C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31290","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAB1","description":"ICD-IHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHD1","description":"ICD-AIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC21","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYF1","description":"ICD-CEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUB1","description":"ICD-KBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel drg >16<=48 in w/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6246","description":"Hydrogel drg >16<=48 in w/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE11A","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEC1","description":"ICD-OCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFF0","description":"ICD-KGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Harness figure of 8 sing con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6675","description":"Harness figure of 8 sing con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIC1","description":"ICD-KIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise kidney blood vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50100","description":"Revise kidney blood vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1BC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BC31","description":"ICD-1BC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Obstetrical care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59410","description":"Obstetrical care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ingest challenge ini 120 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95076","description":"Ingest challenge ini 120 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney & ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50234","description":"Removal of kidney & ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ocular prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5916","description":"Ocular prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct lumbar spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72133","description":"Ct lumbar spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB121","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX4D","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hhcp-serv of ot_ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0152","description":"Hhcp-serv of ot_ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNE0","description":"ICD-FGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Analysis tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88358","description":"Analysis tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nonpowered pressure mattress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0373","description":"Nonpowered pressure mattress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDD0","description":"ICD-IIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay lipoprotein pla2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83698","description":"Assay lipoprotein pla2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vbac delivery only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59612","description":"Vbac delivery only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 4 std cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0869","description":"Pwc gp 4 std cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDA1","description":"ICD-CIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGA1","description":"ICD-GBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPF1","description":"ICD-GGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace socket below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5700","description":"Replace socket below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25230","description":"Partial removal of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKC0","description":"ICD-BBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56810","description":"Repair of perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fosaprepitant (teva)_ not therapeutically equivalent to j1453_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1456","description":"Injection_ fosaprepitant (teva)_ not therapeutically equivalent to j1453_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX0B","description":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFF1","description":"ICD-JBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPD1","description":"ICD-KIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bowel to bowel fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44130","description":"Bowel to bowel fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUC1","description":"ICD-JAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVE1","description":"ICD-BEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVC1","description":"ICD-GCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB20","description":"Low Rehab_ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXF1","description":"ICD-CBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSB0","description":"ICD-KHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJC0","description":"ICD-BDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKE1","description":"ICD-BGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNC1","description":"ICD-BHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"BCG live intravesical instillation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9030","description":"BCG live intravesical instillation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDED0","description":"ICD-JDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colpopexy extraperitoneal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57282","description":"Colpopexy extraperitoneal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ evaluation of 65 common drugs by LC-MS/MS_ urine_ each drug reported detected or not detected","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0093U","description":"Prescription drug monitoring_ evaluation of 65 common drugs by LC-MS/MS_ urine_ each drug reported detected or not detected","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFE0","description":"ICD-KGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB235","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIE1","description":"ICD-ECIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"I131 iodide sol_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9529","description":"I131 iodide sol_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJE1","description":"ICD-KEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/pleurodesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32650","description":"Thoracoscopy w/pleurodesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKB1","description":"ICD-KHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHD0","description":"ICD-MDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ difelikefalin_ 0.1 microgram_ (for ESRD on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0879","description":"Injection_ difelikefalin_ 0.1 microgram_ (for ESRD on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchial allergy tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95071","description":"Bronchial allergy tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prenatal flow sheet","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0501F","description":"Prenatal flow sheet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOF0","description":"ICD-PLOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic procd strg endur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0237","description":"Therapeutic procd strg endur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD10A","description":"Clinically Complex _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECE0","description":"ICD-OECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKE1","description":"ICD-OKKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Monit store cryo embryo 30 d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4040","description":"Monit store cryo embryo 30 d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1032T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1032T","description":"CPT-1032T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93152","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt info into recall system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"7010F","description":"Pt info into recall system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJF0","description":"ICD-JBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; initial single probe stain procedure (List separately in addition to code for prima","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0848T","description":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; initial single probe stain procedure (List separately in addition to code for prima","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"2 cc sterile syringe&needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4207","description":"2 cc sterile syringe&needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPC0","description":"ICD-CBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVD1","description":"ICD-OFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTE1","description":"ICD-FDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brain imaging (pet)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78608","description":"Brain imaging (pet)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18A","description":"Special Care Low _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tdap vaccine 7 yrs/> im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90715","description":"Tdap vaccine 7 yrs/> im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"I131 serum albumin_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9524","description":"I131 serum albumin_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tibial tubercle hgt w/ toe f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5020","description":"Tibial tubercle hgt w/ toe f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVB0","description":"ICD-GIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis c rna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87520","description":"Hepatitis c rna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSC0","description":"ICD-CHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJC1","description":"ICD-OJJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCC0","description":"ICD-NLCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRA0","description":"ICD-OCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPD0","description":"ICD-KHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of head brace","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20661","description":"Application of head brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAF0","description":"ICD-MJAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCA1","description":"ICD-ACCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Free fascial flap microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15758","description":"Free fascial flap microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Supply/accessory/service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9900","description":"Supply/accessory/service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYB0","description":"ICD-KDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostomy shower protect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7523","description":"Tracheostomy shower protect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOD1","description":"ICD-CEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4413","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","description":"HCPCS-Q4413","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNF1","description":"ICD-OHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIA0","description":"ICD-JAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prolong clincl staff svc add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99416","description":"Prolong clincl staff svc add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDE1","description":"ICD-NEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASD1","description":"ICD-HASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOD1","description":"ICD-KHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKA1","description":"ICD-BFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Arthroflex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4125","description":"Arthroflex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCF0","description":"ICD-MGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRD0","description":"ICD-HCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUD0","description":"ICD-NCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plan of care for moderate to severe pain not documented on or before the date of the second visit with a clinician_ reason not","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1002","description":"Plan of care for moderate to severe pain not documented on or before the date of the second visit with a clinician_ reason not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSC0","description":"ICD-PKSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAF1","description":"ICD-OIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADB0","description":"ICD-NADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21246","description":"Reconstruction of jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release muscles of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26593","description":"Release muscles of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPC0","description":"ICD-KDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood glucose monitor home","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0607","description":"Blood glucose monitor home","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL22","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pw actuator replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2378","description":"Pw actuator replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIED0","description":"ICD-GIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lso s/c shell/panel custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0640","description":"Lso s/c shell/panel custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQD0","description":"ICD-CDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFF1","description":"ICD-KCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Metacarp fx orthosis pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3918","description":"Metacarp fx orthosis pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQF0","description":"ICD-OLQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tx/pro/dx inj new drug addon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96375","description":"Tx/pro/dx inj new drug addon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0484U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","description":"CPT-0484U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHA1","description":"ICD-AIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSC0","description":"ICD-DFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJD0","description":"ICD-CGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFF1","description":"ICD-CBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace/revise brain shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62230","description":"Replace/revise brain shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ dalbavancin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0875","description":"Injection_ dalbavancin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33702","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Midfacial prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8041","description":"Midfacial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGB0","description":"ICD-FDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0498U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","description":"CPT-0498U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHED1","description":"ICD-KHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLF1","description":"ICD-KGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adult foster care per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5140","description":"Adult foster care per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m labeled rbc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9560","description":"Tc99m labeled rbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBB0","description":"ICD-BGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prev visit est age 40-64","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99396","description":"Prev visit est age 40-64","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter_ ureteral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1758","description":"Catheter_ ureteral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1352","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMF1","description":"ICD-NLMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hhs/hospice of rn ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0299","description":"Hhs/hospice of rn ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVB0","description":"ICD-JIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"F18 fdg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9552","description":"F18 fdg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0010","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFC0","description":"ICD-GGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPE0","description":"ICD-FFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s) of sclerosant for spider veins (telangiectasia)_ limb or trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36468","description":"Injection(s) of sclerosant for spider veins (telangiectasia)_ limb or trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of nasal valve collapse with low energy_ temperature-controlled (ie_ radiofrequency) subcutaneous/submucosal remodeling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30469","description":"Repair of nasal valve collapse with low energy_ temperature-controlled (ie_ radiofrequency) subcutaneous/submucosal remodeling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt asked re symp auto dysfxn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4326F","description":"Pt asked re symp auto dysfxn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKC1","description":"ICD-JBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIC1","description":"ICD-CGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC4A","description":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intrvl 3/>yr pts clnscp docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0529F","description":"Intrvl 3/>yr pts clnscp docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Denture reln cmplt maxil ch","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5730","description":"Denture reln cmplt maxil ch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCID1","description":"ICD-OCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRD1","description":"ICD-PHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD15A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal with reinsertion_ non-biodegradable drug delivery implants_ 4 or more (services for subdermal implants)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0518","description":"Removal with reinsertion_ non-biodegradable drug delivery implants_ 4 or more (services for subdermal implants)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFB1","description":"ICD-KDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILD0","description":"ICD-EILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUC0","description":"ICD-EAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cst hgh nble mtl inlay 2 srf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6602","description":"Cst hgh nble mtl inlay 2 srf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pressure pneum appl full arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0672","description":"Pressure pneum appl full arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXC0","description":"ICD-NIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXF1","description":"ICD-OCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKE1","description":"ICD-FBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADD0","description":"ICD-EADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bk knee joints single axis p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5676","description":"Bk knee joints single axis p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDD1","description":"ICD-MBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKD0","description":"ICD-NAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAF0","description":"ICD-IGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Attendant care service /diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5126","description":"Attendant care service /diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9169","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9169","description":"HCPCS-C9169","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQB1","description":"ICD-GCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDC0","description":"ICD-NHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Audiometry air & bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92553","description":"Audiometry air & bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4396","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","description":"HCPCS-Q4396","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOB1","description":"ICD-DCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEE1","description":"ICD-BFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCB1","description":"ICD-BFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0105","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0105","description":"HCPCS-C0105","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHA0","description":"ICD-ODHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE160","description":"Special Care High _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Full length surg stocking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4510","description":"Full length surg stocking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1AC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AC11","description":"ICD-1AC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDC0","description":"ICD-IEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUA0","description":"ICD-OHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bridge noble metal cast","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6212","description":"Bridge noble metal cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"remove broken implant retaining screw","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6096","description":"remove broken implant retaining screw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAB0","description":"ICD-CIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx head/neck t1-t2no prg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9109","description":"Onc dx head/neck t1-t2no prg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSB0","description":"ICD-KGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28A","description":"Clinically Complex _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJC1","description":"ICD-OIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEB0","description":"ICD-ODEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUE1","description":"ICD-GAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auditory Evoked Potentials; Screening Of Auditory Potential With Broadband Stimuli_ Automated Analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92650","description":"Auditory Evoked Potentials; Screening Of Auditory Potential With Broadband Stimuli_ Automated Analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSD0","description":"ICD-DHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRF1","description":"ICD-GCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18I","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMC1","description":"ICD-CDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Preventive counseling indiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99403","description":"Preventive counseling indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heel leather reinforced","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3440","description":"Heel leather reinforced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWA1","description":"ICD-LBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRF1","description":"ICD-GBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reposition intraocular lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66825","description":"Reposition intraocular lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXB0","description":"ICD-KCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNC0","description":"ICD-CDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRB1","description":"ICD-CCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHC0","description":"ICD-IBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Helminth antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86682","description":"Helminth antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of foot tendon(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28230","description":"Incision of foot tendon(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise intestine lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44110","description":"Excise intestine lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablative laser treatment_ non-contact_ full field and fractional ablation_ open wound_ per day_ total treatment surface area; first 20 sq cm or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0491T","description":"Ablative laser treatment_ non-contact_ full field and fractional ablation_ open wound_ per day_ total treatment surface area; first 20 sq cm or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMD1","description":"ICD-AFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMA0","description":"ICD-NGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFED1","description":"ICD-EFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc visc aorta 4 graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34844","description":"Endovasc visc aorta 4 graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTB0","description":"ICD-ODTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB42","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18C","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA23A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41015","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ortho shoe add march bar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3595","description":"Ortho shoe add march bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILB1","description":"ICD-KILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pelv & thor control gluteal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2650","description":"Pelv & thor control gluteal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGB1","description":"ICD-BIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISA1","description":"ICD-HISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNC1","description":"ICD-GBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUF1","description":"ICD-FIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Renal biopsy open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50205","description":"Renal biopsy open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disposable collection and storage bag for breast milk_ any size_ any type_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4287","description":"Disposable collection and storage bag for breast milk_ any size_ any type_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism National Decision Support Company_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1004","description":"Clinical Decision Support Mechanism National Decision Support Company_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC23C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXF1","description":"ICD-GDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cont intraop neuro monitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0453","description":"Cont intraop neuro monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNB0","description":"ICD-BBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE12D","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18D","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNB1","description":"ICD-JFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8A","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAID1","description":"ICD-KAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGND1","description":"ICD-KGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCA1","description":"ICD-IDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYE1","description":"ICD-HIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIC1","description":"ICD-BGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERA1","description":"ICD-KERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5938","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5938","description":"CDT-D5938","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVE1","description":"ICD-JGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cranial cervical orthosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0112","description":"Cranial cervical orthosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Introduction Of Mixture Of Saline And Air For Sonosalpingography To Confirm Occlusion Of Fallopian Tubes_ Transcervical Approach_ Including Transvaginal Ultrasound And Pelvic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0568T","description":"Introduction Of Mixture Of Saline And Air For Sonosalpingography To Confirm Occlusion Of Fallopian Tubes_ Transcervical Approach_ Including Transvaginal Ultrasound And Pelvic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBC0","description":"ICD-AHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4CA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CA31","description":"ICD-4CA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hpv low-risk types","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87623","description":"Hpv low-risk types","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Culture bacteria anaerobic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87073","description":"Culture bacteria anaerobic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE212","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUD1","description":"ICD-AHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ak/knee disartic pelvic band","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5697","description":"Ak/knee disartic pelvic band","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28G","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Buprenorphine oral 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0571","description":"Buprenorphine oral 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANA0","description":"ICD-CANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBC0","description":"ICD-KBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGA0","description":"ICD-KDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIE1","description":"ICD-CAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove femur lesion/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27357","description":"Remove femur lesion/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Graft_ vascular","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1768","description":"Graft_ vascular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA104","description":"Clinically Complex _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL2D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert uro/ves nck sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53445","description":"Insert uro/ves nck sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC260","description":"Reduced Physical Function _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50728","description":"Revise ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDC1","description":"ICD-GIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Anal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1072","description":"Radiation Therapy For Anal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chromogenic substrate assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85130","description":"Chromogenic substrate assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWD0","description":"ICD-KFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1BB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BB21","description":"ICD-1BB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDD0","description":"ICD-ECDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Most Recent Hemoglobin A1C (Hba1C) Level 7.0 To 9.0%","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2089","description":"Most Recent Hemoglobin A1C (Hba1C) Level 7.0 To 9.0%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXF1","description":"ICD-CFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dermabrasion total face","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15780","description":"Dermabrasion total face","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Us leiomyomata ablate <200","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0071T","description":"Us leiomyomata ablate <200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSC1","description":"ICD-KCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88016","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBD1","description":"ICD-JIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRA1","description":"ICD-PGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFB0","description":"ICD-BHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVF1","description":"ICD-KIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1802","description":"HCPCS-B1802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYC0","description":"ICD-LEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Color vision examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92283","description":"Color vision examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAE1","description":"ICD-BEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRC1","description":"ICD-HCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFE0","description":"ICD-BAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90624","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","description":"CPT-90624","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAF1","description":"ICD-OCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enterectomy live donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44133","description":"Enterectomy live donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB21A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUC1","description":"ICD-NCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETD0","description":"ICD-BETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eye exam & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92019","description":"Eye exam & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMA0","description":"ICD-KGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42650","description":"Dilation of salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mrgfus strtctc les abltj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0398T","description":"Mrgfus strtctc les abltj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAF0","description":"ICD-JGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0107","description":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIE0","description":"ICD-OJIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMA1","description":"ICD-OHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE220","description":"Clinically Complex _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAB0","description":"ICD-GGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin and muscle repair face","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15845","description":"Skin and muscle repair face","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Order for ceph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9197","description":"Order for ceph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKB0","description":"ICD-FIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBA1","description":"ICD-GCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVA0","description":"ICD-CEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIB1","description":"ICD-FIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB07","description":"Very High Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen amphetamines 1/2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80324","description":"Drug screen amphetamines 1/2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1106","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWB1","description":"ICD-LEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSC0","description":"ICD-DHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQB1","description":"ICD-KIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTF0","description":"ICD-ADTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIB0","description":"ICD-MEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKA0","description":"ICD-BFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLB1","description":"ICD-GGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYA1","description":"ICD-CAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip wall fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27226","description":"Treat hip wall fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHF1","description":"ICD-JGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JB11","description":"ICD-3JB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBF1","description":"ICD-FFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGD0","description":"ICD-OKGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCA1","description":"ICD-NDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPF1","description":"ICD-JAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEME1","description":"ICD-BEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDE0","description":"ICD-BEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLB1","description":"ICD-FCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eardrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69620","description":"Repair of eardrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDA1","description":"ICD-FHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repl batt for aed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0607","description":"Repl batt for aed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA220","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA11C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBB1","description":"ICD-GFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr hern preemie reduc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49491","description":"Rpr hern preemie reduc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGB0","description":"ICD-CHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLED0","description":"ICD-OLED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Phone e/m phys/qhp 11-20 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99442","description":"Phone e/m phys/qhp 11-20 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHC1","description":"ICD-MHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQA0","description":"ICD-CEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVF1","description":"ICD-CCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Discharge(s) for AMI between July 1 of the year prior measurement year to June 30 of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9798","description":"Discharge(s) for AMI between July 1 of the year prior measurement year to June 30 of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC116","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNC0","description":"ICD-GCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBC1","description":"ICD-OKBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRF1","description":"ICD-DHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp axillary-pop-tibial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35623","description":"Art byp axillary-pop-tibial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBD1","description":"ICD-EIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEA1","description":"ICD-MJEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGC1","description":"ICD-OHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antithrombin iii injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7197","description":"Antithrombin iii injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC130","description":"Special Care Low _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chlorothiazide sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1205","description":"Chlorothiazide sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDD1","description":"ICD-OBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove carotid body lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60600","description":"Remove carotid body lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neuromodulation stimulator system_ adjunct to rehabilitation therapy regime","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4593","description":"Neuromodulation stimulator system_ adjunct to rehabilitation therapy regime","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension_ percutaneous_ including imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32998","description":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension_ percutaneous_ including imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES206","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPD0","description":"ICD-GHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFC1","description":"ICD-NKFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETE1","description":"ICD-NETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRE1","description":"ICD-OLRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair amputee fixed arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1200","description":"Wheelchair amputee fixed arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mammogram screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77057","description":"Mammogram screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3EA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EA11","description":"ICD-3EA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKF1","description":"ICD-OCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQC1","description":"ICD-OLQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXF0","description":"ICD-BGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQA1","description":"ICD-KIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAF1","description":"ICD-MAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plmt post facet implt addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0222T","description":"Plmt post facet implt addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIID1","description":"ICD-OIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prq revasc byp graft 1 vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92937","description":"Prq revasc byp graft 1 vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair biceps tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23430","description":"Repair biceps tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWC1","description":"ICD-CHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00870","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00870","description":"CPT-00870","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCF0","description":"ICD-FHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA26","description":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUC1","description":"ICD-NAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD113","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOB1","description":"ICD-KCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Underarm crutch pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4635","description":"Underarm crutch pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove armpit lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38745","description":"Remove armpit lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPA1","description":"ICD-GIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBC0","description":"ICD-CCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc hip/pelv tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27048","description":"Exc hip/pelv tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4KA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KA21","description":"ICD-4KA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUE1","description":"ICD-MHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXF1","description":"ICD-JAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis access study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90940","description":"Hemodialysis access study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMF1","description":"ICD-KHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDF0","description":"ICD-NBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leg pain was not measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 to 20 weeks) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9949","description":"Leg pain was not measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 to 20 weeks) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33300","description":"Repair of heart wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXD0","description":"ICD-KHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHE0","description":"ICD-FGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERC0","description":"ICD-DERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epsd bk pain for 6 wks/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1134F","description":"Epsd bk pain for 6 wks/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL4B","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA254","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3CA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CA11","description":"ICD-3CA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKF1","description":"ICD-GHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient died prior to the end of the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1060","description":"Patient died prior to the end of the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCE0","description":"ICD-GHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJB1","description":"ICD-CDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hfo without joints pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3924","description":"Hfo without joints pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPF1","description":"ICD-KIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1022","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1022","description":"HCPCS-E1022","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elbow arthroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29830","description":"Elbow arthroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1203","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1203","description":"HCPCS-B1203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gen use back cush wdth>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2612","description":"Gen use back cush wdth>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLC0","description":"ICD-GGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXB0","description":"ICD-KDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIE0","description":"ICD-ACIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hiv rna vrl ld ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25078","description":"Resect forarm/wrist tum 3cm>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNF1","description":"ICD-NLNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bx done w/colposcopy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58110","description":"Bx done w/colposcopy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWA1","description":"ICD-PGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iv chelationtherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0300","description":"Iv chelationtherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLC1","description":"ICD-ABLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lubricant per ounce","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4402","description":"Lubricant per ounce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILD0","description":"ICD-MILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOB1","description":"ICD-HAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Evoked auditory test limited","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92587","description":"Evoked auditory test limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPA0","description":"ICD-JIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ggt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82977","description":"Assay of ggt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXA0","description":"ICD-KFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA145","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33400","description":"Repair of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB22","description":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABC0","description":"ICD-KABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSE1","description":"ICD-DHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICB1","description":"ICD-AICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEF0","description":"ICD-BCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACC1","description":"ICD-JACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Body pos d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8983","description":"Body pos d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOA1","description":"ICD-KHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oxacillin sodium injeciton","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2700","description":"Oxacillin sodium injeciton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA12C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26750","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDC1","description":"ICD-GFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRB0","description":"ICD-KFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8H","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special pump services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99190","description":"Special pump services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incis spine 3 column thorac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22206","description":"Incis spine 3 column thorac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIB0","description":"ICD-AGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE225","description":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAME0","description":"ICD-OAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD14D","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth ear surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12051","description":"Anesth ear surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPF1","description":"ICD-FDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eeg monitoring/function test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95958","description":"Eeg monitoring/function test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Isoetharine comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7647","description":"Isoetharine comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Design mlc device for imrt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77338","description":"Design mlc device for imrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC201","description":"Clinically Complex _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Deb musc/fascia add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11046","description":"Deb musc/fascia add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUD1","description":"ICD-FCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBC0","description":"ICD-BIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGME1","description":"ICD-OGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFME0","description":"ICD-KFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0903","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0903","description":"CDT-D0903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUB1","description":"ICD-GGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA15","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAF1","description":"ICD-ICAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELC1","description":"ICD-FELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXF1","description":"ICD-BIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHE1","description":"ICD-BBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKF0","description":"ICD-NKKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC56","description":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUC1","description":"ICD-OFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBB1","description":"ICD-OIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Patisiran_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0222","description":"Injection_ Patisiran_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGA0","description":"ICD-GGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJA0","description":"ICD-KFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter_ guiding","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1887","description":"Catheter_ guiding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFA1","description":"ICD-CEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Below knee suction socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5647","description":"Below knee suction socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB241","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGC1","description":"ICD-CCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bp sys>=140 and/or dias >=90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8477","description":"Bp sys>=140 and/or dias >=90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPA1","description":"ICD-BIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRD0","description":"ICD-HFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBA1","description":"ICD-GEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lsh w/t/o uterus above 250 g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58544","description":"Lsh w/t/o uterus above 250 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRB1","description":"ICD-CIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDF1","description":"ICD-OCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28525","description":"Treat toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNF1","description":"ICD-JBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional_ two or more tests_ any method; each additional 30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96137","description":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional_ two or more tests_ any method; each additional 30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOE0","description":"ICD-KEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision lesion mouth roof","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42107","description":"Excision lesion mouth roof","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIF0","description":"ICD-KHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0591U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","description":"CPT-0591U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fluoride applicator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5986","description":"Fluoride applicator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rsa lower extr exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0350T","description":"Rsa lower extr exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVD0","description":"ICD-OBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEF1","description":"ICD-OFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation therapy management","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77431","description":"Radiation therapy management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUD0","description":"ICD-BIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDME0","description":"ICD-KDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36576","description":"Repair tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVB1","description":"ICD-BHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOD0","description":"ICD-DHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSE0","description":"ICD-PFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEC0","description":"ICD-FEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQE0","description":"ICD-HHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGE1","description":"ICD-KIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of precision att","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5867","description":"Replacement of precision att","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNF0","description":"ICD-ODNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHA0","description":"ICD-JGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18H","description":"Special Care Low _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTE1","description":"ICD-NBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9748","description":"Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHA0","description":"ICD-JIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noner transport case worker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0160","description":"Noner transport case worker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Technical Calculation Only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77091","description":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Technical Calculation Only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"P-mastectomy w/ln removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19302","description":"P-mastectomy w/ln removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDA1","description":"ICD-NCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glycopyrrolate comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7642","description":"Glycopyrrolate comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Irrigation syringe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4322","description":"Irrigation syringe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFB0","description":"ICD-FGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGA0","description":"ICD-BHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQE1","description":"ICD-LBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXC1","description":"ICD-GIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD13A","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dna analysis ret-oncogene","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3840","description":"Dna analysis ret-oncogene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDE1","description":"ICD-OBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEC0","description":"ICD-OLEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIF0","description":"ICD-FBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair webbed toe(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28345","description":"Repair webbed toe(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXB0","description":"ICD-OJXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJB0","description":"ICD-BHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5298","description":"Hearing aid noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATA0","description":"ICD-IATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVB0","description":"ICD-NEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNC1","description":"ICD-KDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJA1","description":"ICD-FCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29897","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRC0","description":"ICD-PFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0668","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","description":"HCPCS-J0668","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental consultation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9310","description":"Dental consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic control hip heavy dut","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2620","description":"Pelvic control hip heavy dut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHE1","description":"ICD-FCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHA0","description":"ICD-CDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOE0","description":"ICD-CIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBE0","description":"ICD-NHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX52","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB25C","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tilt table evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93660","description":"Tilt table evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of toe lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28108","description":"Removal of toe lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Liver disease_ 10 biochemical assays (a2-macroglobulin_ haptoglobin_ apolipoprotein A1_ bilirubin_ GGT_ ALT_ AST_ triglycerides_ cholesterol_ fasting glucose) and biometric an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0166U","description":"Liver disease_ 10 biochemical assays (a2-macroglobulin_ haptoglobin_ apolipoprotein A1_ bilirubin_ GGT_ ALT_ AST_ triglycerides_ cholesterol_ fasting glucose) and biometric an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open wedge/bx lung infiltr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32096","description":"Open wedge/bx lung infiltr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWE1","description":"ICD-DAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRF1","description":"ICD-ODRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vacuum drain bottle/tube kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7048","description":"Vacuum drain bottle/tube kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pacemaker system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33234","description":"Removal of pacemaker system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQF1","description":"ICD-CAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHA0","description":"ICD-AHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove femur lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27355","description":"Remove femur lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWE0","description":"ICD-OHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINB0","description":"ICD-NINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPE0","description":"ICD-CCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1084T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1084T","description":"CPT-1084T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"SanoGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4319","description":"SanoGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXD1","description":"ICD-FDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tl201 thallium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9505","description":"Tl201 thallium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPC0","description":"ICD-JCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSB0","description":"ICD-DBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient received at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after the pat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1174","description":"Patient received at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after the pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glucose other fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82945","description":"Glucose other fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO hip intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an adequa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9729","description":"Patient unable to complete the FOTO hip intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an adequa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQB0","description":"ICD-GDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27607","description":"Treat lower leg bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Us transrectal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76872","description":"Us transrectal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 50MCG/0.25MLBST","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0064A","description":"ADM SARSCOV2 50MCG/0.25MLBST","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGA1","description":"ICD-OLGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAC0","description":"ICD-MAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Followup eval of foot pt lop","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0246","description":"Followup eval of foot pt lop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIE1","description":"ICD-AGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Man w/ch acc seat w>=20in<24in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2201","description":"Man w/ch acc seat w>=20in<24in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYC1","description":"ICD-KGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35102","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGE1","description":"ICD-NGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTF1","description":"ICD-JDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD13C","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWF0","description":"ICD-KDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIB0","description":"ICD-AAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB25C","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Subs eval for condition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1121F","description":"Subs eval for condition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical boot each child","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3209","description":"Surgical boot each child","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVC1","description":"ICD-NHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Segesterone acetate and ethinyl estradiol 0.15 mg_ 0.013 mgper 24 hours; yearly vaginal system_ ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7294","description":"Segesterone acetate and ethinyl estradiol 0.15 mg_ 0.013 mgper 24 hours; yearly vaginal system_ ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (lung cancer)_ four-probe FISH (3q29_ 3p22.1_ 10q22.3_ 10cen) assay_ whole blood_ predictive algorithm-generated evaluation reported as decreased or increased risk fo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0317U","description":"Oncology (lung cancer)_ four-probe FISH (3q29_ 3p22.1_ 10q22.3_ 10cen) assay_ whole blood_ predictive algorithm-generated evaluation reported as decreased or increased risk fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXA1","description":"ICD-GFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUA0","description":"ICD-IBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXB0","description":"ICD-KHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Screen depression performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3725F","description":"Screen depression performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESC1","description":"ICD-GESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNE0","description":"ICD-JBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Human fibrinogen conc inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7178","description":"Human fibrinogen conc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKF1","description":"ICD-OFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTB0","description":"ICD-AGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCME0","description":"ICD-KCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHA0","description":"ICD-CCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE225","description":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc shoulder les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23071","description":"Exc shoulder les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ high density foam roll for bandage_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6602","description":"Gradient compression bandaging supply_ high density foam roll for bandage_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPC1","description":"ICD-JHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0637U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0637U","description":"CPT-0637U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLB1","description":"ICD-BFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plasma volume multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78111","description":"Plasma volume multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj pantoprazole sodium_ via","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9113","description":"Inj pantoprazole sodium_ via","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB155","description":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection for salivary x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42550","description":"Injection for salivary x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91451","description":"Anesth removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth esophageal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50051","description":"Anesth esophageal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALA0","description":"ICD-MALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLC1","description":"ICD-AFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHC1","description":"ICD-GIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00532","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00532","description":"CPT-00532","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVC1","description":"ICD-FBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of sirolimus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80195","description":"Assay of sirolimus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTC1","description":"ICD-OFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJC1","description":"ICD-CGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mdd in remission","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3092F","description":"Mdd in remission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algori","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81541","description":"Oncology (prostate)_ mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algori","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35261","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXD0","description":"ICD-BFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAE0","description":"ICD-FEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METF0","description":"ICD-METF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autotransplant parathyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60512","description":"Autotransplant parathyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFB1","description":"ICD-BIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC206","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ambulance waiting 1/2 hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0420","description":"Ambulance waiting 1/2 hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFF0","description":"ICD-OLFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients With Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2151","description":"Patients With Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit enteral per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9340","description":"Hit enteral per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELC1","description":"ICD-GELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWA0","description":"ICD-GEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suspension of uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58400","description":"Suspension of uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEA1","description":"ICD-NIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQB0","description":"ICD-HEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Temporal bone surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69979","description":"Temporal bone surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJD1","description":"ICD-JBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSB1","description":"ICD-LDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBF1","description":"ICD-NDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath w/drainage 2-way silcne","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4315","description":"Cath w/drainage 2-way silcne","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise max/zygoma b9 tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21030","description":"Excise max/zygoma b9 tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADF0","description":"ICD-IADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Walker leg extenders set of4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0158","description":"Walker leg extenders set of4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJC0","description":"ICD-GIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of leg tendon each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27665","description":"Repair of leg tendon each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFF1","description":"ICD-BAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlso r fram soft ant pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0466","description":"Tlso r fram soft ant pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient exhibits 2 or more risk factors for postoperative vomiting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9954","description":"Patient exhibits 2 or more risk factors for postoperative vomiting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHB0","description":"ICD-OBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30450","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis b dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87517","description":"Hepatitis b dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oral appliance therapy (OAT) titration visit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9955","description":"Oral appliance therapy (OAT) titration visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aortic circulation assist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33970","description":"Aortic circulation assist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX22","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRA1","description":"ICD-GGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"R & l heart cath congenital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93532","description":"R & l heart cath congenital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA2B","description":"Medium Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGA0","description":"ICD-JDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55869","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","description":"CPT-55869","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ below knee_ 30-40 mmhg_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6552","description":"Gradient compression stocking_ below knee_ 30-40 mmhg_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBF1","description":"ICD-EBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERF1","description":"ICD-CERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMA1","description":"ICD-AIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ped size brief/diaper sm/med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4529","description":"Ped size brief/diaper sm/med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 7 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP07","description":"Auto.test pane pricing code_ 7 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOC0","description":"ICD-DBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACA0","description":"ICD-MACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone srgry cmptr CT/MRI imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0055T","description":"Bone srgry cmptr CT/MRI imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE231","description":"Clinically Complex _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Outrigger bil w/ vert extens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1085","description":"Outrigger bil w/ vert extens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr f/e/e/n/l/m 2.6-5.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12013","description":"Rpr f/e/e/n/l/m 2.6-5.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ft arch suprt premold longit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3040","description":"Ft arch suprt premold longit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"LAMINECTOMY_ FACETECTOMY_ OR FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD_ CAUDA EQUINA AND/OR NERVE ROOT[S] [EG_ SPINAL OR LATERAL RECESS STENOSIS]","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63052","description":"LAMINECTOMY_ FACETECTOMY_ OR FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD_ CAUDA EQUINA AND/OR NERVE ROOT[S] [EG_ SPINAL OR LATERAL RECESS STENOSIS]","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXE0","description":"ICD-KEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0105","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0105","description":"HCPCS-A0105","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB3D","description":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHD1","description":"ICD-JHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thromboemb risk assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1180F","description":"Thromboemb risk assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIB1","description":"ICD-MCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEC1","description":"ICD-CBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8X","description":"Low Rehab_ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVA1","description":"ICD-CGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFC1","description":"ICD-OCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKB0","description":"ICD-FFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEE1","description":"ICD-OGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUC1","description":"ICD-FDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEB0","description":"ICD-GHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rn home care per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1030","description":"Rn home care per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of pancreas open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48100","description":"Biopsy of pancreas open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Op rad mg intent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9238","description":"Op rad mg intent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of calcium deposits","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23000","description":"Removal of calcium deposits","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50070","description":"Incision of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHD1","description":"ICD-AAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHC0","description":"ICD-OAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cervic collar w air bladders","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0856","description":"Cervic collar w air bladders","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOF1","description":"ICD-GEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Whchr s-recl fxd arm leg res","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1100","description":"Whchr s-recl fxd arm leg res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Storage/year reprod tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89344","description":"Storage/year reprod tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit new","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99202","description":"Office/outpatient visit new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair lightweight det a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1088","description":"Wheelchair lightweight det a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-sterile gauze > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6218","description":"Non-sterile gauze > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAF1","description":"ICD-KGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8H","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thiotepa injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9340","description":"Thiotepa injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCB0","description":"ICD-GGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Microprocessor control uplmb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6882","description":"Microprocessor control uplmb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wound warming device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0231","description":"Wound warming device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSC0","description":"ICD-KFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstr lwr jaw segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21198","description":"Reconstr lwr jaw segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJF0","description":"ICD-GHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESA1","description":"ICD-GESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJF1","description":"ICD-NLJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0682T","description":"Removal Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEF1","description":"ICD-NJEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin-oxygen affinity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82820","description":"Hemoglobin-oxygen affinity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35363","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJE1","description":"ICD-CFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGE1","description":"ICD-GIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apexification/recalc final","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3353","description":"Apexification/recalc final","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBA1","description":"ICD-FDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17281","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYE0","description":"ICD-PKYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGC1","description":"ICD-OCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Triamcinolone a inj prs-free","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3300","description":"Triamcinolone a inj prs-free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sperm washing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58323","description":"Sperm washing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB213","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE106","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYA1","description":"ICD-DDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht leg splnt ped p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4047","description":"Cast sup sht leg splnt ped p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Optical coherence tomography (OCT) of middle ear_ with interpretation and report; unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0485T","description":"Optical coherence tomography (OCT) of middle ear_ with interpretation and report; unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKE1","description":"ICD-CAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKF0","description":"ICD-FIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Storage/year oocyte(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89346","description":"Storage/year oocyte(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPE0","description":"ICD-BGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Periodontal maint procedures","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4910","description":"Periodontal maint procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lymph vessel x-ray trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75807","description":"Lymph vessel x-ray trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28H","description":"Special Care Low _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKD0","description":"ICD-JBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRE1","description":"ICD-LCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mltispectrl digital les alys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0400T","description":"Mltispectrl digital les alys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB31","description":"Medium Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJE1","description":"ICD-FIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artificial saliva","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9155","description":"Artificial saliva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTC1","description":"ICD-NHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oth resp proc_ indiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0238","description":"Oth resp proc_ indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCC1","description":"ICD-OCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDB1","description":"ICD-MBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise finger/toe nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64702","description":"Revise finger/toe nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBD0","description":"ICD-ECBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation of small int","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2053","description":"Transplantation of small int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"repair cast partial framework_ mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5621","description":"repair cast partial framework_ mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq vertebral augmentation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22515","description":"Perq vertebral augmentation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUD0","description":"ICD-CEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIF1","description":"ICD-MHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insrt/redo pn/gastr stimul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64590","description":"Insrt/redo pn/gastr stimul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFB0","description":"ICD-GIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOD0","description":"ICD-GHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALA1","description":"ICD-MALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59135","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rabies vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90675","description":"Rabies vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal foreign body mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40805","description":"Removal foreign body mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITC1","description":"ICD-CITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No tdap or td or 1tet/dipth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9417","description":"No tdap or td or 1tet/dipth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBE1","description":"ICD-OFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRD0","description":"ICD-DDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"PIGF Preeclampsia Screen_ PerkinElmer Genetics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0243U","description":"PIGF Preeclampsia Screen_ PerkinElmer Genetics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients With A Catheter That Have Limited Life Expectancy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0050","description":"Patients With A Catheter That Have Limited Life Expectancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autonomic nrv syst funj test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95923","description":"Autonomic nrv syst funj test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNB0","description":"ICD-NDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUD0","description":"ICD-AIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD231","description":"Special Care High _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXA1","description":"ICD-OFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHF0","description":"ICD-EIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cervical traction equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0855","description":"Cervical traction equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRD1","description":"ICD-HBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHA1","description":"ICD-JHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXA1","description":"ICD-BGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBE0","description":"ICD-ACBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAC0","description":"ICD-GEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Er- or pr- breast cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3316F","description":"Er- or pr- breast cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUF1","description":"ICD-NJUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBC1","description":"ICD-OEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX33","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat metatarsal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28485","description":"Treat metatarsal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLC1","description":"ICD-EGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKE0","description":"ICD-BBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56637","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ methylated PENK DNA detection by linear target enrichment-quantitative methylation-specific real-time PCR (LTE-qMSP)_ urine_ reported as likelihood of blad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0452U","description":"Oncology (bladder)_ methylated PENK DNA detection by linear target enrichment-quantitative methylation-specific real-time PCR (LTE-qMSP)_ urine_ reported as likelihood of blad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ABO GNOTYP ABO 7 EXONS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0180U","description":"ABO GNOTYP ABO 7 EXONS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Atten goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9166","description":"Atten goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert ant segment drain int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0376T","description":"Insert ant segment drain int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ risperidone (rykindo)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2801","description":"Injection_ risperidone (rykindo)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDC1","description":"ICD-JFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen quant gabapentin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80171","description":"Drug screen quant gabapentin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJB1","description":"ICD-FGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystourethroscopy_ with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis_ male_ including","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52284","description":"Cystourethroscopy_ with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis_ male_ including","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUC1","description":"ICD-NDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUD0","description":"ICD-EIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath indw foley 3 way","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4346","description":"Cath indw foley 3 way","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHE1","description":"ICD-IDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ovulation mgmt per cycle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4042","description":"Ovulation mgmt per cycle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tah rad dissect for debulk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58953","description":"Tah rad dissect for debulk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMF0","description":"ICD-KFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL35","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ torso/shoulder_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6569","description":"Gradient compression garment_ torso/shoulder_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9186","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9186","description":"HCPCS-J9186","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt scrned for inj drug use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4290F","description":"Pt scrned for inj drug use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWD1","description":"ICD-PHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intracranial limited study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93888","description":"Intracranial limited study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUA0","description":"ICD-BFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enuresis alarm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8270","description":"Enuresis alarm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abd imag and followup rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9548","description":"Abd imag and followup rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEA0","description":"ICD-FDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anes spine tranthor w/o vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62559","description":"Anes spine tranthor w/o vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rbc serum pretx id dilution","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86976","description":"Rbc serum pretx id dilution","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKB0","description":"ICD-CEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home visit est patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99348","description":"Home visit est patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGC0","description":"ICD-FDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDE0","description":"ICD-KIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18C","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQC1","description":"ICD-HGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Add ue prost s/d acrylic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7405","description":"Add ue prost s/d acrylic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal endoscop po debrid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2342","description":"Nasal endoscop po debrid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of knuckle joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26517","description":"Fusion of knuckle joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ triamcinolone acetonide (Xipere)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3299","description":"Injection_ triamcinolone acetonide (Xipere)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLE1","description":"ICD-IDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBB1","description":"ICD-NIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9610","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","description":"HCPCS-A9610","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPD1","description":"ICD-BFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWF0","description":"ICD-DDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMB0","description":"ICD-JHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colorectal ca screen doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3017F","description":"Colorectal ca screen doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITA0","description":"ICD-OITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Audit/dast 15-30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99408","description":"Audit/dast 15-30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0666U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0666U","description":"CPT-0666U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hip arthro w/labral repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29916","description":"Hip arthro w/labral repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTA0","description":"ICD-BGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMB1","description":"ICD-GEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht arm splnt ped p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4023","description":"Cast sup sht arm splnt ped p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIA0","description":"ICD-CFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rem nonodonto cyst to 1.25cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7460","description":"Rem nonodonto cyst to 1.25cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC20D","description":"Special Care Low _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVB0","description":"ICD-BBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYB0","description":"ICD-LGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDB0","description":"ICD-CEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m pertechnetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9512","description":"Tc99m pertechnetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 3 (HIPPS rate code)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0110","description":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 3 (HIPPS rate code)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ctlso infant immobilizer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1001","description":"Ctlso infant immobilizer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWA0","description":"ICD-DHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Porfimer sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9600","description":"Porfimer sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBF0","description":"ICD-JBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of stomach partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43631","description":"Removal of stomach partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMC1","description":"ICD-MLMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASA1","description":"ICD-KASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray liver w/o hemodyn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75887","description":"Vein x-ray liver w/o hemodyn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANB0","description":"ICD-OANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt no hx act drain 90 d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8562","description":"Pt no hx act drain 90 d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKA1","description":"ICD-OJKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXC1","description":"ICD-KCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"P2y inhib not presc doc reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9439","description":"P2y inhib not presc doc reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Add proc construct new crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2971","description":"Add proc construct new crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental recement bridge","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6930","description":"Dental recement bridge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLE0","description":"ICD-OFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXD0","description":"ICD-CIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASD0","description":"ICD-HASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no disc tx opt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9400","description":"Doc reas no disc tx opt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMC1","description":"ICD-JDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJF1","description":"ICD-NAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Afo rig ant tib prefab tcf/=","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1932","description":"Afo rig ant tib prefab tcf/=","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGA1","description":"ICD-BBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSD0","description":"ICD-CBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYF1","description":"ICD-KEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD24A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD24B","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTB0","description":"ICD-NFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of big toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28310","description":"Revision of big toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPB1","description":"ICD-JFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heterophile antibody absrbj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86310","description":"Heterophile antibody absrbj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hizentra injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1559","description":"Hizentra injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bortezomib_ not otherwise specified_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9044","description":"Injection_ bortezomib_ not otherwise specified_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFC0","description":"ICD-CHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQA1","description":"ICD-HBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heparin assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85520","description":"Heparin assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc advncd dis comfort 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1152F","description":"Doc advncd dis comfort 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acute pvd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1337","description":"Acute pvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16078","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16078","description":"CPT-16078","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBC0","description":"ICD-ICBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient discharged alive following endovascular AAA repair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9263","description":"Documentation of patient discharged alive following endovascular AAA repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Counsel prov driving risks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6110F","description":"Counsel prov driving risks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove sutures same surgeon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15850","description":"Remove sutures same surgeon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE234","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGA1","description":"ICD-GEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDA0","description":"ICD-EGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYF0","description":"ICD-KEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of donor heart/lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33930","description":"Removal of donor heart/lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDC0","description":"ICD-GGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 std port cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0821","description":"Pwc gp 2 std port cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eval risk vte card 30d prior","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9298","description":"Eval risk vte card 30d prior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNF0","description":"ICD-NGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAC1","description":"ICD-IAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHE1","description":"ICD-IAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLE1","description":"ICD-GBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay nonendocrine receptor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84238","description":"Assay nonendocrine receptor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICD1","description":"ICD-MICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28C","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE115","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap rmvl gastr adj all parts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43774","description":"Lap rmvl gastr adj all parts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB1B","description":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVF1","description":"ICD-OJVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHA1","description":"ICD-OGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCB0","description":"ICD-ECCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient Receiving >5 Mg Daily Prednisone (Or Equivalent) For Longer Than 6 Months_ And Improvement Or No Change In Disease Activity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2113","description":"Patient Receiving >5 Mg Daily Prednisone (Or Equivalent) For Longer Than 6 Months_ And Improvement Or No Change In Disease Activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKE1","description":"ICD-OJKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDF1","description":"ICD-BGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEE0","description":"ICD-CBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKF0","description":"ICD-OAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSA0","description":"ICD-KGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bed cradle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0280","description":"Bed cradle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHE1","description":"ICD-CBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home health care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99374","description":"Home health care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUE0","description":"ICD-ABUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0668","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","description":"HCPCS-G0668","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMC1","description":"ICD-GBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERC1","description":"ICD-DERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNB1","description":"ICD-NKNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFB1","description":"ICD-GFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIA1","description":"ICD-ABIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18F","description":"Special Care High _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXC0","description":"ICD-NHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove skin nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64788","description":"Remove skin nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft head/neck 9 remiss <5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9393","description":"Ini phq9 >9 remiss <5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHE0","description":"ICD-GGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx esophageal mets recur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9098","description":"Onc dx esophageal mets recur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQA0","description":"ICD-KIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUF0","description":"ICD-GDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45395","description":"Lap removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nk cells total count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86357","description":"Nk cells total count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMB1","description":"ICD-MFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repl batt lithium 3.6 v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0604","description":"Repl batt lithium 3.6 v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA214","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB205","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Footrest complete assembly","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0045","description":"Footrest complete assembly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bevacizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9035","description":"Bevacizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Path rpt malig cancer docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3318F","description":"Path rpt malig cancer docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEF1","description":"ICD-CCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBE1","description":"ICD-CGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLF0","description":"ICD-MKLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYC1","description":"ICD-GDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWB1","description":"ICD-DEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXE1","description":"ICD-NCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD134","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stress tte complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93351","description":"Stress tte complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWA1","description":"ICD-HEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise inner ear window","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69840","description":"Revise inner ear window","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCA1","description":"ICD-JFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHD0","description":"ICD-OHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transect artery sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61611","description":"Transect artery sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enter feed supkit syr by day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4034","description":"Enter feed supkit syr by day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Caries preventive medicament application - per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1355","description":"Caries preventive medicament application - per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Asparaginase_ Recombinant_ (Rylaze)_ 0.1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9021","description":"Injection_ Asparaginase_ Recombinant_ (Rylaze)_ 0.1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPA1","description":"ICD-GCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDE0","description":"ICD-JGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disconnect locking wrist uni","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6615","description":"Disconnect locking wrist uni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSC1","description":"ICD-LHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJC0","description":"ICD-JHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUA0","description":"ICD-CCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALA1","description":"ICD-IALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPD0","description":"ICD-CCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMC0","description":"ICD-MGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pos pain assess no f/u doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8509","description":"Pos pain assess no f/u doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Scr unheal etoh w/counsel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9621","description":"Scr unheal etoh w/counsel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWB1","description":"ICD-LBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enzyme histochemistry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88319","description":"Enzyme histochemistry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHF0","description":"ICD-KHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILF1","description":"ICD-EILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00918","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00918","description":"CPT-00918","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMF0","description":"ICD-OFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPE0","description":"ICD-CGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision constricting tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26596","description":"Excision constricting tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Valvotomy pulmonary valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33471","description":"Valvotomy pulmonary valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00882","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00882","description":"CPT-00882","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVE1","description":"ICD-JHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise inner ear nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69950","description":"Incise inner ear nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALB0","description":"ICD-JALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drnble ostomy pouch w/o barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5062","description":"Drnble ostomy pouch w/o barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES33A","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACA0","description":"ICD-CACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMA0","description":"ICD-ODMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKD1","description":"ICD-GFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXC1","description":"ICD-BGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQA1","description":"ICD-OFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPD0","description":"ICD-FFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPF1","description":"ICD-OAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAA0","description":"ICD-NAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPA1","description":"ICD-CIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ infliximab-dyyb (Zymfentra)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1748","description":"Injection_ infliximab-dyyb (Zymfentra)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (von Willebrand disease [VWD])_ von Willebrand factor (VWF) and collagen III binding by enzyme-linked immunosorbent assays (ELISA)_ plasma_ report of collagen III b","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0279U","description":"Hematology (von Willebrand disease [VWD])_ von Willebrand factor (VWF) and collagen III binding by enzyme-linked immunosorbent assays (ELISA)_ plasma_ report of collagen III b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUF0","description":"ICD-JCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHB0","description":"ICD-JGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ins mark abd/pel for rt perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49411","description":"Ins mark abd/pel for rt perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daptomycin (Baxter)_ not therapeutically equivalent to J0878_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0874","description":"Injection_ daptomycin (Baxter)_ not therapeutically equivalent to J0878_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95149","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOE1","description":"ICD-OBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKB1","description":"ICD-OKKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Analgesics non-opioid 1 or 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80329","description":"Analgesics non-opioid 1 or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dsm-5 info mdd docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1040F","description":"Dsm-5 info mdd docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNA0","description":"ICD-CFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABD1","description":"ICD-AABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone strength and fracture-risk assessment using digital X-ray radiogrammetry-bone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0749T","description":"Bone strength and fracture-risk assessment using digital X-ray radiogrammetry-bone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPD0","description":"ICD-BEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVF1","description":"ICD-FFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ leuprolide acetate for depot suspension (lutrate)_ 7.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1954","description":"Injection_ leuprolide acetate for depot suspension (lutrate)_ 7.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection Bezlotoxumab 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9490","description":"Injection Bezlotoxumab 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGF1","description":"ICD-OJGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain arm/elbow bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23935","description":"Drain arm/elbow bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHB0","description":"ICD-IBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPB1","description":"ICD-OKPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX4D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINB0","description":"ICD-FINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28A","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dentures complete mandible","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5120","description":"Dentures complete mandible","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic appliance half arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0655","description":"Pneumatic appliance half arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCF0","description":"ICD-AGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPC1","description":"ICD-CGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"1dose menig vac btwn 11 & 13","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9414","description":"1dose menig vac btwn 11 & 13","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVF0","description":"ICD-CHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of anal septum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46070","description":"Incision of anal septum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC110","description":"Special Care High _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dc power adapter_ port conc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1358","description":"Dc power adapter_ port conc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRB1","description":"ICD-KGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPB1","description":"ICD-GHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29885","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOB1","description":"ICD-GIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCC1","description":"ICD-CGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA40","description":"Very High Rehab _ ADL Index 0-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEB0","description":"ICD-IFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abx pres w/in 10 dys of symp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9505","description":"Abx pres w/in 10 dys of symp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECD1","description":"ICD-CECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noner transport wheelch van","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0130","description":"Noner transport wheelch van","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTC1","description":"ICD-IDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB1A","description":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay toxin or antitoxin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87230","description":"Assay toxin or antitoxin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEA0","description":"ICD-KHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"PAS (Consumer)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1792","description":"PAS (Consumer)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUC1","description":"ICD-ODUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAD1","description":"ICD-JFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPD1","description":"ICD-FFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASA0","description":"ICD-LASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL14","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq device breast 1st imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19281","description":"Perq device breast 1st imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special base curve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2730","description":"Special base curve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQC1","description":"ICD-PFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOE1","description":"ICD-DDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clozapine_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0136","description":"Clozapine_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB30","description":"Low Rehab_ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perc d-e cor revasc t cabg b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9605","description":"Perc d-e cor revasc t cabg b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPF1","description":"ICD-FCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Growth stimulation gene 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83006","description":"Growth stimulation gene 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home visit new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99342","description":"Home visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Management of established patient-caregiver dyad with dementia_ high complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0526","description":"Management of established patient-caregiver dyad with dementia_ high complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHC0","description":"ICD-JBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Create eardrum opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69436","description":"Create eardrum opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPD0","description":"ICD-NBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replantation of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54438","description":"Replantation of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32480","description":"Partial removal of lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative assay drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80299","description":"Quantitative assay drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMC0","description":"ICD-NKMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIA1","description":"ICD-MJIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct chest spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72128","description":"Ct chest spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37293","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","description":"CPT-37293","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPB1","description":"ICD-JEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0945T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","description":"CPT-0945T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLE0","description":"ICD-IHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18X","description":"Clinically Complex _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUA1","description":"ICD-BFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTD0","description":"ICD-KGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cancelled appointment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9987","description":"Cancelled appointment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACE0","description":"ICD-JACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAF0","description":"ICD-IFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERD1","description":"ICD-PERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWE1","description":"ICD-CFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Integra bmwd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4104","description":"Integra bmwd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFC0","description":"ICD-JGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1098","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","description":"HCPCS-J1098","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMB0","description":"ICD-JIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB206","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKF0","description":"ICD-FGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepatology (nonalcoholic steatohepatitis [NASH])_ miR-34a-5p_ alpha 2-macroglobulin_ YKL40_ HbA1c_ serum and whole blood_ algorithm reported as a single score for NASH activit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0468U","description":"Hepatology (nonalcoholic steatohepatitis [NASH])_ miR-34a-5p_ alpha 2-macroglobulin_ YKL40_ HbA1c_ serum and whole blood_ algorithm reported as a single score for NASH activit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2211","description":"Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01916","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01916","description":"CPT-01916","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB111","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUC0","description":"ICD-AGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug Assay_ Presumptive_ 30 Or More Drugs Or Metabolites_ Urine_ Liquid Chromatography With Tandem Mass Spectrometry (Lc-Ms/Ms) Using Multiple Reaction Monitoring (Mrm)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0227U","description":"Drug Assay_ Presumptive_ 30 Or More Drugs Or Metabolites_ Urine_ Liquid Chromatography With Tandem Mass Spectrometry (Lc-Ms/Ms) Using Multiple Reaction Monitoring (Mrm)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYE0","description":"ICD-HFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUA1","description":"ICD-MGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILB1","description":"ICD-MILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4344","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","description":"HCPCS-Q4344","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIA1","description":"ICD-OAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sterile eye pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6410","description":"Sterile eye pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITF0","description":"ICD-BITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJD1","description":"ICD-FIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKD0","description":"ICD-GCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWC0","description":"ICD-HHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGA0","description":"ICD-BDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht arm adult plstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4009","description":"Cast sup sht arm adult plstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITE0","description":"ICD-OITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMB0","description":"ICD-FEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAA1","description":"ICD-NAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Methylprednisolone 80 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1040","description":"Methylprednisolone 80 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heart image spect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78494","description":"Heart image spect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRD0","description":"ICD-OJRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFND1","description":"ICD-GFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"4-bar link above knee w/swng","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5614","description":"4-bar link above knee w/swng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLID1","description":"ICD-MLID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBF0","description":"ICD-GDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rx corneoscleral cntact lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92317","description":"Rx corneoscleral cntact lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIB1","description":"ICD-JGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecallantide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1290","description":"Ecallantide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHF0","description":"ICD-FEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKB0","description":"ICD-OGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27882","description":"Amputation of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUF1","description":"ICD-MCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHE0","description":"ICD-NEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUE0","description":"ICD-JHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERD0","description":"ICD-HERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXC1","description":"ICD-NDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of sternum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21740","description":"Reconstruction of sternum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKA1","description":"ICD-CDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMD1","description":"ICD-CCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0426","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0426","description":"CDT-D0426","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore limb vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35860","description":"Explore limb vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ext wear ost skn barr <=4sqin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4407","description":"Ext wear ost skn barr <=4sqin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIA1","description":"ICD-KAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Icg angiography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92240","description":"Icg angiography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Splint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4570","description":"Splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0609","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","description":"HCPCS-J0609","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA40","description":"Medium Rehab _ ADL Index 0-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ infliximab-dyyb_ biosimilar_ (Inflectra)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5103","description":"Injection_ infliximab-dyyb_ biosimilar_ (Inflectra)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBC1","description":"ICD-EDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cerv sr wire occ/man pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0160","description":"Cerv sr wire occ/man pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemoperfusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90997","description":"Hemoperfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1457","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","description":"HCPCS-M1457","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESE1","description":"ICD-GESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSF1","description":"ICD-GBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMD0","description":"ICD-NCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent (sexually transmitted infection)_ Chlamydia trachomatis_ Neisseria gonorrhoeae_ Trichomonas vaginalis_ Mycoplasma genitalium_ multiplex amplified probe techni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0402U","description":"Infectious agent (sexually transmitted infection)_ Chlamydia trachomatis_ Neisseria gonorrhoeae_ Trichomonas vaginalis_ Mycoplasma genitalium_ multiplex amplified probe techni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEB0","description":"ICD-KCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hx bld transf b/f 1992","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9449","description":"Hx bld transf b/f 1992","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy/removal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38520","description":"Biopsy/removal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHD0","description":"ICD-ODHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAA1","description":"ICD-FHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB112","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHB1","description":"ICD-BEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intranasal biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30100","description":"Intranasal biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJC1","description":"ICD-KIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETA0","description":"ICD-AETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3BA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BA21","description":"ICD-3BA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Collect/review data from pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99091","description":"Collect/review data from pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHA0","description":"ICD-MIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYB1","description":"ICD-DGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHD0","description":"ICD-FEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic Repositioning Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including Connec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0677T","description":"Laparoscopic Repositioning Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including Connec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9282","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","description":"HCPCS-J9282","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diabetes prev standard curr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0403T","description":"Diabetes prev standard curr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inject for spine disk x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62290","description":"Inject for spine disk x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUA0","description":"ICD-MCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITE0","description":"ICD-NITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion_ pemivibart_ for the pre-exposure prophylaxis only_ for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known S","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0224","description":"Intravenous infusion_ pemivibart_ for the pre-exposure prophylaxis only_ for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB21B","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINF1","description":"ICD-FINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52283","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB24A","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemostats for dialysis_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1637","description":"Hemostats for dialysis_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB260","description":"Clinically Complex _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Lefamulin (Xenleta)_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9054","description":"Injection_ Lefamulin (Xenleta)_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA31","description":"High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTC0","description":"ICD-JDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLF1","description":"ICD-FCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj calcitriol per 0.1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0636","description":"Inj calcitriol per 0.1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENB0","description":"ICD-OENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18E","description":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of feces/urobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84577","description":"Assay of feces/urobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA01","description":"Low Rehab_ ADL Index 0-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pancreatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48154","description":"Pancreatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUA0","description":"ICD-KIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50040","description":"Drainage of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNF1","description":"ICD-JDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRF1","description":"ICD-PFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"In111 ibritumomab_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9542","description":"In111 ibritumomab_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx ovarian stg1a-b or 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9114","description":"Onc dx ovarian stg1a-b or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOA0","description":"ICD-HIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJF1","description":"ICD-KGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE13A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ nafcillin sodium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0032","description":"Injection_ nafcillin sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKB1","description":"ICD-NLKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63308","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt ref for speech lang path","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4552F","description":"Pt ref for speech lang path","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1041T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1041T","description":"CPT-1041T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEB1","description":"ICD-FGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALA0","description":"ICD-GALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBC0","description":"ICD-MHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQB1","description":"ICD-CAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLF0","description":"ICD-OJLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIB0","description":"ICD-NEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultrafiltration monitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9007","description":"Ultrafiltration monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert emergency airway","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31500","description":"Insert emergency airway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18G","description":"Clinically Complex _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHC0","description":"ICD-BEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Porcelain/ceramic inlay 2srf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6600","description":"Porcelain/ceramic inlay 2srf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOE1","description":"ICD-OIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDD1","description":"ICD-ACDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit cont insulin diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9353","description":"Hit cont insulin diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFE1","description":"ICD-FIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLF0","description":"ICD-CBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKA1","description":"ICD-FGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWB1","description":"ICD-OGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCB1","description":"ICD-MFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA104","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJC1","description":"ICD-FAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of tacrolimus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80197","description":"Assay of tacrolimus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD15A","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Beta amyloid_ AB42/40 ratio_ immunoprecipitation with quantitation by liquid chromatography with tandem mass spectrometry (LC-MS/MS) and qualitative ApoE isoform-specific prot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0412U","description":"Beta amyloid_ AB42/40 ratio_ immunoprecipitation with quantitation by liquid chromatography with tandem mass spectrometry (LC-MS/MS) and qualitative ApoE isoform-specific prot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation cone locator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5985","description":"Radiation cone locator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA36","description":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXB0","description":"ICD-BBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99425","description":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWB1","description":"ICD-HFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biliary endo perq dx w/speci","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47552","description":"Biliary endo perq dx w/speci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial imaging by magnetocardiography (MCG) for detection of cardiac ischemia_ by signal acquisition using minimum 36 channel grid_ generation of magnetic-field time-serie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0541T","description":"Myocardial imaging by magnetocardiography (MCG) for detection of cardiac ischemia_ by signal acquisition using minimum 36 channel grid_ generation of magnetic-field time-serie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia with hypothermia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99116","description":"Anesthesia with hypothermia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brain image w/flow < 4 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78601","description":"Brain image w/flow < 4 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dna analysis apoe alzheimer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3852","description":"Dna analysis apoe alzheimer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANB1","description":"ICD-BANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWB1","description":"ICD-LGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol amino acid 7-","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4176","description":"Parenteral sol amino acid 7-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPB1","description":"ICD-NLPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBF0","description":"ICD-KCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Episodes where the patient had a competing comorbid condition during the 12 months prior to or on the episode date (e.g._ tuberculosis_ neutropenia_ cystic fibrosis_ chronic b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2175","description":"Episodes where the patient had a competing comorbid condition during the 12 months prior to or on the episode date (e.g._ tuberculosis_ neutropenia_ cystic fibrosis_ chronic b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1902","description":"HCPCS-C1902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDA1","description":"ICD-GHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEA1","description":"ICD-KBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application lower leg splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29515","description":"Application lower leg splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAE0","description":"ICD-IFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8I","description":"Low Rehab_ ADL Index 0-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHC1","description":"ICD-NCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOE0","description":"ICD-OCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anastomosis/artery-aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33606","description":"Anastomosis/artery-aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sutimlimab-jome_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9094","description":"Injection_ sutimlimab-jome_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHD0","description":"ICD-MIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEE0","description":"ICD-ADEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTC1","description":"ICD-MDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPB1","description":"ICD-NDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special anesthesia procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99135","description":"Special anesthesia procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9191","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9191","description":"HCPCS-J9191","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBA0","description":"ICD-ADBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAB1","description":"ICD-IAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOF1","description":"ICD-DHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surv score no improv w/tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9605","description":"Surv score no improv w/tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATE0","description":"ICD-CATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (Cutaquig)_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1551","description":"Injection_ immune globulin (Cutaquig)_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4AB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AB31","description":"ICD-4AB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDB0","description":"ICD-EBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKA1","description":"ICD-NAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX32","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of gastrin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82941","description":"Assay of gastrin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cricotracheal resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31592","description":"Cricotracheal resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comm trans waiver/service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2038","description":"Comm trans waiver/service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain thyroid/tongue cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60000","description":"Drain thyroid/tongue cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stenger test pure tone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92565","description":"Stenger test pure tone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQE0","description":"ICD-KEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1009T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","description":"CPT-1009T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aerosol inhalation treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94642","description":"Aerosol inhalation treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD11A","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40820","description":"Treatment of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJB0","description":"ICD-GFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ONC NONSM CLL LNG CA ALYS 23","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0179U","description":"ONC NONSM CLL LNG CA ALYS 23","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRF1","description":"ICD-OKRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nonemergency transport air","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0140","description":"Nonemergency transport air","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIA1","description":"ICD-GGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKD1","description":"ICD-CCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKA1","description":"ICD-JAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JC31","description":"ICD-3JC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEA0","description":"ICD-AAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD105","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fibula bone graft microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20955","description":"Fibula bone graft microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX21","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWB0","description":"ICD-DFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath fl nongyn smears","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88104","description":"Cytopath fl nongyn smears","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB50","description":"Medium Rehab _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSE0","description":"ICD-LDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat sesamoid bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28530","description":"Treat sesamoid bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41009","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hyalomatrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4117","description":"Hyalomatrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICC0","description":"ICD-OICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEF0","description":"ICD-AGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSC1","description":"ICD-KGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Custom shoes depth inlay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3230","description":"Custom shoes depth inlay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64469","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","description":"CPT-64469","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELE1","description":"ICD-GELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDD1","description":"ICD-FIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place gastrostomy tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49440","description":"Place gastrostomy tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43622","description":"Removal of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinolysins screen i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85390","description":"Fibrinolysins screen i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAE1","description":"ICD-EIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX4B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glycosylated hb home device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83037","description":"Glycosylated hb home device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEC1","description":"ICD-OFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transperineal focal laser ablation of malignant prostate tissue_ including transrectal imaging guidance_ with MR-fused images or other enhanced ultrasound imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0655T","description":"Transperineal focal laser ablation of malignant prostate tissue_ including transrectal imaging guidance_ with MR-fused images or other enhanced ultrasound imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33406","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"100 insulin syringes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8490","description":"100 insulin syringes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHC0","description":"ICD-FIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No antipla/p2y12 ord_ rs nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9611","description":"No antipla/p2y12 ord_ rs nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAA0","description":"ICD-BDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHB0","description":"ICD-JHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCE1","description":"ICD-JFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ trans atherec_rotation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1724","description":"Cath_ trans atherec_rotation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor <22.05._without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0207","description":"Traumatic brain injury with Motor <22.05._without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCD0","description":"ICD-MKCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44373","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Volume control ventilator_ without pressure support mode_ may include pressure control mode_ used with invasive interface (e.g._ tracheostomy tube)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0450","description":"Volume control ventilator_ without pressure support mode_ may include pressure control mode_ used with invasive interface (e.g._ tracheostomy tube)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLD1","description":"ICD-KGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGD1","description":"ICD-CIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of tibia nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28035","description":"Decompression of tibia nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWF1","description":"ICD-CCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Provide inr test mater/equip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0249","description":"Provide inr test mater/equip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lithium batt for glucose mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4235","description":"Lithium batt for glucose mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ranibizumab-nuna_ biosimilar_ (Byooviz)_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5124","description":"Injection_ ranibizumab-nuna_ biosimilar_ (Byooviz)_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQB0","description":"ICD-GCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAD0","description":"ICD-IAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-77439","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","description":"CPT-77439","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPF0","description":"ICD-CGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Correct malrotation of bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44055","description":"Correct malrotation of bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bladder & nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51585","description":"Removal of bladder & nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37260","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","description":"CPT-37260","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUD0","description":"ICD-MGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCF0","description":"ICD-MLCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rep part denture cast frame","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5620","description":"Rep part denture cast frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXE1","description":"ICD-FFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1705","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1705","description":"CDT-D1705","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRA1","description":"ICD-OKRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAE1","description":"ICD-AEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDE1","description":"ICD-BDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ chest; 4 or more views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71048","description":"Radiologic examination_ chest; 4 or more views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Per pm reeval est pat infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99391","description":"Per pm reeval est pat infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTD0","description":"ICD-KCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28X","description":"Special Care Low _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHC1","description":"ICD-IFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIB1","description":"ICD-JAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adult disp brief/diap abv xl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4543","description":"Adult disp brief/diap abv xl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDC0","description":"ICD-KCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKF1","description":"ICD-NHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL32","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Qual card diag prior 12 mons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1460F","description":"Qual card diag prior 12 mons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGF0","description":"ICD-OLGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYE1","description":"ICD-GAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wet mounts/ w preparations","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0111","description":"Wet mounts/ w preparations","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSA0","description":"ICD-DCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1CA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CA31","description":"ICD-1CA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00520","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00520","description":"CPT-00520","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic analysis of cochlear implant_ patient younger than 7 years of age; subsequent reprogramming","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92602","description":"Diagnostic analysis of cochlear implant_ patient younger than 7 years of age; subsequent reprogramming","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAB0","description":"ICD-GHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTE1","description":"ICD-BDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMA0","description":"ICD-ECMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTB0","description":"ICD-GGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINB1","description":"ICD-NINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYA1","description":"ICD-OKYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIE1","description":"ICD-EEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21082","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA ENTAMOEBA HISTOLYTICA DISPAR GRP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87336","description":"IAAD IA ENTAMOEBA HISTOLYTICA DISPAR GRP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX06","description":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKD1","description":"ICD-GAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of leg artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34203","description":"Removal of leg artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNC0","description":"ICD-JHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOD1","description":"ICD-GCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Egd dilate stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43245","description":"Egd dilate stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAA0","description":"ICD-EDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXF0","description":"ICD-JDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOF1","description":"ICD-LDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEF0","description":"ICD-GDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair brow defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67900","description":"Repair brow defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Serum lvls ca/ipth/lpd ord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3278F","description":"Serum lvls ca/ipth/lpd ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVC1","description":"ICD-JEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCB0","description":"ICD-JGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tick-borne relapsing fever Borrelia group_ antibody detection to 4 recombinant protein groups_ by immunoblot_ IgM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0043U","description":"Tick-borne relapsing fever Borrelia group_ antibody detection to 4 recombinant protein groups_ by immunoblot_ IgM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place device impacted tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7283","description":"Place device impacted tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic control band & belt b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2640","description":"Pelvic control band & belt b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITF1","description":"ICD-EITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"XCellerate_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4234","description":"XCellerate_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTE1","description":"ICD-BHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fees w/laryngeal sense test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92616","description":"Fees w/laryngeal sense test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQD0","description":"ICD-GAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMA1","description":"ICD-FCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASB0","description":"ICD-CASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Back Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 3.0 Or Back Pain Measured By The Visual Analog Sca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2136","description":"Back Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 3.0 Or Back Pain Measured By The Visual Analog Sca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative screen metals","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83018","description":"Quantitative screen metals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1KC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KC11","description":"ICD-1KC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interventional Radiology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4012","description":"Interventional Radiology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNF1","description":"ICD-NFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CT studies not reported to a radiation dose index registry due to medical reasons (eg_ ct studies performed for radiation treatment planning or image-guided radiation trtmnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9325","description":"CT studies not reported to a radiation dose index registry due to medical reasons (eg_ ct studies performed for radiation treatment planning or image-guided radiation trtmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Physical therapy evaluation: moderate complexity_ requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97162","description":"Physical therapy evaluation: moderate complexity_ requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHE0","description":"ICD-AHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient was not prescribed a 180-day course of treatment with beta-blockers post discharge for AMI","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9804","description":"Patient was not prescribed a 180-day course of treatment with beta-blockers post discharge for AMI","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (liver)_ surveillance for hepatocellular carcinoma (HCC) in high-risk patients_ analysis of methylation patterns on circulating cell-free DNA (cfDNA) plus measurement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0333U","description":"Oncology (liver)_ surveillance for hepatocellular carcinoma (HCC) in high-risk patients_ analysis of methylation patterns on circulating cell-free DNA (cfDNA) plus measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB41","description":"Low Rehab_ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATA0","description":"ICD-AATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66505","description":"Incision of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2101","description":"HCPCS-A2101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINA1","description":"ICD-JINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMD1","description":"ICD-BIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp subclav-axillary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35616","description":"Art byp subclav-axillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLD0","description":"ICD-GCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECF0","description":"ICD-AECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQC0","description":"ICD-ODQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies_ other t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0018","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies_ other t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAF1","description":"ICD-MJAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHD0","description":"ICD-KCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESD1","description":"ICD-DESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLC1","description":"ICD-FGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flu vacc iiv3 no preserv id","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90654","description":"Flu vacc iiv3 no preserv id","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair stomach opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43870","description":"Repair stomach opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01230","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01230","description":"CPT-01230","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX14","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOD0","description":"ICD-OCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place gastrostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43831","description":"Place gastrostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Manual cell count each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85032","description":"Manual cell count each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELF1","description":"ICD-CELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJC1","description":"ICD-GIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC26","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAA1","description":"ICD-GAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB146","description":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIB0","description":"ICD-KHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat metatarsal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28475","description":"Treat metatarsal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L1972","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1972","description":"HCPCS-L1972","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 6","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA46","description":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATD1","description":"ICD-EATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBC1","description":"ICD-NKBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGB1","description":"ICD-NKGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPD0","description":"ICD-BCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal/revision of cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29700","description":"Removal/revision of cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Quantification Of The Structure And Composition O","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0712T","description":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Quantification Of The Structure And Composition O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGC1","description":"ICD-BHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRF1","description":"ICD-OHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPC1","description":"ICD-GFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mediastinoscopy_ with or without biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39400","description":"Mediastinoscopy_ with or without biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1603","description":"HCPCS-A1603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWA0","description":"ICD-PIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behind ear binaur hearing ai","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5140","description":"Behind ear binaur hearing ai","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFE0","description":"ICD-JCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hfo w/o joints cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3913","description":"Hfo w/o joints cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orthoptic training; under supervision of a physician or other qualified health care professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92066","description":"Orthoptic training; under supervision of a physician or other qualified health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunotherapy administration with electroporation_ intramuscular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0732T","description":"Immunotherapy administration with electroporation_ intramuscular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ed svc ckd ind per session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0420","description":"Ed svc ckd ind per session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1343","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWD1","description":"ICD-LHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCC1","description":"ICD-MFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients Receiving Palliative Care During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0034","description":"Patients Receiving Palliative Care During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYC1","description":"ICD-GFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB10A","description":"Special Care High _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL20","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Synthetic implnt urinary 1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8606","description":"Synthetic implnt urinary 1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Emr pwr cbl elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0492","description":"Emr pwr cbl elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hyoscyamine sulfate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1980","description":"Hyoscyamine sulfate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPE0","description":"ICD-OIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHC1","description":"ICD-GGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITE1","description":"ICD-JITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0533U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","description":"CPT-0533U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLC1","description":"ICD-CFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIB0","description":"ICD-ABIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWB0","description":"ICD-KDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKB0","description":"ICD-NHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who are identified as having an intolerance or allergy to beta-blocker therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9800","description":"Patients who are identified as having an intolerance or allergy to beta-blocker therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tmj diagnostic arthroscopy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7872","description":"Tmj diagnostic arthroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2151","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","description":"HCPCS-J2151","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray female genital tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74740","description":"X-ray female genital tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD10D","description":"Clinically Complex _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACB0","description":"ICD-EACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSA0","description":"ICD-LCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXB1","description":"ICD-NIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYE0","description":"ICD-ODYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQF0","description":"ICD-LFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCME0","description":"ICD-FCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1380","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","description":"HCPCS-M1380","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAB0","description":"ICD-FEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERC0","description":"ICD-PERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Triamcinolone comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7683","description":"Triamcinolone comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSA1","description":"ICD-KBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (melanoma)_ gene expression profiling by RTqPCR_ PRAME and LINC00518_ superficial collection using adhesive patch(es)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0089U","description":"Oncology (melanoma)_ gene expression profiling by RTqPCR_ PRAME and LINC00518_ superficial collection using adhesive patch(es)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKF1","description":"ICD-FCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIF0","description":"ICD-FDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47610","description":"Removal of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1202","description":"HCPCS-B1202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQC1","description":"ICD-CCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWA1","description":"ICD-CFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31070","description":"Exploration of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1118","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove tonsils and adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42820","description":"Remove tonsils and adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWF0","description":"ICD-PBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCB0","description":"ICD-ACCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDF0","description":"ICD-FBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLF1","description":"ICD-MJLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (genetic thrombosis)_ genomic sequence analysis of 12 genes_ blood_ buccal swab_ or amniotic fluid (Versitiā„¢ Thrombosis Panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0278U","description":"Hematology (genetic thrombosis)_ genomic sequence analysis of 12 genes_ blood_ buccal swab_ or amniotic fluid (Versitiā„¢ Thrombosis Panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEB1","description":"ICD-NAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELD0","description":"ICD-GELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Walker platform attachment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0154","description":"Walker platform attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray skull epidural","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75872","description":"Vein x-ray skull epidural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYF0","description":"ICD-GCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLA1","description":"ICD-JDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGD1","description":"ICD-BDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50600","description":"Exploration of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Battery charger_ single mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2366","description":"Battery charger_ single mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESE1","description":"ICD-KESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCE1","description":"ICD-FBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp4 std mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0884","description":"Pwc gp4 std mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOB1","description":"ICD-PAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rvw meds by rx/dr in rcrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1160F","description":"Rvw meds by rx/dr in rcrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSE0","description":"ICD-LFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVF1","description":"ICD-NIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAF1","description":"ICD-MHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHF0","description":"ICD-JGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXF0","description":"ICD-OHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat skull fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62000","description":"Treat skull fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Smoking cessation gum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4995","description":"Smoking cessation gum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA134","description":"Clinically Complex _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGE0","description":"ICD-KGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBC1","description":"ICD-NFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEB0","description":"ICD-ADEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSC0","description":"ICD-LBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIA1","description":"ICD-NHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0547U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","description":"CPT-0547U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; respiratory syncytial virus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87807","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; respiratory syncytial virus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of sperm cord lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55520","description":"Removal of sperm cord lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B2002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2002","description":"HCPCS-B2002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone/skin graft microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20969","description":"Bone/skin graft microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXC0","description":"ICD-OEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Denture reln cmplt mand lab","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5751","description":"Denture reln cmplt mand lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt cat/pn cat/hist grd docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3260F","description":"Pt cat/pn cat/hist grd docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Min hd traum gcs=15 w/ct ed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9530","description":"Min hd traum gcs=15 w/ct ed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPA1","description":"ICD-JGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIC1","description":"ICD-CIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUE1","description":"ICD-GDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove intracorporeal device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33980","description":"Remove intracorporeal device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc taa repr incl subcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33880","description":"Endovasc taa repr incl subcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWB1","description":"ICD-DCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKE0","description":"ICD-BEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPD1","description":"ICD-NJPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy and dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46604","description":"Anoscopy and dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stnd wt pwr whlchr w control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0011","description":"Stnd wt pwr whlchr w control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE14A","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24505","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Retr bone flap to fix skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62148","description":"Retr bone flap to fix skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L5657","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","description":"HCPCS-L5657","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Quadrilateral brim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2188","description":"Quadrilateral brim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAD1","description":"ICD-FDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cancer treatmentplan initial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0353","description":"Cancer treatmentplan initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJF0","description":"ICD-CEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML4B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect distal finger tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26262","description":"Resect distal finger tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69740","description":"Repair facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Geriatrics Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4008","description":"Geriatrics Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX30","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foot joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28072","description":"Removal of foot joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMA1","description":"ICD-CEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insj/rplc car modulj atr elt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0410T","description":"Insj/rplc car modulj atr elt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18B","description":"Special Care Low _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQF0","description":"ICD-CCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tissue not image intraop","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8874","description":"Tissue not image intraop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBE1","description":"ICD-CEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIME1","description":"ICD-IIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUF1","description":"ICD-JDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGD0","description":"ICD-OFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYA0","description":"ICD-PDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompress disc rf lumbar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2348","description":"Decompress disc rf lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGE0","description":"ICD-FEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"WoundPlus_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4326","description":"WoundPlus_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug test def 8-14 classes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0481","description":"Drug test def 8-14 classes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPD1","description":"ICD-NHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lamaze class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9436","description":"Lamaze class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transapical mitral valve repair_ including transthoracic echocardiography_ when performed_ with placement of artificial chordae tendineae","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0543T","description":"Transapical mitral valve repair_ including transthoracic echocardiography_ when performed_ with placement of artificial chordae tendineae","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWE0","description":"ICD-PEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD241","description":"Special Care Low _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam thorac spine 2vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72070","description":"X-ray exam thorac spine 2vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lamellar bdy fetal lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83664","description":"Lamellar bdy fetal lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUF1","description":"ICD-MFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA135","description":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Accessory for gradient compression garment or wrap with adjustable straps_ non-otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6593","description":"Accessory for gradient compression garment or wrap with adjustable straps_ non-otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE13B","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHD0","description":"ICD-MGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC13C","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEME0","description":"ICD-IEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDF1","description":"ICD-FEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rbc mechanical fragility","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85547","description":"Rbc mechanical fragility","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQD1","description":"ICD-PCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo sling operation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51992","description":"Laparo sling operation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVF0","description":"ICD-CEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKD0","description":"ICD-BIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1EA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EA11","description":"ICD-1EA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepa vacc ped/adol 3 dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90634","description":"Hepa vacc ped/adol 3 dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI compatible system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0859","description":"MRI compatible system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOE0","description":"ICD-GFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXA1","description":"ICD-OAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAF1","description":"ICD-OGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVD0","description":"ICD-BFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surveillance colonoscopy - personal history of colonic polyps_ colon cancer_ or other malignant neoplasm of rectum_ rectosigmoid junction_ and anus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9936","description":"Surveillance colonoscopy - personal history of colonic polyps_ colon cancer_ or other malignant neoplasm of rectum_ rectosigmoid junction_ and anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTA1","description":"ICD-OGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUF0","description":"ICD-EEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFB0","description":"ICD-JDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMF0","description":"ICD-MEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic aortic graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33875","description":"Thoracic aortic graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Powered pressure reducing underlay/pad_ alternating_ with pump_ inc heavy duty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0183","description":"Powered pressure reducing underlay/pad_ alternating_ with pump_ inc heavy duty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRF0","description":"ICD-LHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of vein clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34451","description":"Removal of vein clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIE1","description":"ICD-OFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEA0","description":"ICD-KDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert lens prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66985","description":"Insert lens prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of prostate abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55725","description":"Drainage of prostate abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPB0","description":"ICD-FCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55709","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","description":"CPT-55709","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJA1","description":"ICD-NLJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18B","description":"Special Care Low _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJD1","description":"ICD-KEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patients with primary headache diagnosis and imaging other than CT or MRI obtained","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1028","description":"Documentation of patients with primary headache diagnosis and imaging other than CT or MRI obtained","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC5C","description":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adjust toe ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1830","description":"Adjust toe ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGME1","description":"ICD-NGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01484","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01484","description":"CPT-01484","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (thyroid)_ DNA and mRNA of 112 genes_ next-generation sequencing_ fine needle aspirate of thyroid nodule_ algorithmic analysis reported as a categorical result (Posi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0026U","description":"Oncology (thyroid)_ DNA and mRNA of 112 genes_ next-generation sequencing_ fine needle aspirate of thyroid nodule_ algorithmic analysis reported as a categorical result (Posi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Most recent BP is less than or equal to 140/90 mm Hg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9788","description":"Most recent BP is less than or equal to 140/90 mm Hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIC1","description":"ICD-AEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJE1","description":"ICD-KCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQE1","description":"ICD-KEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of palm bursas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26030","description":"Drainage of palm bursas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pet image w/ct full body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78816","description":"Pet image w/ct full body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGD1","description":"ICD-BIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPF0","description":"ICD-ODPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVB0","description":"ICD-CEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAA1","description":"ICD-MLAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSC1","description":"ICD-LGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50575","description":"Kidney endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Children With A Competing Diagnosis For Upper Respiratory Infection Within Three Days Of Diagnosis Of Pharyngitis (E.G._ Intestinal Infection_ Pertussis_ Bacterial Infection_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2097","description":"Children With A Competing Diagnosis For Upper Respiratory Infection Within Three Days Of Diagnosis Of Pharyngitis (E.G._ Intestinal Infection_ Pertussis_ Bacterial Infection_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOB1","description":"ICD-PDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQC0","description":"ICD-CHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVA1","description":"ICD-FAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of tongue fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41115","description":"Excision of tongue fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXD1","description":"ICD-OAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBA0","description":"ICD-JFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMA0","description":"ICD-GIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoe molded to pt silicone s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3251","description":"Shoe molded to pt silicone s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEC0","description":"ICD-EGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMC1","description":"ICD-FBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTB1","description":"ICD-OJTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dextranomer/hyaluronic acid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8604","description":"Dextranomer/hyaluronic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27253","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGD1","description":"ICD-GFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERD1","description":"ICD-LERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apply finger cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29086","description":"Apply finger cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of skull/sutures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61558","description":"Excision of skull/sutures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove colloid cyst w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62162","description":"Remove colloid cyst w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFC0","description":"ICD-OLFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement blood pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1620","description":"Replacement blood pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMA1","description":"ICD-OBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWC0","description":"ICD-DBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HA21","description":"ICD-2HA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Semen analysis w/count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89310","description":"Semen analysis w/count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"RenoGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4321","description":"RenoGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Healthcare Professional Online Assessment_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 5-10 Minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2061","description":"Qualified Nonphysician Healthcare Professional Online Assessment_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 5-10 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANF1","description":"ICD-KANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice in snf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5004","description":"Hospice in snf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPA1","description":"ICD-OBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVB0","description":"ICD-OJVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKF1","description":"ICD-CFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNE0","description":"ICD-OLNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0618U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","description":"CPT-0618U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXF1","description":"ICD-OJXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24582","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0824T","description":"Transcatheter removal of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFND0","description":"ICD-KFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antidepressants class 1 or 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80332","description":"Antidepressants class 1 or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL1A","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tooth pin retention","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2951","description":"Tooth pin retention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27158","description":"Revision of pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter insertion of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0823T","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art trnsposj subclav carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35694","description":"Art trnsposj subclav carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGF0","description":"ICD-NFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15933","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEE1","description":"ICD-KAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor vii proconvertin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85230","description":"Clot factor vii proconvertin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61518","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Performance Met: The Residual Change Score Is Equal To Or Greater Than 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2152","description":"Performance Met: The Residual Change Score Is Equal To Or Greater Than 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of hemorrhoid(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46221","description":"Ligation of hemorrhoid(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNC0","description":"ICD-FDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHA1","description":"ICD-EBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage lymph node lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38300","description":"Drainage lymph node lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIB0","description":"ICD-OCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHD0","description":"ICD-AIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFC0","description":"ICD-JDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00472","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00472","description":"CPT-00472","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1804","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1804","description":"CDT-D1804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99284","description":"Emergency dept visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor_ ear level_ replacement_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8624","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor_ ear level_ replacement_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQC0","description":"ICD-PBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prgrmg eval npgs apnea study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0436T","description":"Prgrmg eval npgs apnea study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAND0","description":"ICD-JAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Front castr compl pneum tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0071","description":"Front castr compl pneum tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28126","description":"Partial removal of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repl measr scales jaw motion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1702","description":"Repl measr scales jaw motion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of hip/thigh fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27025","description":"Incision of hip/thigh fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHC0","description":"ICD-KFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18G","description":"Special Care High _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYA1","description":"ICD-GEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ltwt portbl power whlchr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0012","description":"Ltwt portbl power whlchr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEID1","description":"ICD-NEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERB0","description":"ICD-HERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFB0","description":"ICD-CAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEF1","description":"ICD-CEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatry (Stress Disorders)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 72 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0292U","description":"Psychiatry (Stress Disorders)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 72 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surgery of breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40451","description":"Anesth surgery of breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOE1","description":"ICD-PEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKC0","description":"ICD-NFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSC0","description":"ICD-OLSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB15B","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr umbil hern block < 5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49582","description":"Rpr umbil hern block < 5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX4D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNA1","description":"ICD-KBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENF0","description":"ICD-OENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTF1","description":"ICD-EDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ acetaminophen (hikma) not therapeutically equivalent to j0131_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0137","description":"Injection_ acetaminophen (hikma) not therapeutically equivalent to j0131_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Estradiol; Free_ Direct Measurement (Eg_ Equilibrium Dialysis)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82681","description":"Estradiol; Free_ Direct Measurement (Eg_ Equilibrium Dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC244","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chikungunya virus vaccine_ live attenuated_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90589","description":"Chikungunya virus vaccine_ live attenuated_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinician Documented That Patient Recevied Vascular Access Other Than Autogenous AV Fistula_ Reason not Specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8532","description":"Clinician Documented That Patient Recevied Vascular Access Other Than Autogenous AV Fistula_ Reason not Specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA126","description":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admin on the same date of service for ages under 21 Medicaid only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0312","description":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admin on the same date of service for ages under 21 Medicaid only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGB1","description":"ICD-CBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUC0","description":"ICD-OHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKA1","description":"ICD-NKKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18X","description":"Special Care Low _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKE1","description":"ICD-GGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKD1","description":"ICD-NJKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPB0","description":"ICD-FIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTC1","description":"ICD-NKTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVB0","description":"ICD-OIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNA1","description":"ICD-JFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place breast cath for rad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19297","description":"Place breast cath for rad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise major vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33824","description":"Revise major vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKB0","description":"ICD-CIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBA1","description":"ICD-OLBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUA0","description":"ICD-FDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQC1","description":"ICD-LHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHF1","description":"ICD-NIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No record of HBV results documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9915","description":"No record of HBV results documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee joint drop lock ea jnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2405","description":"Knee joint drop lock ea jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEB1","description":"ICD-FHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Re-Exploration Of Pelvic Wound With Removal Of Preperitoneal Pelvic Packing_ Including Repacking_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49014","description":"Re-Exploration Of Pelvic Wound With Removal Of Preperitoneal Pelvic Packing_ Including Repacking_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUF0","description":"ICD-MDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Culture bacterial urine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P7001","description":"Culture bacterial urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIB1","description":"ICD-EHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iodine I-131_ Iobenguane_ 1 Millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9590","description":"Iodine I-131_ Iobenguane_ 1 Millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatry (eg_ depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ genomic analysis panel_ variant analysis of 15 genes_ including deletion/duplication ana","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0345U","description":"Psychiatry (eg_ depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ genomic analysis panel_ variant analysis of 15 genes_ including deletion/duplication ana","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore/drain eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67440","description":"Explore/drain eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRD1","description":"ICD-GIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28A","description":"Clinically Complex _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE250","description":"Clinically Complex _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPD0","description":"ICD-BBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMC0","description":"ICD-IGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYB1","description":"ICD-OLYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAE0","description":"ICD-KCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLF1","description":"ICD-EFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75746","description":"Artery x-rays lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1823","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","description":"HCPCS-E1823","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap part colectomy w/stoma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44206","description":"Lap part colectomy w/stoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Itch severity assessment score was not reduced by at least 2 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1206","description":"Itch severity assessment score was not reduced by at least 2 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD14A","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ivf canc p aspir case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4021","description":"Ivf canc p aspir case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOF0","description":"ICD-KCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVB0","description":"ICD-GFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2110","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33031","description":"Partial removal of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKC0","description":"ICD-OEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIA1","description":"ICD-NJIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOA1","description":"ICD-LIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx prostate t1no progres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9077","description":"Onc dx prostate t1no progres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPE1","description":"ICD-BDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA4C","description":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPD0","description":"ICD-NGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFB1","description":"ICD-GGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOC0","description":"ICD-OHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOD0","description":"ICD-GDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJD0","description":"ICD-KCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIB0","description":"ICD-CHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth neck organ 1yr/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32051","description":"Anesth neck organ 1yr/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOF1","description":"ICD-LFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJC1","description":"ICD-ODJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUB0","description":"ICD-OAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB3B","description":"Low Rehab_ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Supp maint employ_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2026","description":"Supp maint employ_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUF0","description":"ICD-NAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-77437","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","description":"CPT-77437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX1A","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4479","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","description":"HCPCS-A4479","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Telehealth consultation_ critical care_ initial_ physicians typically spend 60 minutes communicating with the patient and providers via telehealth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0508","description":"Telehealth consultation_ critical care_ initial_ physicians typically spend 60 minutes communicating with the patient and providers via telehealth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nandrolone decanoate 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2320","description":"Nandrolone decanoate 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59121","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUB1","description":"ICD-AIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBA0","description":"ICD-NGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovas iliac a device addon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34808","description":"Endovas iliac a device addon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ non-stranded_c-131","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2643","description":"Brachytx_ non-stranded_c-131","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATE1","description":"ICD-JATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ht inj antiemetic diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9370","description":"Ht inj antiemetic diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVF0","description":"ICD-BDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVA0","description":"ICD-CIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIC1","description":"ICD-NKIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUF0","description":"ICD-GCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage mouth roof lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42000","description":"Drainage mouth roof lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB21B","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEF1","description":"ICD-OCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMA1","description":"ICD-NHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHD0","description":"ICD-JDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBD0","description":"ICD-IGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adhesive remover_ wipes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4456","description":"Adhesive remover_ wipes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWC1","description":"ICD-PEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA21","description":"Very High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath concentrate tech","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88108","description":"Cytopath concentrate tech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical trays","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4550","description":"Surgical trays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBD0","description":"ICD-MBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRC0","description":"ICD-DGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB204","description":"Special Care Low _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERF1","description":"ICD-HERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWC0","description":"ICD-HBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATC1","description":"ICD-AATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prostatectomy (turp)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52601","description":"Prostatectomy (turp)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFB1","description":"ICD-CDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine sulfate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84392","description":"Assay of urine sulfate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJC0","description":"ICD-NBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD13D","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUF0","description":"ICD-OEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASE0","description":"ICD-OASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Braf gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81210","description":"Braf gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lenacapavir_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1961","description":"Injection_ lenacapavir_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWE1","description":"ICD-PGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLID0","description":"ICD-MLID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXB0","description":"ICD-BFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJF1","description":"ICD-JIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINE1","description":"ICD-KINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8C","description":"Very High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4243","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4243","description":"HCPCS-Q4243","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE23B","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC112","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Self-care ed provided to pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4450F","description":"Self-care ed provided to pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGD0","description":"ICD-GAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm 20.1-30.0","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12056","description":"Intmd rpr face/mm 20.1-30.0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decalcification procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0475","description":"Decalcification procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ho post-op hip abduction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1686","description":"Ho post-op hip abduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOA1","description":"ICD-OGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt ref oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8564","description":"Pt ref oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay serum cholinesterase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82480","description":"Assay serum cholinesterase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tib/per revasc add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37232","description":"Tib/per revasc add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICA1","description":"ICD-NICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRA1","description":"ICD-HDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCF0","description":"ICD-JGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHED0","description":"ICD-GHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Covers for upright each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1120","description":"Covers for upright each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB11","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth larynx/trach < 1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32651","description":"Anesth larynx/trach < 1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNF0","description":"ICD-BBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSE1","description":"ICD-PHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDC0","description":"ICD-EHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36011","description":"Place catheter in vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD21C","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNF1","description":"ICD-BHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Supp for self-adm injections","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4211","description":"Supp for self-adm injections","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEC0","description":"ICD-MHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavior counsel obesity 15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0447","description":"Behavior counsel obesity 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1101T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1101T","description":"CPT-1101T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKB1","description":"ICD-CDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ chloroprocaine hydrochloride (clorotekal)_ per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2402","description":"Injection_ chloroprocaine hydrochloride (clorotekal)_ per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pros sock single ply upper l","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8485","description":"Pros sock single ply upper l","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQC1","description":"ICD-KAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC10C","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBA0","description":"ICD-MLBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Srsf2 (Serine And Arginine-Rich Splicing Factor 2) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ P95H_ P95L)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81348","description":"Srsf2 (Serine And Arginine-Rich Splicing Factor 2) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ P95H_ P95L)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECB1","description":"ICD-BECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEC0","description":"ICD-FHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation applicator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5983","description":"Radiation applicator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGE1","description":"ICD-NDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HIV-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87390","description":"IAAD IA HIV-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGE0","description":"ICD-FFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBE1","description":"ICD-FIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were in hospice at any time during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1025","description":"Patients who were in hospice at any time during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fimbrioplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58760","description":"Fimbrioplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","description":"HCPCS-J9601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDA1","description":"ICD-EFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Micafungin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2248","description":"Micafungin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIE1","description":"ICD-NBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVD1","description":"ICD-JCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWF1","description":"ICD-OIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD12C","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIE0","description":"ICD-IDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETB0","description":"ICD-NETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTA0","description":"ICD-KCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMD0","description":"ICD-OFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"BRCA2 (BRCA2_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie_ detection of large gene rearrangements)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81167","description":"BRCA2 (BRCA2_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie_ detection of large gene rearrangements)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home visit new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99345","description":"Home visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIA0","description":"ICD-EIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remov vert idrl bdy thrclmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63306","description":"Remov vert idrl bdy thrclmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX10","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo ablate liver cryosurg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47371","description":"Laparo ablate liver cryosurg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Whirlpool tub_ walk-in_ portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1301","description":"Whirlpool tub_ walk-in_ portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay for calprotectin fecal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83993","description":"Assay for calprotectin fecal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVD0","description":"ICD-BBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Penile venous occlusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37790","description":"Penile venous occlusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVC1","description":"ICD-JHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQE1","description":"ICD-HGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTA0","description":"ICD-GFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNC1","description":"ICD-FHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Graftjacket xpress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4113","description":"Graftjacket xpress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ chest; single view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71045","description":"Radiologic examination_ chest; single view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement pulmonary valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33475","description":"Replacement pulmonary valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAB1","description":"ICD-NGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFC0","description":"ICD-KEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCB0","description":"ICD-KDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Memory d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9170","description":"Memory d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Generator_ neurostimulator (implantable)_ non-rechargeable with carotid sinus baroreceptor stimulation lead(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1825","description":"Generator_ neurostimulator (implantable)_ non-rechargeable with carotid sinus baroreceptor stimulation lead(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5299","description":"Hearing service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB51","description":"High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNE1","description":"ICD-JDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC55","description":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRB0","description":"ICD-HFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transport parking fees/tolls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0170","description":"Transport parking fees/tolls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKC0","description":"ICD-KIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTC1","description":"ICD-FBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHC1","description":"ICD-IGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pralidoxime chloride inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2730","description":"Pralidoxime chloride inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX2C","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADE0","description":"ICD-KADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDC0","description":"ICD-ADDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFE0","description":"ICD-NJFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resolve Matrix_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2024","description":"Resolve Matrix_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBA0","description":"ICD-CHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNB0","description":"ICD-GFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Protamine sulfate per 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4802","description":"Protamine sulfate per 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUB0","description":"ICD-JBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54100","description":"Biopsy of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQA0","description":"ICD-OIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2DC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DC11","description":"ICD-2DC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCF1","description":"ICD-NBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tongue jaw & neck surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41155","description":"Tongue jaw & neck surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUB1","description":"ICD-JIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esoph imped function test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91037","description":"Esoph imped function test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace vad intra w/o bp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33982","description":"Replace vad intra w/o bp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWC1","description":"ICD-GFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBC0","description":"ICD-NFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML25","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIE1","description":"ICD-GCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHF1","description":"ICD-MFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystouretero w/excise tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52355","description":"Cystouretero w/excise tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPC1","description":"ICD-CCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt counsld on exam for moles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5005F","description":"Pt counsld on exam for moles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFD1","description":"ICD-FIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAB0","description":"ICD-OCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVB1","description":"ICD-KCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vision svcs frames purchases","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2020","description":"Vision svcs frames purchases","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWA1","description":"ICD-KFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIB0","description":"ICD-FAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suspension of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54640","description":"Suspension of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of vulva/perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56605","description":"Biopsy of vulva/perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQE0","description":"ICD-CIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJF1","description":"ICD-CEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNE0","description":"ICD-OBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITC0","description":"ICD-MITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Battery charger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4613","description":"Battery charger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUD0","description":"ICD-KIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ voretigene neparvovec-rzyl_ 1 billion vector genome","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9032","description":"Injection_ voretigene neparvovec-rzyl_ 1 billion vector genome","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPC1","description":"ICD-JFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOE0","description":"ICD-OGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plumb/elec wk hm hemo equip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4870","description":"Plumb/elec wk hm hemo equip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thrombolytic venous therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37212","description":"Thrombolytic venous therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJF0","description":"ICD-BCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise lumb artif disc addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0165T","description":"Revise lumb artif disc addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIA1","description":"ICD-ACIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUA0","description":"ICD-JFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEB1","description":"ICD-JFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDA0","description":"ICD-NBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNB0","description":"ICD-NLNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXE0","description":"ICD-BBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOD1","description":"ICD-HFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Polysom <6 yrs cpap/bilvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95783","description":"Polysom <6 yrs cpap/bilvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDB0","description":"ICD-BDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4KA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KA31","description":"ICD-4KA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resource-intensive services for patients for whom the use of specialized mobility-assistive technology (such as adjustable height chairs or tables_ patient lift_ and adjustabl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0501","description":"Resource-intensive services for patients for whom the use of specialized mobility-assistive technology (such as adjustable height chairs or tables_ patient lift_ and adjustabl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE251","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUA1","description":"ICD-JFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLE0","description":"ICD-GCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert bladder catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51701","description":"Insert bladder catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection_ all nonselec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34705","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection_ all nonselec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOB0","description":"ICD-OBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSA1","description":"ICD-LCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRB0","description":"ICD-CGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPF0","description":"ICD-JBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXC1","description":"ICD-CBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB11C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrast exam thoracic aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75605","description":"Contrast exam thoracic aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLC0","description":"ICD-JGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Myringotomy laser-assist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2225","description":"Myringotomy laser-assist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISA0","description":"ICD-GISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism intermountain clinical decision support mechanism_ as defined by the medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1022","description":"Clinical decision support mechanism intermountain clinical decision support mechanism_ as defined by the medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neuromuscular stim for shock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0745","description":"Neuromuscular stim for shock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXA1","description":"ICD-JCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOA0","description":"ICD-OFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTB0","description":"ICD-OGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC10A","description":"Special Care Low _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient responded completely true for the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1248","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJC0","description":"ICD-NAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gauze > 48 sq in w/border","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6221","description":"Gauze > 48 sq in w/border","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No f/u eval q3mo opiod tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9563","description":"No f/u eval q3mo opiod tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv 1 extremity 1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64642","description":"Chemodenerv 1 extremity 1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAB0","description":"ICD-JFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cysto w/prst8 commissurotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0619T","description":"Cysto w/prst8 commissurotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBME1","description":"ICD-FBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOD1","description":"ICD-PKOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp ilio-mesenteric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35633","description":"Art byp ilio-mesenteric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHE0","description":"ICD-OBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Monthly supplies for use of device coded at e0733","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4541","description":"Monthly supplies for use of device coded at e0733","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKC1","description":"ICD-CHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology colon mrna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81525","description":"Oncology colon mrna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUA0","description":"ICD-NGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by dna-based testing status_ or bo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1195","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by dna-based testing status_ or bo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Molded socket shin sach foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5100","description":"Molded socket shin sach foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPD1","description":"ICD-FGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1804","description":"HCPCS-A1804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Induced abortion 17-24 weeks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2260","description":"Induced abortion 17-24 weeks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAF0","description":"ICD-IBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Posterior Chamber Of Eye_ Medication","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0699T","description":"Injection_ Posterior Chamber Of Eye_ Medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJE1","description":"ICD-BAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYE1","description":"ICD-PAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADD1","description":"ICD-EADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYC0","description":"ICD-GDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tourniquet for dialysis_ ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4929","description":"Tourniquet for dialysis_ ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of facial/other nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64868","description":"Fusion of facial/other nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIE0","description":"ICD-ADIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sealant repair per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1353","description":"Sealant repair per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal biliary drg cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47537","description":"Removal biliary drg cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLD1","description":"ICD-GCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEB1","description":"ICD-IGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Porcelain Fused To Noble Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6083","description":"Implant Supported Crown - Porcelain Fused To Noble Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33697","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWD1","description":"ICD-HIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove tissue expander(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11971","description":"Remove tissue expander(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNC1","description":"ICD-BCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXE1","description":"ICD-NIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNC1","description":"ICD-JDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVD0","description":"ICD-CBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANA0","description":"ICD-BANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0536","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","description":"HCPCS-G0536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Opps service_sched team conf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0175","description":"Opps service_sched team conf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc daily aspirin or contra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9277","description":"Doc daily aspirin or contra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJA0","description":"ICD-JFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLF0","description":"ICD-JGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rolapitant_ oral_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8670","description":"Rolapitant_ oral_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB10","description":"High Rehab _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUE0","description":"ICD-NIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB44","description":"High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADE0","description":"ICD-JADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWB1","description":"ICD-HDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Postop applicat rigid dsg on","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6388","description":"Postop applicat rigid dsg on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHD0","description":"ICD-IHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intl custm cong/latyp insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5681","description":"Intl custm cong/latyp insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB15D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCF1","description":"ICD-FFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHE0","description":"ICD-NAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPE1","description":"ICD-OGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJD1","description":"ICD-GAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wrist disart myoelectronic c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6925","description":"Wrist disart myoelectronic c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt immunity to hep a docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3215F","description":"Pt immunity to hep a docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQC0","description":"ICD-PKQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBF0","description":"ICD-BEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL03","description":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hgb lvl <11 g/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3281F","description":"Hgb lvl <11 g/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of arm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24310","description":"Revision of arm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWA0","description":"ICD-CHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9978","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of retinal detachment; by scleral buckling or vitrectomy_ on patient having previous ipsilateral retinal detachment repair(s) using scleral buckling or vit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67112","description":"Repair of retinal detachment; by scleral buckling or vitrectomy_ on patient having previous ipsilateral retinal detachment repair(s) using scleral buckling or vit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tumor cell deplete of harvst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38211","description":"Tumor cell deplete of harvst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy remove for body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46608","description":"Anoscopy remove for body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENC0","description":"ICD-CENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Term dev_ passive hand mitt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6703","description":"Term dev_ passive hand mitt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHED1","description":"ICD-EHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVA0","description":"ICD-BBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (minimal residual disease [MRD])_ next-generation targeted sequencing analysis_ cell-free DNA_ initial (baseline) assessment to determine a patient specific panel for","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0306U","description":"Oncology (minimal residual disease [MRD])_ next-generation targeted sequencing analysis_ cell-free DNA_ initial (baseline) assessment to determine a patient specific panel for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOA0","description":"ICD-LIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTD1","description":"ICD-EFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injecte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1322","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injecte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aerosol mask used w nebulize","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7015","description":"Aerosol mask used w nebulize","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disposable catheter tips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4860","description":"Disposable catheter tips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Uterine Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1105","description":"Radiation Therapy For Uterine Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood glucose level test","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0412","description":"Blood glucose level test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQF1","description":"ICD-LBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1450","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","description":"HCPCS-M1450","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD226","description":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGB1","description":"ICD-NEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITB0","description":"ICD-JITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGA0","description":"ICD-JFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetoscop laser ther ttts","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2411","description":"Fetoscop laser ther ttts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBF0","description":"ICD-JGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIC1","description":"ICD-AAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVA1","description":"ICD-KHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODID1","description":"ICD-ODID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLB0","description":"ICD-JGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKD0","description":"ICD-FFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear medicine therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79999","description":"Nuclear medicine therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HA11","description":"ICD-2HA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPD0","description":"ICD-GCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOC0","description":"ICD-GIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acupunct w/o stimul addl 15m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97811","description":"Acupunct w/o stimul addl 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavior identification assessment_ administered by a physician or other qualified health care professional_ each 15 minutes of the physician_s or other qualified health care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97151","description":"Behavior identification assessment_ administered by a physician or other qualified health care professional_ each 15 minutes of the physician_s or other qualified health care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27831","description":"Treat lower leg dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE12C","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCD0","description":"ICD-NFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENC1","description":"ICD-CENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBE0","description":"ICD-OEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCD0","description":"ICD-FGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ko dbl upright w/air pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1848","description":"Ko dbl upright w/air pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cerv cancer screen docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3015F","description":"Cerv cancer screen docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHA0","description":"ICD-KDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMD1","description":"ICD-FHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXE0","description":"ICD-OEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIA0","description":"ICD-OBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEID0","description":"ICD-NEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHC1","description":"ICD-NJHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGB0","description":"ICD-OEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1418","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","description":"HCPCS-M1418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp vhd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0827","description":"Pwc gp vhd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diast bp <80 mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3078F","description":"Diast bp <80 mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0909T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","description":"CPT-0909T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"B-12 binding capacity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82608","description":"B-12 binding capacity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace non-molded calf lace","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4055","description":"Replace non-molded calf lace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHF1","description":"ICD-KCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRC1","description":"ICD-HDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunization admin by intramuscular injection of s (SARS-CoV-2) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3 mL dosage_ tris-sucrose form first dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0051A","description":"Immunization admin by intramuscular injection of s (SARS-CoV-2) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3 mL dosage_ tris-sucrose form first dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLE0","description":"ICD-IDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCA1","description":"ICD-GGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAD0","description":"ICD-GGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31084","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mr angiograph head w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70546","description":"Mr angiograph head w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj potassium chloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3480","description":"Inj potassium chloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGD1","description":"ICD-KIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBF0","description":"ICD-KIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNB0","description":"ICD-BHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mech remov tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36596","description":"Mech remov tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had a baseline pam score and a second score within 6 to 12 month of baseline pam score","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1345","description":"Patients who had a baseline pam score and a second score within 6 to 12 month of baseline pam score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perphenazine 4mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0175","description":"Perphenazine 4mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Protozoa antibody nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86753","description":"Protozoa antibody nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cane adjust/fixed quad/3 pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0105","description":"Cane adjust/fixed quad/3 pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHC1","description":"ICD-BCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETC1","description":"ICD-GETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRD0","description":"ICD-CIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGD0","description":"ICD-NJGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trluml perip athrc visceral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0235T","description":"Trluml perip athrc visceral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ped gastro ed given caregvr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4058F","description":"Ped gastro ed given caregvr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOC0","description":"ICD-OKOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of acth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82024","description":"Assay of acth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGF1","description":"ICD-JBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prochlorperazine 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0183","description":"Prochlorperazine 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cmptr ophth dx img ant segmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92132","description":"Cmptr ophth dx img ant segmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHA1","description":"ICD-CFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMB1","description":"ICD-AGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIF1","description":"ICD-IDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23616","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUD1","description":"ICD-CGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Frozen plasma_ pooled_ sd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9023","description":"Frozen plasma_ pooled_ sd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFF0","description":"ICD-ODFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB10D","description":"Special Care Low _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray of mammary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77053","description":"X-ray of mammary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQF0","description":"ICD-PAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACA0","description":"ICD-GACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMF1","description":"ICD-EDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug test presump opt inst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0478","description":"Drug test presump opt inst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBF0","description":"ICD-BGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUA1","description":"ICD-KBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAD1","description":"ICD-FIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pontic - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6243","description":"Pontic - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan (sodium hyaluronate) or derivative_ durolane_ intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7318","description":"Hyaluronan (sodium hyaluronate) or derivative_ durolane_ intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRF1","description":"ICD-OIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTE0","description":"ICD-NLTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEF1","description":"ICD-BHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Combined anteroposterior colporrhaphy_ including cystourethroscopy_ when performed;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57260","description":"Combined anteroposterior colporrhaphy_ including cystourethroscopy_ when performed;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGF0","description":"ICD-FHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGE1","description":"ICD-BBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pml/raralpha 1 breakpoint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81316","description":"Pml/raralpha 1 breakpoint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urokinase 250_000 iu inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3365","description":"Urokinase 250_000 iu inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore wound abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20102","description":"Explore wound abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alteplase recombinant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2997","description":"Alteplase recombinant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKC1","description":"ICD-BBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSA1","description":"ICD-PCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLB1","description":"ICD-AGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urinary pouch on barr w/flng","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5073","description":"Urinary pouch on barr w/flng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJC1","description":"ICD-KHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBB0","description":"ICD-BFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup long arm ped plster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4007","description":"Cast sup long arm ped plster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDE1","description":"ICD-CHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise hip joint replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27137","description":"Revise hip joint replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compressor nondispos filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7014","description":"Compressor nondispos filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQB0","description":"ICD-KDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVE0","description":"ICD-GAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFB0","description":"ICD-GAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBED0","description":"ICD-GBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient died including all deaths occurring during the hospitalization in which the operation was performed_ even if after 30 days_ and those deaths occurring after discharge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9812","description":"Patient died including all deaths occurring during the hospitalization in which the operation was performed_ even if after 30 days_ and those deaths occurring after discharge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX23","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBB1","description":"ICD-GIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urine culture/colony count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87086","description":"Urine culture/colony count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of a subcutaneous peritoneal ascites pump_ including reconnection between pump and indwelling bladder and peritoneal catheters_ including initial programming and i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0871T","description":"Replacement of a subcutaneous peritoneal ascites pump_ including reconnection between pump and indwelling bladder and peritoneal catheters_ including initial programming and i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVC1","description":"ICD-CAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Strapping of hand or finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29280","description":"Strapping of hand or finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELC0","description":"ICD-BELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSF0","description":"ICD-PLSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYF1","description":"ICD-PDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leukocyte phagocytosis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86344","description":"Leukocyte phagocytosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dtap-hep b-ipv vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90723","description":"Dtap-hep b-ipv vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwr seat combo w/shear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1007","description":"Pwr seat combo w/shear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (melanoma)_ autophagy and beclin 1 regulator 1 (AMBRA1) and loricrin (AMLo) by immunohistochemistry_ formalin-fixed paraffin-embedded (FFPE) tissue_ report for risk o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0387U","description":"Oncology (melanoma)_ autophagy and beclin 1 regulator 1 (AMBRA1) and loricrin (AMLo) by immunohistochemistry_ formalin-fixed paraffin-embedded (FFPE) tissue_ report for risk o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUB1","description":"ICD-NAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Cervical Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1083","description":"Radiation Therapy For Cervical Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ctr mount pwr elev leg rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1012","description":"Ctr mount pwr elev leg rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVA1","description":"ICD-OLVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWC1","description":"ICD-PAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVA1","description":"ICD-GCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOF0","description":"ICD-OGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transfer of iliopsoas muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27111","description":"Transfer of iliopsoas muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJE1","description":"ICD-NHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVB1","description":"ICD-CHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLA1","description":"ICD-IFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prev visit new age 18-39","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99385","description":"Prev visit new age 18-39","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD24D","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKD0","description":"ICD-KDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ocular imp_ aqueous drain de","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1783","description":"Ocular imp_ aqueous drain de","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKB1","description":"ICD-CCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQA1","description":"ICD-HFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye muscle(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67318","description":"Revise eye muscle(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy finger joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26110","description":"Biopsy finger joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18F","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc brst cncr stage 1 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3374F","description":"Ajcc brst cncr stage 1 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic duct procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38381","description":"Thoracic duct procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMA0","description":"ICD-OJMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACB1","description":"ICD-BACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB20A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC46","description":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKB1","description":"ICD-FGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWE1","description":"ICD-KAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCD1","description":"ICD-AFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBE0","description":"ICD-BHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft arm/leg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64898","description":"Nerve graft arm/leg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Myelin Oligodendrocyte Glycoprotein (Mog-Igg1) Antibody; Cell-Based Immunofluorescence Assay (Cba)_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86362","description":"Myelin Oligodendrocyte Glycoprotein (Mog-Igg1) Antibody; Cell-Based Immunofluorescence Assay (Cba)_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOA0","description":"ICD-PKOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx orbit fx w/o implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21406","description":"Opn tx orbit fx w/o implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPE1","description":"ICD-JAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0671","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0671","description":"HCPCS-G0671","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUF0","description":"ICD-MJUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ped wc modify width adjustm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1011","description":"Ped wc modify width adjustm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVE0","description":"ICD-OHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KA21","description":"ICD-2KA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXF1","description":"ICD-BFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Head control interface mech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2327","description":"Head control interface mech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCB1","description":"ICD-JHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUE1","description":"ICD-CBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYA0","description":"ICD-CGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVD1","description":"ICD-NCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUC0","description":"ICD-FHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYA0","description":"ICD-CHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgery/speech prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31611","description":"Surgery/speech prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI angio abdom w orw/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74185","description":"MRI angio abdom w orw/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61892","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOE0","description":"ICD-LFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENA1","description":"ICD-NENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hand held low vision aids","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2600","description":"Hand held low vision aids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01464","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01464","description":"CPT-01464","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGA0","description":"ICD-JAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMA0","description":"ICD-OCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76529","description":"Echo exam of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHA1","description":"ICD-ODHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACA0","description":"ICD-AACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCB0","description":"ICD-NJCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITD1","description":"ICD-OITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIE0","description":"ICD-AIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBF1","description":"ICD-KIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJE1","description":"ICD-JCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUC0","description":"ICD-NIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWB0","description":"ICD-KBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLE1","description":"ICD-NJLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prq card stent/ath/angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92934","description":"Prq card stent/ath/angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49593","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contraceptive hormone patch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7304","description":"Contraceptive hormone patch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Large size footplate each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0041","description":"Large size footplate each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"guided tissue regeneration - non-resorbable barrier_ per implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6107","description":"guided tissue regeneration - non-resorbable barrier_ per implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGA0","description":"ICD-FGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74775","description":"X-ray exam of perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9809","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQA1","description":"ICD-HGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE13D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOB1","description":"ICD-HEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD24C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHB1","description":"ICD-NFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct guide for tissue ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77013","description":"Ct guide for tissue ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92641","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","description":"CPT-92641","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair anomaly w/conduit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33608","description":"Repair anomaly w/conduit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFF1","description":"ICD-CAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Isoproterenol comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7657","description":"Isoproterenol comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Agglutinins febrile antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86000","description":"Agglutinins febrile antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQB0","description":"ICD-OIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL3D","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHB0","description":"ICD-ABHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adj shoulder ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1840","description":"Adj shoulder ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pain neg no plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8731","description":"Pain neg no plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Composite byp grft pros&vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35681","description":"Composite byp grft pros&vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1601","description":"HCPCS-B1601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trimethobenzamide hcl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3250","description":"Trimethobenzamide hcl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Needle biopsy spinal cord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62269","description":"Needle biopsy spinal cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ciliary transsleral therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66710","description":"Ciliary transsleral therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYE0","description":"ICD-OFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2313","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2313","description":"HCPCS-J2313","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt ed re comp thxpy rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4268F","description":"Pt ed re comp thxpy rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal biophys profile w/nst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76818","description":"Fetal biophys profile w/nst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ophthalmology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4020","description":"Ophthalmology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nursing facility care init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99306","description":"Nursing facility care init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Above knee manual lock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5925","description":"Above knee manual lock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8X","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEB1","description":"ICD-GCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASD0","description":"ICD-LASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSF0","description":"ICD-DCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKA0","description":"ICD-NDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCA0","description":"ICD-MCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01520","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01520","description":"CPT-01520","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ost skn barr extnd =4sq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4411","description":"Ost skn barr extnd =4sq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICF1","description":"ICD-JICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVF0","description":"ICD-NDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical obturator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5931","description":"Surgical obturator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCC1","description":"ICD-EBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reposition pacing-defib lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33215","description":"Reposition pacing-defib lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBB1","description":"ICD-EFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVF1","description":"ICD-FIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sheath above knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8410","description":"Sheath above knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adult foster care per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5141","description":"Adult foster care per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0537U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","description":"CPT-0537U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breast reconstr w/lat flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19361","description":"Breast reconstr w/lat flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBC1","description":"ICD-OIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA13A","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Presc opiates >6 wks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9583","description":"Presc opiates >6 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBD1","description":"ICD-GBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETD0","description":"ICD-FETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDD1","description":"ICD-JDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOC0","description":"ICD-HIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGC1","description":"ICD-OIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/bx infiltrate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32607","description":"Thoracoscopy w/bx infiltrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIF1","description":"ICD-BIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDE0","description":"ICD-AIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRE1","description":"ICD-GCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVA0","description":"ICD-OIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEC1","description":"ICD-KEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETB1","description":"ICD-FETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-91125","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","description":"CPT-91125","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove brain canal fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61050","description":"Remove brain canal fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQD1","description":"ICD-OCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOB0","description":"ICD-GGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGD1","description":"ICD-BFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45100","description":"Biopsy of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cntct lens gas permbl bifocl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2512","description":"Cntct lens gas permbl bifocl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0801","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0801","description":"CDT-D0801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Addition of walker to cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29440","description":"Addition of walker to cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLC0","description":"ICD-EHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBE1","description":"ICD-MDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPB0","description":"ICD-KHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBC1","description":"ICD-NBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFB1","description":"ICD-GEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0164","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0164","description":"HCPCS-J0164","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fixed wing air mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0435","description":"Fixed wing air mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB5A","description":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of peritoneum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74190","description":"X-ray exam of peritoneum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSB1","description":"ICD-HDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQF1","description":"ICD-OBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRB0","description":"ICD-GCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOD1","description":"ICD-CAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj biperiden lactate/5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0190","description":"Inj biperiden lactate/5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKA0","description":"ICD-JDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKA1","description":"ICD-KEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKE0","description":"ICD-KFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place duod/jej tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49441","description":"Place duod/jej tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00912","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00912","description":"CPT-00912","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ rapid sequence analysis_ each comparator genome (eg_ parents_ siblings)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0425U","description":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ rapid sequence analysis_ each comparator genome (eg_ parents_ siblings)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oral busulfan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8510","description":"Oral busulfan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXE1","description":"ICD-OJXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUE1","description":"ICD-AIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCF1","description":"ICD-GFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUC0","description":"ICD-AIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKD1","description":"ICD-NHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIB1","description":"ICD-FBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTF1","description":"ICD-ACTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISD0","description":"ICD-PISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHF0","description":"ICD-ODHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCA1","description":"ICD-NKCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Grp psych partial hosp 45-50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0410","description":"Grp psych partial hosp 45-50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABC0","description":"ICD-AABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lso corset front","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0972","description":"Lso corset front","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrivalent (IIV4)_ split virus_ preservative free_ 0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90686","description":"Influenza virus vaccine_ quadrivalent (IIV4)_ split virus_ preservative free_ 0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVA1","description":"ICD-OEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVB0","description":"ICD-CGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35002","description":"Repair artery rupture neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECF1","description":"ICD-JECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fluciclovine f-18_ diagnostic_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9588","description":"Fluciclovine f-18_ diagnostic_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ischm stroke symp lt3 hrsb/4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1065F","description":"Ischm stroke symp lt3 hrsb/4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMB0","description":"ICD-MBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAD0","description":"ICD-EGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-15015","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","description":"CPT-15015","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vaginectomy partial w/nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57109","description":"Vaginectomy partial w/nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUB0","description":"ICD-FGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Misc vision item or service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2799","description":"Misc vision item or service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYA0","description":"ICD-PLYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDE1","description":"ICD-JGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGC0","description":"ICD-NJGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCB0","description":"ICD-ODCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFC1","description":"ICD-BEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of pilonidal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10081","description":"Drainage of pilonidal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6067","description":"Implant supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMB1","description":"ICD-KAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Muramidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85549","description":"Muramidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEE0","description":"ICD-CAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSA1","description":"ICD-CCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBD0","description":"ICD-FIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE23D","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB224","description":"Clinically Complex _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gi nuclear procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78299","description":"Gi nuclear procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKD1","description":"ICD-NIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFC0","description":"ICD-KFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETB0","description":"ICD-EETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Team conf w/o pat by hc pro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99368","description":"Team conf w/o pat by hc pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Beta-blocker therapy rxd/tkn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4008F","description":"Beta-blocker therapy rxd/tkn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33952","description":"Ecmo/ecls insj prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARE1","description":"ICD-KARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHF0","description":"ICD-FHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWA0","description":"ICD-GHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADME0","description":"ICD-ADME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSD1","description":"ICD-GHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transfusion procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86999","description":"Transfusion procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esano aaa_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4273","description":"Esano aaa_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNF1","description":"ICD-GBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC4B","description":"High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTC1","description":"ICD-OHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYA1","description":"ICD-PCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUD0","description":"ICD-NIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHD0","description":"ICD-FGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTF1","description":"ICD-MGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Management of established patient with dementia_ moderate to high complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0528","description":"Management of established patient with dementia_ moderate to high complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg 2.1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11423","description":"Exc h-f-nk-sp b9+marg 2.1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0316","description":"Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo new ureter/bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50947","description":"Laparo new ureter/bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXB1","description":"ICD-CEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Harvest eye tissue alograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68371","description":"Harvest eye tissue alograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIF1","description":"ICD-FCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMB0","description":"ICD-KFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWC0","description":"ICD-GHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4422","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","description":"HCPCS-Q4422","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITF0","description":"ICD-MITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"PalinGen or ProMatrX_ 0.36 mg per 0.25 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4174","description":"PalinGen or ProMatrX_ 0.36 mg per 0.25 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWF0","description":"ICD-GIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Analysis of clinical data stored in computers (eg_ ECGs_ blood pressures_ hematologic data)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99090","description":"Analysis of clinical data stored in computers (eg_ ECGs_ blood pressures_ hematologic data)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX13","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNB1","description":"ICD-KDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJB1","description":"ICD-BDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEED1","description":"ICD-FEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablate arrhythmia add on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93655","description":"Ablate arrhythmia add on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC140","description":"Reduced Physical Function _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC205","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMC1","description":"ICD-JEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDB1","description":"ICD-JCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTC1","description":"ICD-AHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHC1","description":"ICD-NLHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYC1","description":"ICD-DHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28F","description":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGF1","description":"ICD-CAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphc trifocal 4.25-7/>6","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2310","description":"Lens sphc trifocal 4.25-7/>6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDB0","description":"ICD-GFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Residential Habilitation 4-8","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0102","description":"Residential Habilitation 4-8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Liver & spleen image/flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78216","description":"Liver & spleen image/flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLD1","description":"ICD-FCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implnt/abut fixed dent max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6114","description":"Implnt/abut fixed dent max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVB1","description":"ICD-NDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1901","description":"HCPCS-A1901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"H2o stat docd normal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2030F","description":"H2o stat docd normal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECF0","description":"ICD-MECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sildenafil citrate_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0090","description":"Sildenafil citrate_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25240","description":"Partial removal of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Afo spiral molded to pt plas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1950","description":"Afo spiral molded to pt plas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62258","description":"Replace brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc advncd dis cmfrt not 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1153F","description":"Doc advncd dis cmfrt not 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHF0","description":"ICD-NEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHD0","description":"ICD-EFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXE0","description":"ICD-CIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1DA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DA11","description":"ICD-1DA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIC1","description":"ICD-MJIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBF0","description":"ICD-ACBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electro hearng aid tst both","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92595","description":"Electro hearng aid tst both","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENA1","description":"ICD-GENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAA0","description":"ICD-NEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient had more than one emergency department visit in the last 30 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9850","description":"Patient had more than one emergency department visit in the last 30 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHF1","description":"ICD-OLHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGC1","description":"ICD-ODGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBB0","description":"ICD-NFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hpv high-risk types","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87624","description":"Hpv high-risk types","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBB1","description":"ICD-ICBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEB0","description":"ICD-CGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABF0","description":"ICD-JABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDB1","description":"ICD-JBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blm gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81209","description":"Blm gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIE0","description":"ICD-NCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implantation of catheter-delivered prosthetic pulmonary valve_ endovascular approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0262T","description":"Implantation of catheter-delivered prosthetic pulmonary valve_ endovascular approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEC0","description":"ICD-AFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray exam of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74283","description":"Contrast x-ray exam of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HA31","description":"ICD-2HA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNF0","description":"ICD-JFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDB1","description":"ICD-FHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artery to vein shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36835","description":"Artery to vein shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGME0","description":"ICD-EGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB2D","description":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSA0","description":"ICD-PCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36903","description":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE144","description":"Clinically Complex _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKD1","description":"ICD-JEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMB0","description":"ICD-EBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pmkr_ single_ rate-resp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1786","description":"Pmkr_ single_ rate-resp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCD0","description":"ICD-MLCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKF0","description":"ICD-BAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mecp2 gene dup/delet variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81304","description":"Mecp2 gene dup/delet variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES306","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01638","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01638","description":"CPT-01638","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEA1","description":"ICD-MLEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIC1","description":"ICD-EAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINB1","description":"ICD-FINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNF0","description":"ICD-GHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth head/neck/ptrunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30051","description":"Anesth head/neck/ptrunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASE1","description":"ICD-DASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIC1","description":"ICD-CHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ak sleeve susp neoprene/equa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5695","description":"Ak sleeve susp neoprene/equa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIB0","description":"ICD-CAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65235","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIF0","description":"ICD-MJIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXE1","description":"ICD-BHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Demonstrate use home inr mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0248","description":"Demonstrate use home inr mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ready gradient sleeve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8424","description":"Ready gradient sleeve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ bra_ for nighttime use_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6528","description":"Gradient compression garment_ bra_ for nighttime use_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esoph optical endomicroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43206","description":"Esoph optical endomicroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67908","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28555","description":"Repair foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASB0","description":"ICD-PASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLC0","description":"ICD-KCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETA0","description":"ICD-JETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVB1","description":"ICD-FHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDC1","description":"ICD-OJDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWD0","description":"ICD-DAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dry pressure mattress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0184","description":"Dry pressure mattress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE150","description":"Special Care Low _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Meperidine hydrochl /100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2175","description":"Meperidine hydrochl /100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB216","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXA0","description":"ICD-JBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITD1","description":"ICD-NITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIC0","description":"ICD-BHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWE0","description":"ICD-HEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHB1","description":"ICD-JDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foll-up eval q3mo opiod tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9562","description":"Foll-up eval q3mo opiod tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESE0","description":"ICD-PESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXA0","description":"ICD-NBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHC1","description":"ICD-NDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTA0","description":"ICD-NKTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLA1","description":"ICD-NKLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJC1","description":"ICD-NCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUF1","description":"ICD-IDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection Hpc Nos 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9985","description":"Injection Hpc Nos 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of epididymis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54800","description":"Biopsy of epididymis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age And Had At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Dementia Medication","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2124","description":"Patients 66-80 Years Of Age And Had At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Dementia Medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap es sph augment dev place","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0392T","description":"Lap es sph augment dev place","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOD1","description":"ICD-OEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ins tun ip cath for dial opn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49421","description":"Ins tun ip cath for dial opn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9936","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9936","description":"CDT-D9936","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWF1","description":"ICD-CDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCD0","description":"ICD-EGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSB1","description":"ICD-OBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 22 Or Functional Status M","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2142","description":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 22 Or Functional Status M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0663U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0663U","description":"CPT-0663U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQA0","description":"ICD-DAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHB0","description":"ICD-ECHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of bile duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47425","description":"Incision of bile duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVE1","description":"ICD-OIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Functional electric stim nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0770","description":"Functional electric stim nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ganciclovir sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1570","description":"Ganciclovir sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gerd symps assessed 12 month","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1118F","description":"Gerd symps assessed 12 month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAE0","description":"ICD-IBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Njx tfrml eprl w/us cer/thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0229T","description":"Njx tfrml eprl w/us cer/thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXA0","description":"ICD-OGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECB0","description":"ICD-AECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of gland abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56420","description":"Drainage of gland abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lymph system imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78195","description":"Lymph system imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXA0","description":"ICD-CEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAC1","description":"ICD-OFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTD1","description":"ICD-BDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUB1","description":"ICD-NCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIF0","description":"ICD-EAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEC0","description":"ICD-KHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHA1","description":"ICD-AHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9292","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","description":"HCPCS-J9292","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOC1","description":"ICD-DDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTB0","description":"ICD-BGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inject for sacroiliac joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0259","description":"Inject for sacroiliac joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with 3-dimensional high resolution esophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0240T","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with 3-dimensional high resolution esophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIE0","description":"ICD-MAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1076T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1076T","description":"CPT-1076T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDE0","description":"ICD-EGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWC1","description":"ICD-GAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urine ost pch bar w lock fln","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4433","description":"Urine ost pch bar w lock fln","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEF1","description":"ICD-OGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3BB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BB31","description":"ICD-3BB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Review And Interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93244","description":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Review And Interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Maxillofacial fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21100","description":"Maxillofacial fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSC0","description":"ICD-LCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL24","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bx breast add lesion us imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19084","description":"Bx breast add lesion us imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYF0","description":"ICD-CFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0024","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDA0","description":"ICD-IFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation physics consult","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77336","description":"Radiation physics consult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-70472","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","description":"CPT-70472","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSE0","description":"ICD-LBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKF1","description":"ICD-NFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWC0","description":"ICD-LGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGED0","description":"ICD-CGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01442","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01442","description":"CPT-01442","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAD0","description":"ICD-EAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28545","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8A","description":"Very High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFE1","description":"ICD-FGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXC0","description":"ICD-BIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB250","description":"Special Care High _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFF1","description":"ICD-GEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETC0","description":"ICD-NETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIF1","description":"ICD-AHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJA0","description":"ICD-OHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIE1","description":"ICD-IFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKF1","description":"ICD-OJKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA212","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8D","description":"High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVE0","description":"ICD-OFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNE0","description":"ICD-KGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLB1","description":"ICD-BHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACC0","description":"ICD-FACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLF0","description":"ICD-BCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Multiple surgery abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49220","description":"Multiple surgery abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOC0","description":"ICD-PHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPA0","description":"ICD-OKPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC3B","description":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUE0","description":"ICD-EDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Self-help/peer svc per 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0038","description":"Self-help/peer svc per 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLD1","description":"ICD-AHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXB1","description":"ICD-FGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQE0","description":"ICD-LAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCF0","description":"ICD-GDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHF0","description":"ICD-GHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sterile cefuroxime injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0697","description":"Sterile cefuroxime injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJC1","description":"ICD-GAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSC0","description":"ICD-GGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDC1","description":"ICD-KGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLA0","description":"ICD-NCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lung ventilat&perfus imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78582","description":"Lung ventilat&perfus imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemi-facial prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8044","description":"Hemi-facial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUC1","description":"ICD-FIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMD1","description":"ICD-MLMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVE0","description":"ICD-GCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment Of Amblyopia Using An Online Digital Program; Assessment Of Patient Performance And Program Data By Physician Or Other Qualified Health Care Professional_ With Repor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0688T","description":"Treatment Of Amblyopia Using An Online Digital Program; Assessment Of Patient Performance And Program Data By Physician Or Other Qualified Health Care Professional_ With Repor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRC1","description":"ICD-CIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKC1","description":"ICD-FBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXF0","description":"ICD-CGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Part removal hip bone deep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27071","description":"Part removal hip bone deep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB15","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0518U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","description":"CPT-0518U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy_ flexible_ proximal to splenic flexure; with transendoscopic stent placement (includes predilation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6025","description":"Colonoscopy_ flexible_ proximal to splenic flexure; with transendoscopic stent placement (includes predilation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASF0","description":"ICD-LASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphc trifocal 4.25-7/4.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2309","description":"Lens sphc trifocal 4.25-7/4.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"BRCA1 (BRCA1_ DNA repair associated)_ BRCA2 (BRCA2_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie_ de","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81164","description":"BRCA1 (BRCA1_ DNA repair associated)_ BRCA2 (BRCA2_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie_ de","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKB0","description":"ICD-GGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD11B","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFE0","description":"ICD-GCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Occlude fallopian tube(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58615","description":"Occlude fallopian tube(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastroplasty duodenal switch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43845","description":"Gastroplasty duodenal switch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHA0","description":"ICD-GDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Services performed by a physical therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program_ each 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2168","description":"Services performed by a physical therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program_ each 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKA0","description":"ICD-FHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHB0","description":"ICD-KIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Facial replacement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5929","description":"Facial replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUF1","description":"ICD-NGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSE1","description":"ICD-HHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inter active grp psych parti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0411","description":"Inter active grp psych parti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical placement of craniofacial implant - extra oral","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7993","description":"Surgical placement of craniofacial implant - extra oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low-level laser trmt 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8948","description":"Low-level laser trmt 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEE0","description":"ICD-FDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFA1","description":"ICD-OAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj melphalan hydrochl 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9245","description":"Inj melphalan hydrochl 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Init bk ptb plaster direct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5500","description":"Init bk ptb plaster direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Retinal polarization scan_ ocular screening with on-site automated results_ bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0469T","description":"Retinal polarization scan_ ocular screening with on-site automated results_ bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 160 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0144U","description":"Drug assay_ definitive_ 160 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB23B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cosyntropin_ not otherwise specified_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0833","description":"Injection_ cosyntropin_ not otherwise specified_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1101","description":"HCPCS-A1101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTC1","description":"ICD-OLTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEE0","description":"ICD-OKEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOB1","description":"ICD-KBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"M/phmtrc alys ishquant/semiq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88377","description":"M/phmtrc alys ishquant/semiq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6014","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt not on statin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9508","description":"Doc pt not on statin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB15B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSD1","description":"ICD-HGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise spine accessory nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63191","description":"Incise spine accessory nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFA0","description":"ICD-BCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX42","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Management of established patient with dementia_ low complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0527","description":"Management of established patient with dementia_ low complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCF1","description":"ICD-IBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSB1","description":"ICD-OFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prolong service w/o contact","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99358","description":"Prolong service w/o contact","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXE1","description":"ICD-CDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Retinal tamp_ silicone oil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1814","description":"Retinal tamp_ silicone oil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50551","description":"Kidney endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC05","description":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chiropract manj 3-4 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98941","description":"Chiropract manj 3-4 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQC1","description":"ICD-GFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90999","description":"Dialysis procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brachy linear_ non-str_p-103","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2636","description":"Brachy linear_ non-str_p-103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUD0","description":"ICD-FGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15935","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAE1","description":"ICD-ICAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Other bone graft microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20962","description":"Other bone graft microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc s/n/h/f/g mal+mrg 0.6-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11621","description":"Exc s/n/h/f/g mal+mrg 0.6-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urgent care center global","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9083","description":"Urgent care center global","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXF0","description":"ICD-NHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HEPATITIS DELTA ANTIGEN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87380","description":"IAAD IA HEPATITIS DELTA ANTIGEN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSD0","description":"ICD-GHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of silver diamine fluoride 38%_ by a physician or other qualified health care professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0792T","description":"Application of silver diamine fluoride 38%_ by a physician or other qualified health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam si joints 3/> vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72202","description":"X-ray exam si joints 3/> vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXC0","description":"ICD-JFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral infus pump statio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9006","description":"Parenteral infus pump statio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEA1","description":"ICD-MHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antiemetic drug oral nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8597","description":"Antiemetic drug oral nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBF1","description":"ICD-JBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct perfusion w/contrast cbf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0042T","description":"Ct perfusion w/contrast cbf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rx cntact lens aphakia 2 eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92316","description":"Rx cntact lens aphakia 2 eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE125","description":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLD0","description":"ICD-BFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28G","description":"Clinically Complex _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Store prev froz embryos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4027","description":"Store prev froz embryos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAC0","description":"ICD-FHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EA21","description":"ICD-2EA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDD0","description":"ICD-MBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHD1","description":"ICD-IAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of lingual tonsil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42870","description":"Excision of lingual tonsil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28E","description":"Special Care Low _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIC1","description":"ICD-IBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67975","description":"Reconstruction of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB5C","description":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATA0","description":"ICD-NATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Relieve bladder contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52640","description":"Relieve bladder contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRF0","description":"ICD-PDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRB0","description":"ICD-PHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABA0","description":"ICD-GABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICC1","description":"ICD-IICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTC1","description":"ICD-OBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETC1","description":"ICD-OETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"GYPB GNOTYP NTRNS 1 5 SEUX 3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0190U","description":"GYPB GNOTYP NTRNS 1 5 SEUX 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low frequency non-thermal us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97610","description":"Low frequency non-thermal us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRD1","description":"ICD-GDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJD1","description":"ICD-GCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML56","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD22C","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCB0","description":"ICD-ABCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABF1","description":"ICD-CABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWC1","description":"ICD-LDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Conform band n/s w>=5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6444","description":"Conform band n/s w>=5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Legion pneumo dna dir prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87540","description":"Legion pneumo dna dir prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATB1","description":"ICD-BATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB217","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCE1","description":"ICD-BCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spring-ass rot wrst w/ latch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6623","description":"Spring-ass rot wrst w/ latch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDA1","description":"ICD-NDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) not achieved within the 30 minutes immediately before or the","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9773","description":"At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) not achieved within the 30 minutes immediately before or the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBF1","description":"ICD-GDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWC1","description":"ICD-PKWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50065","description":"Incision of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37289","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","description":"CPT-37289","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFD1","description":"ICD-FAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise lwr jaw cyst w/repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21047","description":"Excise lwr jaw cyst w/repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"New episode for condition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1127F","description":"New episode for condition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXE1","description":"ICD-KDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLE1","description":"ICD-JBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMA0","description":"ICD-GDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE211","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0704","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0704","description":"CDT-D0704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA136","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0506","description":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVE1","description":"ICD-NLVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abutment Supported Retainer - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6195","description":"Abutment Supported Retainer - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHE0","description":"ICD-FAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma scrn hgh risk direc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0117","description":"Glaucoma scrn hgh risk direc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHND1","description":"ICD-BHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Microsurg epi sperm asp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4028","description":"Microsurg epi sperm asp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGB1","description":"ICD-KGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Duplex Scan Of Arterial Inflow And Venous Outflow For Preoperative Vessel Assessment Prior To Creation Of Hemodialysis Access; Complete Unilateral Study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93986","description":"Duplex Scan Of Arterial Inflow And Venous Outflow For Preoperative Vessel Assessment Prior To Creation Of Hemodialysis Access; Complete Unilateral Study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOD0","description":"ICD-HGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMF1","description":"ICD-OIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYF0","description":"ICD-GFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQA1","description":"ICD-LGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prev visit new age 40-64","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99386","description":"Prev visit new age 40-64","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVD1","description":"ICD-GCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA0A","description":"Very High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB221","description":"Special Care High _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTA1","description":"ICD-NKTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy knee joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27330","description":"Biopsy knee joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair liver wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47361","description":"Repair liver wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDD0","description":"ICD-FBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALD0","description":"ICD-BALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANA1","description":"ICD-FANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSE1","description":"ICD-PBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0206","description":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAC1","description":"ICD-IHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc med reas no offer eol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9381","description":"Doc med reas no offer eol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB15D","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB151","description":"Special Care Low _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOC0","description":"ICD-GBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8F","description":"Medium Rehab _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical repair of root resorption - anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3471","description":"Surgical repair of root resorption - anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Term dev mech hand vol close","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6709","description":"Term dev mech hand vol close","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ factor VIII_ (antihemophilic factor_ recombinant)_ (Nuwiq)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7209","description":"Injection_ factor VIII_ (antihemophilic factor_ recombinant)_ (Nuwiq)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth cranial surg nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21051","description":"Anesth cranial surg nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJA0","description":"ICD-CDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28F","description":"Clinically Complex _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXB1","description":"ICD-GBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dermacyte Amniotic Membrane Allograft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4248","description":"Dermacyte Amniotic Membrane Allograft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC10D","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTC0","description":"ICD-EFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWF0","description":"ICD-PDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ranibizumab_ via intravitreal implant (Susvimo)_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2779","description":"Injection_ ranibizumab_ via intravitreal implant (Susvimo)_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOC1","description":"ICD-PGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCE1","description":"ICD-JDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLC1","description":"ICD-CBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ANNUAL ALCOHOL MISUSE SCREENING_ 15 MINUTES","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0442","description":"ANNUAL ALCOHOL MISUSE SCREENING_ 15 MINUTES","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Custom sleep apnea appliance fabrication and placement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9947","description":"Custom sleep apnea appliance fabrication and placement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Seg pneumatic appl full arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0668","description":"Seg pneumatic appl full arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFB0","description":"ICD-BDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doppler color flow add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93325","description":"Doppler color flow add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intravascular ultrasound (non-coronary vessel)_ radiological supervisio and interpretation; initial vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75945","description":"Intravascular ultrasound (non-coronary vessel)_ radiological supervisio and interpretation; initial vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise circulation to head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61710","description":"Revise circulation to head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Axolotl graft or axolotl dualgraft_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4210","description":"Axolotl graft or axolotl dualgraft_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIB1","description":"ICD-CIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crisis intervention per hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9484","description":"Crisis intervention per hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKA0","description":"ICD-NLKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES301","description":"Extensive Services _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ercp sphincter pressure meas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43263","description":"Ercp sphincter pressure meas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair iris & ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66680","description":"Repair iris & ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab-qyyp_ biosimilar_ (trazimera)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5116","description":"Injection_ trastuzumab-qyyp_ biosimilar_ (trazimera)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not administering zoster vaccine (e.g._ prior anaphylaxis due to the zoster vaccine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1175","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g._ prior anaphylaxis due to the zoster vaccine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJB1","description":"ICD-KBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disposable nebulizer prefill","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7008","description":"Disposable nebulizer prefill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRD0","description":"ICD-GFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAD0","description":"ICD-FDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJA0","description":"ICD-JIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDD1","description":"ICD-MGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise/drain tear gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68400","description":"Incise/drain tear gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXA0","description":"ICD-BHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYF0","description":"ICD-KGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTA0","description":"ICD-FGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJA1","description":"ICD-NKJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0669","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0669","description":"HCPCS-G0669","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flex thermoplastic collar mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0130","description":"Flex thermoplastic collar mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovas aaa repr w/1-p part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34804","description":"Endovas aaa repr w/1-p part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC21B","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXF0","description":"ICD-KFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUC0","description":"ICD-GGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8I","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQF1","description":"ICD-GHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Asthma impairment assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2015F","description":"Asthma impairment assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fit spectacles monofocal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92340","description":"Fit spectacles monofocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUD1","description":"ICD-NJUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1101","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1101","description":"CDT-D1101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/w resect diag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32668","description":"Thoracoscopy w/w resect diag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8E","description":"Low Rehab_ ADL Index 0-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAB1","description":"ICD-NJAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSF1","description":"ICD-OCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIE0","description":"ICD-BAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiotherapy dose plan imrt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77301","description":"Radiotherapy dose plan imrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUB1","description":"ICD-AAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB154","description":"Special Care High _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXF0","description":"ICD-FEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKD1","description":"ICD-JDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin pinch graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15050","description":"Skin pinch graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTA0","description":"ICD-JCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid monaural in ear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5050","description":"Hearing aid monaural in ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHE0","description":"ICD-JGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIC1","description":"ICD-OGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTC0","description":"ICD-FCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVF0","description":"ICD-JFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSE1","description":"ICD-KGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise/remove neuroelectrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61880","description":"Revise/remove neuroelectrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1041","description":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin sub grft t/arm/lg child","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15273","description":"Skin sub grft t/arm/lg child","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKE1","description":"ICD-JHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27594","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCF0","description":"ICD-IFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AA31","description":"ICD-3AA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTC1","description":"ICD-MGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASE0","description":"ICD-HASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHC1","description":"ICD-MIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation without programming of implanted phrenic nerve stimulator system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93153","description":"Interrogation without programming of implanted phrenic nerve stimulator system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPF0","description":"ICD-NJPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAE1","description":"ICD-KBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTD0","description":"ICD-NJTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc neck les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21552","description":"Exc neck les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"5% dextrose and 0.45% saline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5010","description":"5% dextrose and 0.45% saline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVF1","description":"ICD-OEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDB1","description":"ICD-FFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAE0","description":"ICD-GDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33954","description":"Ecmo/ecls insj prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Phys exam for college","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0622","description":"Phys exam for college","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace socket hip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5702","description":"Replace socket hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUA0","description":"ICD-ABUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clot inhibit prot s free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85306","description":"Clot inhibit prot s free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCA0","description":"ICD-BDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open treatment of rib fracture without fixation_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21805","description":"Open treatment of rib fracture without fixation_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECA0","description":"ICD-MECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB45","description":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHA1","description":"ICD-EFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Omental flap extra-abdom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49904","description":"Omental flap extra-abdom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYE1","description":"ICD-PIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contraceptive pills for bc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4993","description":"Contraceptive pills for bc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFME0","description":"ICD-EFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4433","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","description":"HCPCS-Q4433","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Methylnaltrexone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2212","description":"Methylnaltrexone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX42","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Afo sing solid stirrup calf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1980","description":"Afo sing solid stirrup calf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAF0","description":"ICD-ADAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXD0","description":"ICD-JGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit hydra 3 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9376","description":"Hit hydra 3 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWF0","description":"ICD-PIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert pelv fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22848","description":"Insert pelv fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLD0","description":"ICD-NLLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA213","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacteria and fungi)_ gram-negative bacterial identification and drug resistance element detection_ DNA (21 gram-negative bacterial targets_ 6 resistance ge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0142U","description":"Infectious disease (bacteria and fungi)_ gram-negative bacterial identification and drug resistance element detection_ DNA (21 gram-negative bacterial targets_ 6 resistance ge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELD0","description":"ICD-BELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNA1","description":"ICD-NFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA55","description":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fracture frame attached to b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0920","description":"Fracture frame attached to b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy lysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58660","description":"Laparoscopy lysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYE1","description":"ICD-PFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37255","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","description":"CPT-37255","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anter chamber intraocul lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2630","description":"Anter chamber intraocul lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCB1","description":"ICD-OLCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pediatric wheelchair nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1229","description":"Pediatric wheelchair nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXB0","description":"ICD-JGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWB0","description":"ICD-PBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETE0","description":"ICD-IETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of phosphorus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84100","description":"Assay of phosphorus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3CC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CC31","description":"ICD-3CC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBME0","description":"ICD-MBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBC0","description":"ICD-MIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB20A","description":"Special Care High _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brief (20 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiaryā€™s hom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2006","description":"Brief (20 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiaryā€™s hom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid tumor)_ gene expression profiling by real-time RT-PCR of 7 gene pathways (ER_ AR_ PI3K_ MAPK_ HH_ TGFB_ Notch)_ formalin-fixed paraffin-embedded (FFPE)_ algori","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0262U","description":"Oncology (solid tumor)_ gene expression profiling by real-time RT-PCR of 7 gene pathways (ER_ AR_ PI3K_ MAPK_ HH_ TGFB_ Notch)_ formalin-fixed paraffin-embedded (FFPE)_ algori","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mt bone graft microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20957","description":"Mt bone graft microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAC0","description":"ICD-MFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFF0","description":"ICD-BIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Debride infected skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11000","description":"Debride infected skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBND0","description":"ICD-KBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAE1","description":"ICD-AAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interdental fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21110","description":"Interdental fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no pos air press","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8849","description":"Doc reas no pos air press","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Denture reln part mand chr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5741","description":"Denture reln part mand chr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vis field assmnt tech suppt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0379T","description":"Vis field assmnt tech suppt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYF0","description":"ICD-HEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Holster elec/combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0498","description":"Holster elec/combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFF1","description":"ICD-FFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHD0","description":"ICD-GIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFID0","description":"ICD-CFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coch implant microphone repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8616","description":"Coch implant microphone repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGD1","description":"ICD-FBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Occult blood feces","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82270","description":"Occult blood feces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVF1","description":"ICD-KDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneum compres w/cal pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0652","description":"Pneum compres w/cal pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intensive outpatient psychia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9480","description":"Intensive outpatient psychia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGC0","description":"ICD-KEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Collection of microorganisms","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0415","description":"Collection of microorganisms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPE1","description":"ICD-GEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPA1","description":"ICD-BFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOE0","description":"ICD-PGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDB1","description":"ICD-GHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/dysphag/wt loss/nutr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3760F","description":"Pt w/dysphag/wt loss/nutr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Frenuloplasty","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7963","description":"Frenuloplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0522T","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHB0","description":"ICD-NDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shock absorber for power w/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1016","description":"Shock absorber for power w/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEC1","description":"ICD-MBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clot inhibit prot c activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85303","description":"Clot inhibit prot c activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAE1","description":"ICD-KAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of skull lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61500","description":"Removal of skull lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD250","description":"Special Care High _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46751","description":"Repair of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYA0","description":"ICD-KDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bendamustine HCL (Belrapzo)_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9042","description":"Injection_ bendamustine HCL (Belrapzo)_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKB1","description":"ICD-FIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIC1","description":"ICD-MCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOE1","description":"ICD-CIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDC1","description":"ICD-IEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVF1","description":"ICD-OAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mr ang lwr ext w or w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73725","description":"Mr ang lwr ext w or w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRB0","description":"ICD-GIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection estrone per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1435","description":"Injection estrone per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mohs surg addl block","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17315","description":"Mohs surg addl block","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who have had a hysterectomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9774","description":"Patients who have had a hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens gas permeable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2531","description":"Contact lens gas permeable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMA1","description":"ICD-NCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFD0","description":"ICD-NEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJD0","description":"ICD-NLJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQC1","description":"ICD-GEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGE0","description":"ICD-NCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD105","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDB1","description":"ICD-MDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML0B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5149","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","description":"HCPCS-Q5149","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj dobutamine hcl/250 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1250","description":"Inj dobutamine hcl/250 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJND0","description":"ICD-NJND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJD1","description":"ICD-NDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDE1","description":"ICD-ACDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1055T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1055T","description":"CPT-1055T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALC0","description":"ICD-FALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHB0","description":"ICD-EGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDA1","description":"ICD-KGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKB0","description":"ICD-NAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0668U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0668U","description":"CPT-0668U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMC0","description":"ICD-NJMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA25C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gjb2 gene known fam variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81253","description":"Gjb2 gene known fam variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53460","description":"Revision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29898","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIE0","description":"ICD-AFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection into vocal cord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31513","description":"Injection into vocal cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGC0","description":"ICD-BIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dna/rna sequencing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87153","description":"Dna/rna sequencing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGE1","description":"ICD-BAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHC1","description":"ICD-IDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tick-borne encephalitis virus vaccine_ inactivated; 0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90627","description":"Tick-borne encephalitis virus vaccine_ inactivated; 0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADC0","description":"ICD-EADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAB0","description":"ICD-ACAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinic service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1015","description":"Clinic service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQB0","description":"ICD-PGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYD0","description":"ICD-CDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMB1","description":"ICD-NAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20525","description":"Removal of foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPE1","description":"ICD-NHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fabrication & fitting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2628","description":"Fabrication & fitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEE1","description":"ICD-JGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTB1","description":"ICD-BHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of end stage renal disease (esrd)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1187","description":"Patients with a diagnosis of end stage renal disease (esrd)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE10D","description":"Special Care Low _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQD1","description":"ICD-CAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQC0","description":"ICD-LAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ full gene sequence (List separately in addition to code for primary procedu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0071U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ full gene sequence (List separately in addition to code for primary procedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0017","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUA1","description":"ICD-FAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQB0","description":"ICD-CAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47612","description":"Removal of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBE0","description":"ICD-KHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays adrenal gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75731","description":"Artery x-rays adrenal gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_ risk adj_ level 3","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9009","description":"Mccd_ risk adj_ level 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients on immune checkpoint inhibitor therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1180","description":"Patients on immune checkpoint inhibitor therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDD0","description":"ICD-BBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISE0","description":"ICD-PISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous pulmonary artery revascularization by stent placement_ initial; normal native connections_ bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33901","description":"Percutaneous pulmonary artery revascularization by stent placement_ initial; normal native connections_ bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNA1","description":"ICD-BGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOC1","description":"ICD-KEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pdgfra gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81314","description":"Pdgfra gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9984","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCF1","description":"ICD-GDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUC0","description":"ICD-CDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Muscle biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20200","description":"Muscle biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUA1","description":"ICD-CIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCD1","description":"ICD-OJCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDC1","description":"ICD-AEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVA1","description":"ICD-BFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDA0","description":"ICD-JCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHD0","description":"ICD-IBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of tibia epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27730","description":"Repair of tibia epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMA1","description":"ICD-CHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDC1","description":"ICD-CFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQC1","description":"ICD-PLQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB22C","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRA0","description":"ICD-PBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATD1","description":"ICD-OATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSA1","description":"ICD-KGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUF0","description":"ICD-JDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIE0","description":"ICD-MDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Somatropin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2941","description":"Somatropin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35111","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELA1","description":"ICD-KELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBB0","description":"ICD-IEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0404","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0404","description":"CDT-D0404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYB0","description":"ICD-OHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acoustic immitance testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92570","description":"Acoustic immitance testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELF1","description":"ICD-IELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0655U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0655U","description":"CPT-0655U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKF0","description":"ICD-JCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngography_ contrast_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70373","description":"Laryngography_ contrast_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion catheter artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36625","description":"Insertion catheter artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDC0","description":"ICD-JIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ intravas ultrasound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1753","description":"Cath_ intravas ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVF0","description":"ICD-FAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of abdomen artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37617","description":"Ligation of abdomen artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infusion pump_ programmable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1772","description":"Infusion pump_ programmable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat big toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28490","description":"Treat big toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE111","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXE0","description":"ICD-GDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove nasal foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30320","description":"Remove nasal foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0932T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","description":"CPT-0932T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vad different session","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33992","description":"Remove vad different session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown resin w/ noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2722","description":"Crown resin w/ noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay triiodothyronine (t3)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84480","description":"Assay triiodothyronine (t3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXE0","description":"ICD-CGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38E","description":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Satisfy survey not complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0917","description":"Satisfy survey not complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX3B","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit new","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99201","description":"Office/outpatient visit new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSF0","description":"ICD-LGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of elbow bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24105","description":"Removal of elbow bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQD0","description":"ICD-DEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4362","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","description":"HCPCS-Q4362","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27041","description":"Biopsy of soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYC1","description":"ICD-PJYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPD1","description":"ICD-OKPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0539","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","description":"HCPCS-G0539","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Seg pneumatic appl full leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0667","description":"Seg pneumatic appl full leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVD0","description":"ICD-FGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIF0","description":"ICD-CAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDC0","description":"ICD-OFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEA1","description":"ICD-ECEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of triglycerides","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84478","description":"Assay of triglycerides","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spec sit not prim tumor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8723","description":"Spec sit not prim tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMC0","description":"ICD-ECMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJF0","description":"ICD-NDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Functional status measurement with score was obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1042","description":"Functional status measurement with score was obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lamellas xt_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4291","description":"Lamellas xt_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCA1","description":"ICD-BHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Screening performed and negative","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9920","description":"Screening performed and negative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair bladder-vagina lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57320","description":"Repair bladder-vagina lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Msh6 gene known variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81299","description":"Msh6 gene known variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc hand les sc < 1.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26115","description":"Exc hand les sc < 1.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ini phq9 >9 no remiss >=5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9395","description":"Ini phq9 >9 no remiss >=5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCD0","description":"ICD-CBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fr frz plasma donor retested","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9060","description":"Fr frz plasma donor retested","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Appliance removal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7997","description":"Appliance removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo ablate liver tumor rf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47370","description":"Laparo ablate liver tumor rf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIC1","description":"ICD-ABIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML44","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBC1","description":"ICD-BHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Budesonide comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7627","description":"Budesonide comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHA0","description":"ICD-OIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMD1","description":"ICD-JDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWF1","description":"ICD-LAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJF0","description":"ICD-FIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA10C","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFD0","description":"ICD-JBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFME1","description":"ICD-BFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ eteplirsen_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1428","description":"Injection_ eteplirsen_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHND0","description":"ICD-JHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX3C","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast supplies (plaster)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4580","description":"Cast supplies (plaster)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDC1","description":"ICD-KEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01829","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01829","description":"CPT-01829","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWB0","description":"ICD-DAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay technique_ (eg_ enzyme immunoassay [EIA]_ enzyme-linked immunosorbent assay [ELISA]_ fluorescence immunoassay [FIA]_ immunoch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87467","description":"Infectious agent antigen detection by immunoassay technique_ (eg_ enzyme immunoassay [EIA]_ enzyme-linked immunosorbent assay [ELISA]_ fluorescence immunoassay [FIA]_ immunoch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBC0","description":"ICD-FHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/dxa results document","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8399","description":"Pt w/dxa results document","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQF0","description":"ICD-DBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNF0","description":"ICD-CBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAC0","description":"ICD-MEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBA0","description":"ICD-AIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJE1","description":"ICD-KBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydrate iv infusion add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96361","description":"Hydrate iv infusion add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEC1","description":"ICD-OEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0610U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","description":"CPT-0610U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Below/above elbow lock mech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6698","description":"Below/above elbow lock mech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lutetium Lu 177_ dotatate_ therapeutic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9031","description":"Lutetium Lu 177_ dotatate_ therapeutic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3BC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BC31","description":"ICD-3BC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28B","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJE1","description":"ICD-KGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHB1","description":"ICD-OKHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMF0","description":"ICD-CFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQA0","description":"ICD-OEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYA1","description":"ICD-CGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXB1","description":"ICD-NBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDA1","description":"ICD-OFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair cleft lip/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40700","description":"Repair cleft lip/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAB0","description":"ICD-JCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of anal fissure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46942","description":"Treatment of anal fissure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECC1","description":"ICD-CECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRB1","description":"ICD-OGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDF0","description":"ICD-JGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFA0","description":"ICD-KGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHA0","description":"ICD-BEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLD1","description":"ICD-NHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialys sol fld vol > 4999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4725","description":"Dialys sol fld vol > 4999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALB0","description":"ICD-CALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAC0","description":"ICD-CCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ BICROS_ in the ear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5210","description":"Hearing aid_ BICROS_ in the ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99211","description":"Office/outpatient visit est","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANA1","description":"ICD-OANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Control nose/throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42972","description":"Control nose/throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBF1","description":"ICD-AIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LC31","description":"ICD-4LC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLC1","description":"ICD-BCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3KA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KA21","description":"ICD-3KA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX2A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFF1","description":"ICD-NBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional_ per calendar month. (list separately in additio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G3003","description":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional_ per calendar month. (list separately in additio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home visit new pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99326","description":"Domicil/r-home visit new pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daratumumab_ 10mg (Darzalex)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9476","description":"Injection_ daratumumab_ 10mg (Darzalex)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown-titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2794","description":"Crown-titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYF0","description":"ICD-HDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of new or replacement of permanent pacemaker with ventricular transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for left ventricul","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7538","description":"Insertion of new or replacement of permanent pacemaker with ventricular transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for left ventricul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWB0","description":"ICD-HGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole lauroxil_ 1 mg (Aristada)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9470","description":"Injection_ aripiprazole lauroxil_ 1 mg (Aristada)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ synojoynt_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7331","description":"Hyaluronan or derivative_ synojoynt_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCA1","description":"ICD-OHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replc vagus nerve pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0316T","description":"Replc vagus nerve pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1504","description":"HCPCS-C1504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4IB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IB21","description":"ICD-4IB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLF1","description":"ICD-OGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBC0","description":"ICD-IEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGA1","description":"ICD-ODGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28X","description":"Clinically Complex _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBED1","description":"ICD-CBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/us guide bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45342","description":"Sigmoidoscopy w/us guide bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAE0","description":"ICD-OAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTE1","description":"ICD-ADTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC55","description":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Isoetharine comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7650","description":"Isoetharine comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove & graft wrist lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25136","description":"Remove & graft wrist lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acupunct w/stimul 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97813","description":"Acupunct w/stimul 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise inner eye adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65870","description":"Incise inner eye adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDF0","description":"ICD-NGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Med record copy per page","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9982","description":"Med record copy per page","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC217","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUD0","description":"ICD-OEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGB1","description":"ICD-JCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQC0","description":"ICD-OFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGF0","description":"ICD-OHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIF1","description":"ICD-NDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cataract surgery complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66982","description":"Cataract surgery complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB2B","description":"Very High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDF0","description":"ICD-ACDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHB0","description":"ICD-JDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEB0","description":"ICD-OLEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE230","description":"Special Care High _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD23D","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES360","description":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUF0","description":"ICD-JHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking thighlngth 18-30","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6533","description":"Gc stocking thighlngth 18-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Head And Neck Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1089","description":"Radiation Therapy For Head And Neck Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lever-activated wheel drive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0988","description":"Lever-activated wheel drive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXC1","description":"ICD-BCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATF0","description":"ICD-AATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJF1","description":"ICD-NFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAD1","description":"ICD-CHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4343","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","description":"HCPCS-Q4343","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLD0","description":"ICD-OCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWF0","description":"ICD-CGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWE0","description":"ICD-DGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDND0","description":"ICD-JDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comb art/venous blood tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4755","description":"Comb art/venous blood tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Program intake assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1023","description":"Program intake assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A6519","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","description":"HCPCS-A6519","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comp genet test hyp cardiomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3865","description":"Comp genet test hyp cardiomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXC1","description":"ICD-CEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC43","description":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foam stability fetal lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83662","description":"Foam stability fetal lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPF0","description":"ICD-OKPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1088T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1088T","description":"CPT-1088T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gravlee jet washer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4470","description":"Gravlee jet washer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0590U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","description":"CPT-0590U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRD1","description":"ICD-DBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCB0","description":"ICD-FFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m maa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9540","description":"Tc99m maa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSE0","description":"ICD-CCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj foramen epidural add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64484","description":"Inj foramen epidural add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwr seat recline mech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1004","description":"Pwr seat recline mech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kerecis omega3 marigen shield_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2019","description":"Kerecis omega3 marigen shield_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alveolus open reduction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7671","description":"Alveolus open reduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJA0","description":"ICD-OFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBC0","description":"ICD-KFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQB1","description":"ICD-HCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"I131 tositumomab_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9544","description":"I131 tositumomab_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Embedded ip cath exit-site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49436","description":"Embedded ip cath exit-site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0658U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0658U","description":"CPT-0658U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELD1","description":"ICD-IELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tigecycline injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3243","description":"Tigecycline injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1104T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1104T","description":"CPT-1104T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEC1","description":"ICD-EFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFD1","description":"ICD-KIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIA1","description":"ICD-JEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0601","description":"HCPCS-B0601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTA1","description":"ICD-GFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYA1","description":"ICD-LIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44346","description":"Revision of colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx multi myeloma stage i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9128","description":"Onc dx multi myeloma stage i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABC1","description":"ICD-AABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLD0","description":"ICD-KGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter_ Pressure-Generating_ One-Way Valve_ Intermittently Occlusive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1982","description":"Catheter_ Pressure-Generating_ One-Way Valve_ Intermittently Occlusive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1002","description":"HCPCS-B1002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fna w/o image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10021","description":"Fna w/o image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALD1","description":"ICD-BALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTC0","description":"ICD-MLTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8X","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immed max part dent metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5223","description":"Immed max part dent metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHD1","description":"ICD-BDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCC1","description":"ICD-GCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUE1","description":"ICD-MFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reop req bld grft oth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8577","description":"Reop req bld grft oth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOE0","description":"ICD-HBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJED0","description":"ICD-NJED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDB0","description":"ICD-MBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFA0","description":"ICD-GGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADE1","description":"ICD-EADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXF0","description":"ICD-GBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBF0","description":"ICD-BBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lactoferrin fecal (quant)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83631","description":"Lactoferrin fecal (quant)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1057T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1057T","description":"CPT-1057T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMD0","description":"ICD-FHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEE1","description":"ICD-OCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIE1","description":"ICD-FAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise cornea with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65770","description":"Revise cornea with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"At least two orders for high-risk medications from the same drug class_ (table 4)_ not ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1210","description":"At least two orders for high-risk medications from the same drug class_ (table 4)_ not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXD0","description":"ICD-BHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRB1","description":"ICD-DDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1GA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GA11","description":"ICD-1GA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of bile ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47800","description":"Reconstruction of bile ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNA1","description":"ICD-KHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMD1","description":"ICD-KGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1393","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","description":"HCPCS-M1393","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE10B","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vertebral body tethering_ anterior; up to 7 vertebral segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0656T","description":"Vertebral body tethering_ anterior; up to 7 vertebral segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEC1","description":"ICD-BAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iiv3 vacc no prsv 3 yrs+ im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90656","description":"Iiv3 vacc no prsv 3 yrs+ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVB1","description":"ICD-BDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ promoter methylation profiling by real-time PCR of 3 genes (GSTP1_ APC_ RASSF1)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81551","description":"Oncology (prostate)_ promoter methylation profiling by real-time PCR of 3 genes (GSTP1_ APC_ RASSF1)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Physical medicine procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97139","description":"Physical medicine procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJC0","description":"ICD-FFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXE1","description":"ICD-KAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc sinus ct 28d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9349","description":"Doc sinus ct 28d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGB1","description":"ICD-FDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hla typing a b or c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86812","description":"Hla typing a b or c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNC1","description":"ICD-JGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTD1","description":"ICD-NBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hand tendon reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26502","description":"Hand tendon reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transurethral rf treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53860","description":"Transurethral rf treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX25","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Asp not presc disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9437","description":"Asp not presc disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPE1","description":"ICD-FDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUD0","description":"ICD-ADUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHA1","description":"ICD-OHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Deb musc/fascia 20 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11043","description":"Deb musc/fascia 20 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAE0","description":"ICD-EEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSE1","description":"ICD-GCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRF1","description":"ICD-GDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADE1","description":"ICD-KADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIB1","description":"ICD-MFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDC0","description":"ICD-ODDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVC0","description":"ICD-NKVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mobility d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8980","description":"Mobility d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colon ca screen;barium enema","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0106","description":"Colon ca screen;barium enema","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQF1","description":"ICD-PKQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOA1","description":"ICD-GCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aicd_ dual chamber","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1721","description":"Aicd_ dual chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eeg ordered rvwd reqstd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3650F","description":"Eeg ordered rvwd reqstd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBA1","description":"ICD-KCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (bluepoint) not therapeutically equivalent to j9305_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9322","description":"Injection_ pemetrexed (bluepoint) not therapeutically equivalent to j9305_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37287","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","description":"CPT-37287","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay test for blood fecal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82274","description":"Assay test for blood fecal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGC0","description":"ICD-OGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rev/remvl crtd sns dev total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0269T","description":"Rev/remvl crtd sns dev total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4420","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","description":"HCPCS-Q4420","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEB1","description":"ICD-FCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKA1","description":"ICD-NFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUE0","description":"ICD-FHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB17","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of chest wall respiratory sensor electrode or electrode array","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0468T","description":"Removal of chest wall respiratory sensor electrode or electrode array","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFF1","description":"ICD-GIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lung transplant with bypass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32854","description":"Lung transplant with bypass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE245","description":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bartonella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86611","description":"Bartonella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJA0","description":"ICD-GEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient use of hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9693","description":"Patient use of hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implt/rpl crtd sns dev total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0266T","description":"Implt/rpl crtd sns dev total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suction socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6686","description":"Suction socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test hemidiaphragm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95866","description":"Muscle test hemidiaphragm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laser in situ keratomileusis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0800","description":"Laser in situ keratomileusis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cord blood-derived stem-cell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2142","description":"Cord blood-derived stem-cell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of cyanide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82600","description":"Assay of cyanide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50081","description":"Removal of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reimplant ureter in bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50780","description":"Reimplant ureter in bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Test socket hip disarticulat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5626","description":"Test socket hip disarticulat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disease management program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0315","description":"Disease management program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSD0","description":"ICD-LHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIF0","description":"ICD-KEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHE0","description":"ICD-MKHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen prsmptv 1 class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80302","description":"Drug screen prsmptv 1 class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSF0","description":"ICD-LFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Therapy activation of implanted phrenic nerve stimulator system_ including all interrogation and programming","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93150","description":"Therapy activation of implanted phrenic nerve stimulator system_ including all interrogation and programming","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEB1","description":"ICD-MEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHND0","description":"ICD-GHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANC1","description":"ICD-OANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPA0","description":"ICD-GHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVB0","description":"ICD-NBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18H","description":"Special Care Low _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBE0","description":"ICD-CHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Habil ed waiver per hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2013","description":"Habil ed waiver per hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion_ bamlanivimab_ includes infusion and post administration monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0239","description":"Intravenous infusion_ bamlanivimab_ includes infusion and post administration monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIB0","description":"ICD-JGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWE1","description":"ICD-LIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopy maxillary sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31267","description":"Endoscopy maxillary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0602U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","description":"CPT-0602U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJB1","description":"ICD-JHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Long qt synd known fam var","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81281","description":"Long qt synd known fam var","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE15A","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHE1","description":"ICD-KAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKE1","description":"ICD-BEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Free skin flap microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15757","description":"Free skin flap microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFF0","description":"ICD-GGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYC0","description":"ICD-DIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Positron emission tomography radiopharmaceutical_ diagnostic_ for tumor identification_ not otherwise classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9597","description":"Positron emission tomography radiopharmaceutical_ diagnostic_ for tumor identification_ not otherwise classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"64 lead ecg w/i&r only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0180T","description":"64 lead ecg w/i&r only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWA0","description":"ICD-KIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/o preop order iv ab pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8918","description":"Pt w/o preop order iv ab pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUF1","description":"ICD-FEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18B","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; Unmonitored","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95708","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; Unmonitored","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone harvest_auto graft proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7295","description":"Bone harvest_auto graft proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXD0","description":"ICD-CFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1415","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","description":"HCPCS-M1415","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28X","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D8671","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D8671","description":"CDT-D8671","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chest x-ray special views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71035","description":"Chest x-ray special views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Physical medicine procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97799","description":"Physical medicine procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRD0","description":"ICD-OHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFC0","description":"ICD-BIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQA1","description":"ICD-OGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD144","description":"Clinically Complex _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPC0","description":"ICD-KAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIC1","description":"ICD-AFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Osteopath manj 5-6 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98927","description":"Osteopath manj 5-6 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chromatography_ quantitative_ column (eg_ gas liquid or hplc); multiple analytes_ single stationary and mobile phase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82492","description":"Chromatography_ quantitative_ column (eg_ gas liquid or hplc); multiple analytes_ single stationary and mobile phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYB1","description":"ICD-HEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng leg splnt ped f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4044","description":"Cast sup lng leg splnt ped f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Period O","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2114","description":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Period O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJE0","description":"ICD-KIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRF1","description":"ICD-PBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAF0","description":"ICD-OEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQB1","description":"ICD-DHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD20A","description":"Clinically Complex _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cbc without platelet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0307","description":"Cbc without platelet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Monitor elec or comb vad rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0484","description":"Monitor elec or comb vad rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair hand joint with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26542","description":"Repair hand joint with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUC0","description":"ICD-NKUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYB1","description":"ICD-LEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEE1","description":"ICD-FHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4297","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","description":"HCPCS-A4297","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETE1","description":"ICD-GETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQB0","description":"ICD-PDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYB0","description":"ICD-LFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enteral feed sup kit grav by","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4036","description":"Enteral feed sup kit grav by","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRA1","description":"ICD-HIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAA1","description":"ICD-GBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSE1","description":"ICD-DCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01200","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01200","description":"CPT-01200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt doc no events on discharg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8907","description":"Pt doc no events on discharg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHE0","description":"ICD-GCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBE1","description":"ICD-OBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx pancreatic unknwn nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9108","description":"Onc dx pancreatic unknwn nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67800","description":"Remove eyelid lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB46","description":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSC0","description":"ICD-PBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMC1","description":"ICD-IAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Cranberry Peak_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1008","description":"Clinical Decision Support Mechanism Cranberry Peak_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVB1","description":"ICD-NKVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWC0","description":"ICD-KBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPB1","description":"ICD-JGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFC1","description":"ICD-FDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neurectomy hamstring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27325","description":"Neurectomy hamstring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove femur lesion/fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27358","description":"Remove femur lesion/fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUA0","description":"ICD-EGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home mgmt preterm labor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9208","description":"Home mgmt preterm labor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Neisseria gonorrhoeae","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87850","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Neisseria gonorrhoeae","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFE1","description":"ICD-GAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18C","description":"Clinically Complex _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Arthrodesis_ sacroiliac joint_ percutaneous or minimally invasive (indirect visualization)_ with image guidance_ placement of transfixing device(s) and intra-articular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0809T","description":"Arthrodesis_ sacroiliac joint_ percutaneous or minimally invasive (indirect visualization)_ with image guidance_ placement of transfixing device(s) and intra-articular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHA0","description":"ICD-GEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWC1","description":"ICD-CEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAD0","description":"ICD-EFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHC0","description":"ICD-BGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect radius tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24152","description":"Resect radius tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92638","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","description":"CPT-92638","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Re-evalest ptproblem focus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0170","description":"Re-evalest ptproblem focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ped size brief/diaper lg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4530","description":"Ped size brief/diaper lg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKF0","description":"ICD-NDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1006T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","description":"CPT-1006T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABD0","description":"ICD-IABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4IC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IC31","description":"ICD-4IC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert eye socket implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67550","description":"Insert eye socket implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialysate solution_ non-dex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4728","description":"Dialysate solution_ non-dex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; osteoarticular_ including articular surface and contiguous bone (List separately in a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20932","description":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; osteoarticular_ including articular surface and contiguous bone (List separately in a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXF1","description":"ICD-OBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERD1","description":"ICD-GERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUB1","description":"ICD-OBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIA1","description":"ICD-JFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBME0","description":"ICD-CBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPF0","description":"ICD-CEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDB1","description":"ICD-MCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLA0","description":"ICD-BCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2FB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FB31","description":"ICD-2FB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair spec size w foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1223","description":"Wheelchair spec size w foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Terbutaline sulf comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7680","description":"Terbutaline sulf comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA112","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pectin based ostomy paste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4406","description":"Pectin based ostomy paste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHB0","description":"ICD-OHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pediatric Patient With Minor Blunt Head Trauma And Pecarn Prediction Criteria Are Not Assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0047","description":"Pediatric Patient With Minor Blunt Head Trauma And Pecarn Prediction Criteria Are Not Assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lacosamide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80235","description":"Lacosamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB3A","description":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of kidney wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50500","description":"Repair of kidney wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01472","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01472","description":"CPT-01472","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUE0","description":"ICD-NKUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIB1","description":"ICD-OKIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/control bleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45382","description":"Colonoscopy w/control bleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKE1","description":"ICD-OFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCE0","description":"ICD-OJCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0936T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","description":"CPT-0936T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLC1","description":"ICD-IBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC01","description":"High Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFA1","description":"ICD-BBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOA0","description":"ICD-PDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCD1","description":"ICD-KGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEB1","description":"ICD-KHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aicd_ single chamber","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1722","description":"Aicd_ single chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKE1","description":"ICD-GIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWD1","description":"ICD-LIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBF0","description":"ICD-KDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Evaluation heart device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93640","description":"Evaluation heart device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJF0","description":"ICD-BDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fistula cannulation set_ ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4730","description":"Fistula cannulation set_ ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWF1","description":"ICD-ODWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIF0","description":"ICD-JEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 3RD DOSE PFIZER","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0003A","description":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 3RD DOSE PFIZER","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILD0","description":"ICD-FILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCB1","description":"ICD-OJCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHB1","description":"ICD-MHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration for testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54560","description":"Exploration for testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRA0","description":"ICD-DCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOB1","description":"ICD-KGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40800","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"All inclusive payment for services related to highly coordinated and integrated opioid use disorder (oud) treatment services furnished for the demonstration project","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2172","description":"All inclusive payment for services related to highly coordinated and integrated opioid use disorder (oud) treatment services furnished for the demonstration project","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYF0","description":"ICD-LIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUB0","description":"ICD-ODUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Legion pneumophilia ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87278","description":"Legion pneumophilia ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of major vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37650","description":"Revision of major vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVE1","description":"ICD-GCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXA1","description":"ICD-JAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYA1","description":"ICD-HBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLA1","description":"ICD-NLLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"NFCT DS BCT/VIR RESPIR DNA/RNA 22 TRGT SARSCOV2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0202U","description":"NFCT DS BCT/VIR RESPIR DNA/RNA 22 TRGT SARSCOV2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ko single upright pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0901","description":"Ko single upright pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGA1","description":"ICD-NIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ common and select rare variants (ie_ *2_ *3_ *4_ *4N_ *5_ *6_ *7_ *8_ *9_ *","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0070U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ common and select rare variants (ie_ *2_ *3_ *4_ *4N_ *5_ *6_ *7_ *8_ *9_ *","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCB0","description":"ICD-JHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTA1","description":"ICD-NCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exhaled breath condensate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83987","description":"Exhaled breath condensate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pouch clsd w barr attached","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5051","description":"Pouch clsd w barr attached","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRB0","description":"ICD-GFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIA1","description":"ICD-NDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat elbow fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24635","description":"Treat elbow fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pressure treatment esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43460","description":"Pressure treatment esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRF0","description":"ICD-KIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ secukinumab_ intravenous_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9166","description":"Injection_ secukinumab_ intravenous_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of leg infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73592","description":"X-ray exam of leg infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRE0","description":"ICD-CFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"2+ anti-hyprtnsv agents tkn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4145F","description":"2+ anti-hyprtnsv agents tkn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear rx intracav admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79200","description":"Nuclear rx intracav admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRB0","description":"ICD-CBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE213","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft axill-femoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35521","description":"Art byp grft axill-femoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJE0","description":"ICD-GAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB14","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLA1","description":"ICD-KCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIF0","description":"ICD-JCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIB1","description":"ICD-AEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKF1","description":"ICD-BHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCED1","description":"ICD-BCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMB0","description":"ICD-ECMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sotrovimab_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0247","description":"Injection_ sotrovimab_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJE1","description":"ICD-OHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01340","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01340","description":"CPT-01340","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALB1","description":"ICD-BALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILE0","description":"ICD-OILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise sublingual gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42450","description":"Excise sublingual gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBC1","description":"ICD-CGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD244","description":"Special Care Low _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup body cast fiberglas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4002","description":"Cast sup body cast fiberglas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWC1","description":"ICD-GEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBF1","description":"ICD-MFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRB0","description":"ICD-DBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPC0","description":"ICD-NKPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epoetin alfa_ 100 units esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4081","description":"Epoetin alfa_ 100 units esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVB1","description":"ICD-JIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB246","description":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYE1","description":"ICD-DCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJC1","description":"ICD-BEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHID1","description":"ICD-GHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAC1","description":"ICD-EDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE246","description":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2290","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2290","description":"HCPCS-J2290","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC51","description":"High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNE1","description":"ICD-BBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHB0","description":"ICD-KGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cesarean delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59515","description":"Cesarean delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKC1","description":"ICD-NLKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBA1","description":"ICD-NGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth lumbar puncture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63551","description":"Anesth lumbar puncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion/graft of elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24802","description":"Fusion/graft of elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bridge porcelain high noble","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6240","description":"Bridge porcelain high noble","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWC0","description":"ICD-CHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCB1","description":"ICD-NGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inpatient consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99254","description":"Inpatient consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATC1","description":"ICD-NATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Test for blood flow in graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15860","description":"Test for blood flow in graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transfusion service fetal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36460","description":"Transfusion service fetal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUC1","description":"ICD-OLUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC3C","description":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tissue culture bone marrow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88237","description":"Tissue culture bone marrow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAF0","description":"ICD-NGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGED1","description":"ICD-EGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAF1","description":"ICD-NIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGE0","description":"ICD-GDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Position back cush wd <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2613","description":"Position back cush wd <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy ring each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4404","description":"Ostomy ring each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAD0","description":"ICD-ACAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of complications","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9930","description":"Treatment of complications","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMA1","description":"ICD-BGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dyspnea scrnd no-mild dysp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3450F","description":"Dyspnea scrnd no-mild dysp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC20A","description":"Special Care Low _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKC0","description":"ICD-NCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL16","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA0D","description":"Very High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA3C","description":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQA0","description":"ICD-HFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWA0","description":"ICD-DIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDA1","description":"ICD-JIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVA0","description":"ICD-CFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Back school visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9117","description":"Back school visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain bag/bottle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4911","description":"Drain bag/bottle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFC0","description":"ICD-CCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1004","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1004","description":"CDT-D1004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXA0","description":"ICD-BFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESE0","description":"ICD-KESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct hrt w/3d image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75572","description":"Ct hrt w/3d image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTC0","description":"ICD-IHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQA1","description":"ICD-HAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No tob assess or cess inter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9460","description":"No tob assess or cess inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBF0","description":"ICD-MDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj trigger point 1/2 muscl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20552","description":"Inj trigger point 1/2 muscl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKD1","description":"ICD-NEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"I131 iodobenguate_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9508","description":"I131 iodobenguate_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Arformoterol non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7605","description":"Arformoterol non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACD1","description":"ICD-GACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUF0","description":"ICD-KGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTF1","description":"ICD-MKTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMC1","description":"ICD-CIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52332","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYD1","description":"ICD-DBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYB0","description":"ICD-DFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHA0","description":"ICD-BAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAC1","description":"ICD-KFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AC31","description":"ICD-3AC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nose lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30124","description":"Removal of nose lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJE1","description":"ICD-OAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-rays bone survey complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77075","description":"X-rays bone survey complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIF0","description":"ICD-BIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOD0","description":"ICD-OLOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB246","description":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWB1","description":"ICD-PDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAND0","description":"ICD-NAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Limited (30 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiaryā€™s h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2007","description":"Limited (30 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiaryā€™s h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBF0","description":"ICD-MFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1004","description":"HCPCS-A1004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcyl bifo 7.25-12/4.2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2213","description":"Lens sphcyl bifo 7.25-12/4.2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAD0","description":"ICD-MLAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prolong clincl staff svc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99415","description":"Prolong clincl staff svc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Triamcinolone hexacetonl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3303","description":"Triamcinolone hexacetonl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antibody_ Treponema pallidum_ total and rapid plasma reagin (RPR)_ immunoassay_ qualitativ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0064U","description":"Antibody_ Treponema pallidum_ total and rapid plasma reagin (RPR)_ immunoassay_ qualitativ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFF0","description":"ICD-CFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAC0","description":"ICD-NFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44125","description":"Removal of small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of fetal heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76828","description":"Echo exam of fetal heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVD0","description":"ICD-NJVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ob us follow-up per fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76816","description":"Ob us follow-up per fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA1B","description":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Icut allergy titrate-airborn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95027","description":"Icut allergy titrate-airborn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI neck spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72156","description":"MRI neck spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUC0","description":"ICD-IEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo cholecystoenterostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47570","description":"Laparo cholecystoenterostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mammo assess bengn docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3342F","description":"Mammo assess bengn docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI brain stem w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70553","description":"MRI brain stem w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefepime hydrochloride (baxter)_ not therapeutically equivalent to maxipime_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0701","description":"Injection_ cefepime hydrochloride (baxter)_ not therapeutically equivalent to maxipime_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAC0","description":"ICD-AAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lwr xtr vasc stdy bilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93924","description":"Lwr xtr vasc stdy bilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMF1","description":"ICD-MBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLB0","description":"ICD-BHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBD1","description":"ICD-OHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD131","description":"Special Care Low _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Death did not occur during the index acute care hospitalization","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9815","description":"Death did not occur during the index acute care hospitalization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEC0","description":"ICD-BHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (ovarian) biochemical assays of five proteins (apolipoprotein A-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0108U","description":"Oncology (ovarian) biochemical assays of five proteins (apolipoprotein A-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE105","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC40","description":"Medium Rehab _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophageal recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93615","description":"Esophageal recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Encephaltis west eqne antbdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86654","description":"Encephaltis west eqne antbdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD120","description":"Clinically Complex _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mrs disc pain alg alys data","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0611T","description":"Mrs disc pain alg alys data","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBD1","description":"ICD-NDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIF0","description":"ICD-OHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCA0","description":"ICD-GHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA25","description":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOF1","description":"ICD-PIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ald transmitter microphone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5290","description":"Ald transmitter microphone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mild-mod dep symp by deptool","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3353F","description":"Mild-mod dep symp by deptool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of mastoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70130","description":"X-ray exam of mastoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6035","description":"Gold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEC0","description":"ICD-BCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ triluron_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7332","description":"Hyaluronan or derivative_ triluron_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEA0","description":"ICD-GGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIE1","description":"ICD-NJIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOC1","description":"ICD-GHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Musculoskeletal nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78399","description":"Musculoskeletal nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVE0","description":"ICD-JAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUC1","description":"ICD-EFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGD0","description":"ICD-FDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foot_ adductus positioning device_ adjustable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3161","description":"Foot_ adductus positioning device_ adjustable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"teledentistry - asynchronous; information stored and forwarded to dentist for subse","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9996","description":"teledentistry - asynchronous; information stored and forwarded to dentist for subse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replc tth&acrlc mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5671","description":"Replc tth&acrlc mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD254","description":"Clinically Complex _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLF1","description":"ICD-GDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSC0","description":"ICD-GFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB25B","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUE1","description":"ICD-OKUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPF1","description":"ICD-CAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX21","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHD1","description":"ICD-IEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAD1","description":"ICD-BAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVD1","description":"ICD-OAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breast tomosynthesis bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77062","description":"Breast tomosynthesis bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXC0","description":"ICD-ODXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILF0","description":"ICD-FILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (pan-cancer)_ analysis of minimal residual disease (MRD) from plasma_ with assays personalized to each patient based on prior next-generation sequencing of the patien","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0340U","description":"Oncology (pan-cancer)_ analysis of minimal residual disease (MRD) from plasma_ with assays personalized to each patient based on prior next-generation sequencing of the patien","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML2A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNA1","description":"ICD-NGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3EC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EC11","description":"ICD-3EC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disposable male external cat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4349","description":"Disposable male external cat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYB0","description":"ICD-HAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC151","description":"Special Care High _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Instillation_ hexaminolevulinate hydrochloride_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9589","description":"Instillation_ hexaminolevulinate hydrochloride_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98004","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","description":"CPT-98004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCA0","description":"ICD-BBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQD1","description":"ICD-OJQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIF1","description":"ICD-GGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYA0","description":"ICD-CIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCB1","description":"ICD-NHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIE1","description":"ICD-JFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bk imaging tst not ordered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3331F","description":"Bk imaging tst not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHA1","description":"ICD-IBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEE0","description":"ICD-GEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFE0","description":"ICD-JGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEED0","description":"ICD-MEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMC1","description":"ICD-AFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Absorpt drg <=16 sq in w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6251","description":"Absorpt drg <=16 sq in w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sitz bath/equipment w/faucet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0161","description":"Sitz bath/equipment w/faucet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKA1","description":"ICD-GDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"2d tte w or w/o fol w/con_fu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8924","description":"2d tte w or w/o fol w/con_fu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQE1","description":"ICD-GCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mopath procedure level 9","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81408","description":"Mopath procedure level 9","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEA1","description":"ICD-GBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCF0","description":"ICD-JCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOC1","description":"ICD-OAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEB1","description":"ICD-NJEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Retrograde filling","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3430","description":"Retrograde filling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBD0","description":"ICD-CIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEE0","description":"ICD-GBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALB0","description":"ICD-IALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRD1","description":"ICD-KDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYC0","description":"ICD-GCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27810","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28124","description":"Partial removal of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of salivary stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42340","description":"Removal of salivary stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC26","description":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ belantamab mafodontin-blmf_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9069","description":"Injection_ belantamab mafodontin-blmf_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAC1","description":"ICD-BFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQF1","description":"ICD-CEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFD0","description":"ICD-JAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES151","description":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADA0","description":"ICD-EADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOA1","description":"ICD-CFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPA0","description":"ICD-JFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCE0","description":"ICD-CDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC11","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENF0","description":"ICD-KENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reimplant ureter in bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50782","description":"Reimplant ureter in bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUB0","description":"ICD-BGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX26","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEC0","description":"ICD-AHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICD1","description":"ICD-EICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tenecteplase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3101","description":"Tenecteplase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQB1","description":"ICD-CHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prednisolone acetate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2650","description":"Prednisolone acetate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJD1","description":"ICD-OBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0562U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","description":"CPT-0562U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2GB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GB31","description":"ICD-2GB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76498","description":"MRI procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYE0","description":"ICD-CGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE240","description":"Reduced Physical Function _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKE1","description":"ICD-KIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"External radiation dosimetry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77399","description":"External radiation dosimetry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAD1","description":"ICD-CAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28G","description":"Special Care High _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEB1","description":"ICD-EIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0514U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","description":"CPT-0514U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIC1","description":"ICD-ADIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4410","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","description":"HCPCS-Q4410","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVD0","description":"ICD-CFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGA1","description":"ICD-KFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX5A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tympanostomy (Requiring Insertion Of Ventilating Tube)_ Using An Automated Tube Delivery System_ Iontophoresis Local Anesthesia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0583T","description":"Tympanostomy (Requiring Insertion Of Ventilating Tube)_ Using An Automated Tube Delivery System_ Iontophoresis Local Anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDF0","description":"ICD-OHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1192","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOD0","description":"ICD-GFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTE0","description":"ICD-GHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo ligate spermatic vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55550","description":"Laparo ligate spermatic vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDC1","description":"ICD-IIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB24","description":"High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAF1","description":"ICD-CBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYB1","description":"ICD-LDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSD0","description":"ICD-LGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration_ including lead placement and removal_ upper extremity_ minimum of 10 minut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0883T","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration_ including lead placement and removal_ upper extremity_ minimum of 10 minut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise lower leg tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27691","description":"Revise lower leg tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49321","description":"Laparoscopy biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinician Documented That Patient Was Not An Eligible Candidate For Autogenous AV Fistula","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8531","description":"Clinician Documented That Patient Was Not An Eligible Candidate For Autogenous AV Fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDC1","description":"ICD-OGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc biliary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47579","description":"Laparoscope proc biliary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES34A","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL3B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ewho rigid w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3763","description":"Ewho rigid w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Recement supp part denture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6093","description":"Recement supp part denture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRA0","description":"ICD-PGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDF0","description":"ICD-MIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3CB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CB21","description":"ICD-3CB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection ferric pyrophosphate citrate solution 0.1 mg iron","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9976","description":"Injection ferric pyrophosphate citrate solution 0.1 mg iron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEB1","description":"ICD-KIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Srs spinal lesion addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63621","description":"Srs spinal lesion addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18X","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATD0","description":"ICD-OATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4GC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GC11","description":"ICD-4GC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Pembrolizumab_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9027","description":"Injection_ Pembrolizumab_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Needle Insertion(S) Without Injection(S); 3 Or More Muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20561","description":"Needle Insertion(S) Without Injection(S); 3 Or More Muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL54","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPD0","description":"ICD-OKPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCE1","description":"ICD-MHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHF1","description":"ICD-FIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWA0","description":"ICD-GGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEA0","description":"ICD-NFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUA0","description":"ICD-KFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert levonorgestrel ius","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4981","description":"Insert levonorgestrel ius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"XK GNOTYP XK EXONS 1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0200U","description":"XK GNOTYP XK EXONS 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWB0","description":"ICD-DBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ocular photodynamic ther","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67221","description":"Ocular photodynamic ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parathyroid planar imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78070","description":"Parathyroid planar imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGF0","description":"ICD-JDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psytx pt&/fam w/e&m 60 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90838","description":"Psytx pt&/fam w/e&m 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of jaw nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64738","description":"Incision of jaw nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIC0","description":"ICD-GGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEA1","description":"ICD-AAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0925T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","description":"CPT-0925T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foot foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28192","description":"Removal of foot foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA221","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPC1","description":"ICD-BAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01930","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01930","description":"CPT-01930","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0642U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0642U","description":"CPT-0642U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCND0","description":"ICD-FCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic caster tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2384","description":"Pneumatic caster tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cabg vein five","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33514","description":"Cabg vein five","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFB0","description":"ICD-KEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elastic garment/covering","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4466","description":"Elastic garment/covering","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended-release (brixadi)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0576","description":"Injection_ buprenorphine extended-release (brixadi)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed semi-electr w/ matt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0260","description":"Hosp bed semi-electr w/ matt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOC0","description":"ICD-DIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEE0","description":"ICD-AFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRF1","description":"ICD-HBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26060","description":"Incision of finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAA0","description":"ICD-FDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGA1","description":"ICD-KAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr s/n/ax/gen/trnk 2.5cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12001","description":"Rpr s/n/ax/gen/trnk 2.5cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAC1","description":"ICD-CGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBA1","description":"ICD-KDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis_ copy number variants and microsatellite instability","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81458","description":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis_ copy number variants and microsatellite instability","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth low intestine scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81051","description":"Anesth low intestine scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVF1","description":"ICD-CIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPC0","description":"ICD-NHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOC1","description":"ICD-ODOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23515","description":"Treat clavicle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOA0","description":"ICD-KCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KA31","description":"ICD-2KA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLA1","description":"ICD-FHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPF0","description":"ICD-CHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIC1","description":"ICD-JAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLD1","description":"ICD-AGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDA0","description":"ICD-GIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDF1","description":"ICD-NGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAD0","description":"ICD-AHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28225","description":"Release of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC230","description":"Reduced Physical Function _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANB1","description":"ICD-FANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKE1","description":"ICD-KDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECD0","description":"ICD-IECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKF1","description":"ICD-BFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Collagen gel/paste wound fil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6011","description":"Collagen gel/paste wound fil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intra-atrial recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93602","description":"Intra-atrial recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prior history of known cvd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1256","description":"Prior history of known cvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Upper arm/elbow surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24999","description":"Upper arm/elbow surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Legg perthes orth newington","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1710","description":"Legg perthes orth newington","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFD1","description":"ICD-NFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eeg all night recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95827","description":"Eeg all night recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHC1","description":"ICD-EFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6071","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of major vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37660","description":"Revision of major vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEE1","description":"ICD-CHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHA1","description":"ICD-OLHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation Device Evaluation (In Person) Of Implantable Cardioverter-Defibrillator System With Substernal Electrode_ With Analysis_ Review And Report By A Physician Or Othe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0576T","description":"Interrogation Device Evaluation (In Person) Of Implantable Cardioverter-Defibrillator System With Substernal Electrode_ With Analysis_ Review And Report By A Physician Or Othe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Azithromycin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0456","description":"Azithromycin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo radical nephrectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50545","description":"Laparo radical nephrectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic seq analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81455","description":"Targeted genomic seq analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLB1","description":"ICD-AHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Red blood cell antigen typing_ DNA_ human erythrocyte antigen gene analysis of 35 antigens from 11 blood groups_ utilizing whole blood_ common RBC alleles reported","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0001U","description":"Red blood cell antigen typing_ DNA_ human erythrocyte antigen gene analysis of 35 antigens from 11 blood groups_ utilizing whole blood_ common RBC alleles reported","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQF1","description":"ICD-HAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD113","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMB1","description":"ICD-OHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTE1","description":"ICD-BBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (genetic bleeding disorders)_ genomic sequence analysis of 51 genes_ blood_ buccal swab_ or amniotic fluid_ comprehensive (Versitiā„¢ Comprehensive Bleeding Disorder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0272U","description":"Hematology (genetic bleeding disorders)_ genomic sequence analysis of 51 genes_ blood_ buccal swab_ or amniotic fluid_ comprehensive (Versitiā„¢ Comprehensive Bleeding Disorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIE1","description":"ICD-IHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69550","description":"Remove ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQD1","description":"ICD-PDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of uvula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42140","description":"Excision of uvula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCB0","description":"ICD-FGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of thyroid activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84442","description":"Assay of thyroid activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37788","description":"Revascularization penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPE1","description":"ICD-KEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28H","description":"Clinically Complex _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQB1","description":"ICD-OHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMB1","description":"ICD-CEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Betadine/iodine swabs/wipes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4247","description":"Betadine/iodine swabs/wipes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hla ii typing 1 allele hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81383","description":"Hla ii typing 1 allele hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0488U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","description":"CPT-0488U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJA1","description":"ICD-NAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HB21","description":"ICD-4HB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMA1","description":"ICD-NGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18E","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEE1","description":"ICD-GBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC21A","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare sh","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA16","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare sh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCC1","description":"ICD-CHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQF0","description":"ICD-LIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICE0","description":"ICD-OICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chloroprocaine hcl ophthalmic_ 3% gel_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2403","description":"Chloroprocaine hcl ophthalmic_ 3% gel_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay c-d transfer measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82373","description":"Assay c-d transfer measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAF1","description":"ICD-NCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQB0","description":"ICD-HAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Meg spontaneous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95965","description":"Meg spontaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy revise stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31638","description":"Bronchoscopy revise stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMD0","description":"ICD-OAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX2D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISD1","description":"ICD-GISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBND0","description":"ICD-FBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGB0","description":"ICD-KHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hgb >= 10 g/dl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8976","description":"Hgb >= 10 g/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHD0","description":"ICD-CIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFID1","description":"ICD-BFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMF0","description":"ICD-GDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAC0","description":"ICD-FIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAA1","description":"ICD-AAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATF1","description":"ICD-EATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; duplication/deletion variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81269","description":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; duplication/deletion variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOC0","description":"ICD-DFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYF1","description":"ICD-PLYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Visc & infraren abd 1 prosth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34845","description":"Visc & infraren abd 1 prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"School-based iep ser bundled","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1018","description":"School-based iep ser bundled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAE1","description":"ICD-IGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXA1","description":"ICD-JIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0961T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","description":"CPT-0961T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCF1","description":"ICD-EFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAD1","description":"ICD-OGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKF0","description":"ICD-FCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilate urethra stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53620","description":"Dilate urethra stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHC1","description":"ICD-MKHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hot/cold h2obot/cap/col/wrap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9273","description":"Hot/cold h2obot/cap/col/wrap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney & ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50236","description":"Removal of kidney & ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agents (sexually transmitted infection)_ Chlamydia trachomatis_ Neisseria gonorrhoeae_ and Trichomonas vaginalis_ multiplex amplified probe technique_ vaginal_ endo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0455U","description":"Infectious agents (sexually transmitted infection)_ Chlamydia trachomatis_ Neisseria gonorrhoeae_ and Trichomonas vaginalis_ multiplex amplified probe technique_ vaginal_ endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHF1","description":"ICD-IIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXE0","description":"ICD-NGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonic lavage_ 35 or more liters of water_ gravity-fed_ with induced defecation_ including insertion of rectal catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0736T","description":"Colonic lavage_ 35 or more liters of water_ gravity-fed_ with induced defecation_ including insertion of rectal catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUD1","description":"ICD-OKUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAD0","description":"ICD-CIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5168","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5168","description":"HCPCS-Q5168","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tracheal suction tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4624","description":"Tracheal suction tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCA1","description":"ICD-CHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of myoglobin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83874","description":"Assay of myoglobin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGC0","description":"ICD-JEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIA0","description":"ICD-ADIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTA0","description":"ICD-GCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAB0","description":"ICD-GBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove in/ex hem grps & fiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46261","description":"Remove in/ex hem grps & fiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB135","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45349","description":"Sigmoidoscopy w/resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJF1","description":"ICD-BGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALF0","description":"ICD-BALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cocaine hydrochloride nasal solution (numbrino)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9143","description":"Cocaine hydrochloride nasal solution (numbrino)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIF0","description":"ICD-OAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC17","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTC0","description":"ICD-KFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert drug implant device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11981","description":"Insert drug implant device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc of tobacco user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9276","description":"Doc of tobacco user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMC0","description":"ICD-JGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ ep_ 20 or more elec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1731","description":"Cath_ ep_ 20 or more elec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contour seat for ped size wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2294","description":"Contour seat for ped size wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECME0","description":"ICD-ECME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJE1","description":"ICD-CHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQD1","description":"ICD-OAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYD1","description":"ICD-GAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBE1","description":"ICD-NIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair gum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41872","description":"Repair gum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKA0","description":"ICD-OGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of ovarian cyst(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58800","description":"Drainage of ovarian cyst(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGF1","description":"ICD-OFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPC0","description":"ICD-FEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Scr c/v cyto_thinlayer_rescr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0144","description":"Scr c/v cyto_thinlayer_rescr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Collagen based wound filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6010","description":"Collagen based wound filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGE1","description":"ICD-CAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic anoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46601","description":"Diagnostic anoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIC0","description":"ICD-ADIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compre dental tx transition","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8070","description":"Compre dental tx transition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2GA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GA21","description":"ICD-2GA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo cholecystectomy/graph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47563","description":"Laparo cholecystectomy/graph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIB1","description":"ICD-BAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJF0","description":"ICD-OAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for consultation_ comprehensive_ with review of records and specimens_ with report on referred material (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0840T","description":"Digitization of glass microscope slides for consultation_ comprehensive_ with review of records and specimens_ with report on referred material (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of kidney lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74470","description":"X-ray exam of kidney lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wound warming wound cover","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6000","description":"Wound warming wound cover","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYE1","description":"ICD-KCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTD0","description":"ICD-MCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC36","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBA0","description":"ICD-KIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE213","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40650","description":"Repair lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJD0","description":"ICD-NEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXB1","description":"ICD-GFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc expectant management pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9053","description":"Onc expectant management pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSE0","description":"ICD-PHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANE0","description":"ICD-FANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJID0","description":"ICD-NJID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMA1","description":"ICD-EEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Motion test w/ft press meas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96001","description":"Motion test w/ft press meas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFD1","description":"ICD-BGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYB0","description":"ICD-OGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB32","description":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anthrax vaccine sc or im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90581","description":"Anthrax vaccine sc or im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBE0","description":"ICD-BIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ONC MRNA 5 genes alg risk recr urothelial cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0013M","description":"ONC MRNA 5 genes alg risk recr urothelial cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBD0","description":"ICD-MKBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXA1","description":"ICD-KEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mastoid surgery revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69603","description":"Mastoid surgery revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYD0","description":"ICD-OEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQE1","description":"ICD-DDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploratory heart surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33310","description":"Exploratory heart surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX5C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD156","description":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBC1","description":"ICD-MJBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUE0","description":"ICD-OFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCA1","description":"ICD-NGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 4 genotyping (HPA-4)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa]_ antigen CD61 [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ pos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81108","description":"Human Platelet Antigen 4 genotyping (HPA-4)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa]_ antigen CD61 [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ pos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOF0","description":"ICD-HHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ battery status_ electrode selectability and polarity_ impedanc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95978","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ battery status_ electrode selectability and polarity_ impedanc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB4D","description":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEB1","description":"ICD-ICEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBB1","description":"ICD-AIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX31","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAE1","description":"ICD-EAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVB1","description":"ICD-OGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54435","description":"Revision of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAB0","description":"ICD-FAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE151","description":"Special Care High _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPE0","description":"ICD-FAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD260","description":"Special Care High _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATC1","description":"ICD-IATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLA1","description":"ICD-FBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2032","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","description":"HCPCS-A2032","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE14B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKA1","description":"ICD-CIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Varicella-zoster antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86787","description":"Varicella-zoster antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rubeola ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87283","description":"Rubeola ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOE1","description":"ICD-LGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIE1","description":"ICD-CDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDA0","description":"ICD-ICDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise head/neck of femur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27179","description":"Revise head/neck of femur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood fungus culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87103","description":"Blood fungus culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGE0","description":"ICD-BGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUA0","description":"ICD-BEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0555U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","description":"CPT-0555U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neuromend nerve wrap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9361","description":"Neuromend nerve wrap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBF0","description":"ICD-EEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPF1","description":"ICD-GIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRC0","description":"ICD-KGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prep ak ischial laminated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5590","description":"Prep ak ischial laminated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray male genital tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74440","description":"X-ray male genital tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKA0","description":"ICD-KCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWE1","description":"ICD-GHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Human ig sc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90284","description":"Human ig sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHE1","description":"ICD-IGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGB0","description":"ICD-OFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Smoker/exposed 2nd hnd smoke","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1032F","description":"Smoker/exposed 2nd hnd smoke","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRB0","description":"ICD-LDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABA1","description":"ICD-BABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1372","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","description":"HCPCS-M1372","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYA1","description":"ICD-HAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOE1","description":"ICD-HBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDA1","description":"ICD-JDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24363","description":"Replace elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSB0","description":"ICD-OJSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCF0","description":"ICD-CCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cefepime hcl for injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0692","description":"Cefepime hcl for injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB1C","description":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE144","description":"Special Care Low _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16372","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16372","description":"CPT-16372","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1073T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1073T","description":"CPT-1073T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAC0","description":"ICD-AIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGE0","description":"ICD-BFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cabg meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8497","description":"Cabg meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce eye wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67250","description":"Reinforce eye wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADC1","description":"ICD-KADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXB0","description":"ICD-NHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"1x scrn hcv infect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9451","description":"1x scrn hcv infect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL5C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSD0","description":"ICD-ODSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Palliative Care Services Used By Patient Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9992","description":"Palliative Care Services Used By Patient Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAD1","description":"ICD-KDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cult skin grft f/n/hfg add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15156","description":"Cult skin grft f/n/hfg add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTF1","description":"ICD-CCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00830","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00830","description":"CPT-00830","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVA1","description":"ICD-NJVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFC1","description":"ICD-CEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAB1","description":"ICD-OBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUE1","description":"ICD-OBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ra disease activity mod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3471F","description":"Ra disease activity mod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of lrh hormone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83727","description":"Assay of lrh hormone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pegaspargase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9266","description":"Pegaspargase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home visit new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99343","description":"Home visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKF0","description":"ICD-NGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB240","description":"Special Care Low _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBC1","description":"ICD-BBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML5C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise/drain tear sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68420","description":"Incise/drain tear sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCF0","description":"ICD-KHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDA1","description":"ICD-NEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1318","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95718","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGE1","description":"ICD-NFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67902","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKD0","description":"ICD-JEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFD0","description":"ICD-KHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKA1","description":"ICD-KCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXC1","description":"ICD-GCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWA1","description":"ICD-KHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abrasion lesion single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15786","description":"Abrasion lesion single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diazoxide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1730","description":"Diazoxide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIE1","description":"ICD-IIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGC0","description":"ICD-FGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJB0","description":"ICD-OFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ear mold/insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5264","description":"Ear mold/insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBE0","description":"ICD-BCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Qty act diab retin mg perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9672","description":"Qty act diab retin mg perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQE0","description":"ICD-DBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIC1","description":"ICD-FCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ver doc hear loss","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8565","description":"Ver doc hear loss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOC0","description":"ICD-LFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tumor imaging whole body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78804","description":"Tumor imaging whole body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYB1","description":"ICD-KGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBE0","description":"ICD-OKBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prehensile actuator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7040","description":"Prehensile actuator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fecal bilirubin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82252","description":"Fecal bilirubin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTB1","description":"ICD-MFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJD1","description":"ICD-NIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ toripalimab-tpzi_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3263","description":"Injection_ toripalimab-tpzi_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLD0","description":"ICD-ADLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replcmnt breastpump lok ring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4286","description":"Replcmnt breastpump lok ring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOC0","description":"ICD-OGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJE0","description":"ICD-BGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVD1","description":"ICD-GHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAB1","description":"ICD-EDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUD1","description":"ICD-FHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A6548","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","description":"HCPCS-A6548","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insulin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1815","description":"Insulin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMC0","description":"ICD-EHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLE0","description":"ICD-MLLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUB1","description":"ICD-BAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23174","description":"Remove humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mucormycosis antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86732","description":"Mucormycosis antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of lipoprotein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83718","description":"Assay of lipoprotein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCF1","description":"ICD-ECCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Axolotl DualGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4332","description":"Axolotl DualGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special stains group 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88313","description":"Special stains group 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOA0","description":"ICD-GGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEF0","description":"ICD-GCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTB0","description":"ICD-OCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1058T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1058T","description":"CPT-1058T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cerliponase alfa_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0567","description":"Injection_ cerliponase alfa_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMD0","description":"ICD-JEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30462","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESF1","description":"ICD-HESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWD0","description":"ICD-DFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLA0","description":"ICD-FHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPD1","description":"ICD-JDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEB0","description":"ICD-KGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00211","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00211","description":"CPT-00211","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOD1","description":"ICD-PFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAA1","description":"ICD-AHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Second stage implant surgery","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6011","description":"Second stage implant surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGF0","description":"ICD-CAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESD1","description":"ICD-HESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSA0","description":"ICD-DDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33953","description":"Ecmo/ecls insj prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBF0","description":"ICD-CDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITA0","description":"ICD-CITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXE1","description":"ICD-NJXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66720","description":"Destruction ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQB1","description":"ICD-GBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEC1","description":"ICD-NCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBA0","description":"ICD-ABBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVC1","description":"ICD-KGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKD0","description":"ICD-NFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc esoph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43289","description":"Laparoscope proc esoph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGC0","description":"ICD-NFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure)_ in the office or other outpatient setting requiring direct patient contact beyond t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0514","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure)_ in the office or other outpatient setting requiring direct patient contact beyond t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEF0","description":"ICD-MDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQB1","description":"ICD-KEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pre-op service lvrs complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0302","description":"Pre-op service lvrs complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQE1","description":"ICD-HAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65286","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rerepair ing hernia reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49520","description":"Rerepair ing hernia reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDD1","description":"ICD-OJDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Attendant Care Services_ per 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1793","description":"Attendant Care Services_ per 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL23","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1299","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","description":"HCPCS-J1299","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient received active chemotherapy any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1156","description":"Patient received active chemotherapy any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTF0","description":"ICD-EHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97710","description":"","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Whfo w/joint(s) custom fab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3806","description":"Whfo w/joint(s) custom fab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adult day care per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5102","description":"Adult day care per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKE1","description":"ICD-ODKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4432","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","description":"HCPCS-Q4432","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAF1","description":"ICD-FHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Human papillomavirus (HPV)_ high-risk types (ie_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 51_ 52_ 56_ 58_ 59_ 66_ 68)_ male urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0096U","description":"Human papillomavirus (HPV)_ high-risk types (ie_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 51_ 52_ 56_ 58_ 59_ 66_ 68)_ male urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTC0","description":"ICD-ADTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Corticorelin ovine triflutal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0795","description":"Corticorelin ovine triflutal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRF0","description":"ICD-OFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX42","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rufinamide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80210","description":"Rufinamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHA1","description":"ICD-NIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUD1","description":"ICD-GDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx rectal t1-3_n1-2noprg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9092","description":"Onc dx rectal t1-3_n1-2noprg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRF1","description":"ICD-CFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Conversion ext bil drg cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47535","description":"Conversion ext bil drg cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown full cast noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2792","description":"Crown full cast noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Corplex P_ per cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4231","description":"Corplex P_ per cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Work hardening add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97546","description":"Work hardening add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove lumb artif disc addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0164T","description":"Remove lumb artif disc addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18C","description":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMD0","description":"ICD-ECMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAE1","description":"ICD-CHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVF0","description":"ICD-CGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgery of breast capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19370","description":"Surgery of breast capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAC1","description":"ICD-OAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTA0","description":"ICD-MBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mohs addl stage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17312","description":"Mohs addl stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7531","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7531","description":"HCPCS-J7531","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATE1","description":"ICD-MATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28I","description":"Special Care Low _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRA0","description":"ICD-GCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAF0","description":"ICD-JEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Triamcinolone diacetate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3302","description":"Triamcinolone diacetate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol/drug abuse svc nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0047","description":"Alcohol/drug abuse svc nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18G","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise external hemorrhoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46083","description":"Incise external hemorrhoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1329","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-electronic spirometer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9284","description":"Non-electronic spirometer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC155","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ hexaminolevulinate HCl_ 100 mg_ per study dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9275","description":"Injection_ hexaminolevulinate HCl_ 100 mg_ per study dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYD1","description":"ICD-CHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEA0","description":"ICD-FIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGF1","description":"ICD-NGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic management program_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9141","description":"Diabetic management program_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAF0","description":"ICD-OBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQE0","description":"ICD-HIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUD0","description":"ICD-OCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHB0","description":"ICD-BHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXB0","description":"ICD-GHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAC0","description":"ICD-NHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt not trans to hosp at d/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8915","description":"Pt not trans to hosp at d/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise parotid gland/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42415","description":"Excise parotid gland/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rebase hybrid prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5725","description":"Rebase hybrid prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUB1","description":"ICD-GHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXB1","description":"ICD-JGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wedge resect of lung add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32506","description":"Wedge resect of lung add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision Of Chest Wall Tumor Including Rib(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21601","description":"Excision Of Chest Wall Tumor Including Rib(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWD1","description":"ICD-DAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXC0","description":"ICD-JCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23800","description":"Fusion of shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQC0","description":"ICD-HAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64658","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","description":"CPT-64658","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGC0","description":"ICD-FEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intro/sheath_strble_non-peel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1766","description":"Intro/sheath_strble_non-peel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPB1","description":"ICD-OAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Part pulp for apexogenesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3222","description":"Part pulp for apexogenesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytp urne 3-5 probes ea spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88120","description":"Cytp urne 3-5 probes ea spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vessel injection procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36299","description":"Vessel injection procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thyroid met imaging body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78018","description":"Thyroid met imaging body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUE0","description":"ICD-EEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGD0","description":"ICD-KCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBC1","description":"ICD-IHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVF1","description":"ICD-OKVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disconnect insert locking wr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6616","description":"Disconnect insert locking wr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elec stim unattend for press","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0281","description":"Elec stim unattend for press","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUC1","description":"ICD-NEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of stomach nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64755","description":"Incision of stomach nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEE1","description":"ICD-CBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITE0","description":"ICD-KITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJC0","description":"ICD-NCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIA0","description":"ICD-ECIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYE1","description":"ICD-LDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Programming device evaluation (remote) of subcutaneous cardiac rhythm monitor system_ with iterative adjustment of the implantable device to test the function of the device an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0650T","description":"Programming device evaluation (remote) of subcutaneous cardiac rhythm monitor system_ with iterative adjustment of the implantable device to test the function of the device an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00539","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00539","description":"CPT-00539","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAF1","description":"ICD-AAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44404","description":"Colonoscopy w/injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGB1","description":"ICD-BGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARF1","description":"ICD-OARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anabolic steroid 1 or 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80327","description":"Anabolic steroid 1 or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHD0","description":"ICD-GGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATA1","description":"ICD-BATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hd trapeze bar free standing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0912","description":"Hd trapeze bar free standing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOF0","description":"ICD-OJOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECE1","description":"ICD-JECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00866","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00866","description":"CPT-00866","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0527T","description":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adalimumab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80145","description":"Adalimumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray kidneys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75833","description":"Vein x-ray kidneys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQF1","description":"ICD-OAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEA1","description":"ICD-EHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBD1","description":"ICD-BCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFD1","description":"ICD-CFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Employment - Employment Skills Development (1:15)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1741","description":"Employment - Employment Skills Development (1:15)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEF0","description":"ICD-NBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHF1","description":"ICD-OEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAE1","description":"ICD-MFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lso flex no ri stays pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0628","description":"Lso flex no ri stays pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLB0","description":"ICD-MDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAB0","description":"ICD-FIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduction of forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21138","description":"Reduction of forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVA0","description":"ICD-NBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood typing antigen system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86911","description":"Blood typing antigen system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Moisture exchanger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4483","description":"Moisture exchanger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTF1","description":"ICD-GFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nose polyp(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30110","description":"Removal of nose polyp(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not on a daily aspirin or other antiplatelet (e.g._ history of gastrointestinal bleed_ intra-cranial bleed_ idiopathic thrombocytopenic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9794","description":"Documentation of medical reason(s) for not on a daily aspirin or other antiplatelet (e.g._ history of gastrointestinal bleed_ intra-cranial bleed_ idiopathic thrombocytopenic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of toe joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28024","description":"Exploration of toe joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITE0","description":"ICD-IITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBC0","description":"ICD-JFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEF0","description":"ICD-ICEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23455","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB126","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oral/facial photo images","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0350","description":"Oral/facial photo images","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKB0","description":"ICD-BBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lith ion batt cid_non-earlvl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8623","description":"Lith ion batt cid_non-earlvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBB1","description":"ICD-EGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXD0","description":"ICD-CAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2253","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","description":"HCPCS-J2253","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITA1","description":"ICD-FITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOB0","description":"ICD-HBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOA0","description":"ICD-GAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove anal fist 2 stage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46285","description":"Remove anal fist 2 stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thorax spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22610","description":"Thorax spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert pulse gen sngl lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33212","description":"Insert pulse gen sngl lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"A/d tx program_ per hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2035","description":"A/d tx program_ per hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tonguemuscle_ controlled by hardware remote","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0490","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tonguemuscle_ controlled by hardware remote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adj cmo not pres rsn not gvn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8929","description":"Adj cmo not pres rsn not gvn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOC0","description":"ICD-OFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4400","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","description":"HCPCS-Q4400","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLB1","description":"ICD-CBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJF0","description":"ICD-JHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHC1","description":"ICD-BBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); common variant(s) (eg_ HbS_ HbC_ HbE)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81361","description":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); common variant(s) (eg_ HbS_ HbC_ HbE)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWF0","description":"ICD-CEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHF0","description":"ICD-KBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diagnosticmammographydigital","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0206","description":"Diagnosticmammographydigital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKF0","description":"ICD-JFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prep renal graft/ureteral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50329","description":"Prep renal graft/ureteral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBA1","description":"ICD-FIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair multi-comp penis pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54408","description":"Repair multi-comp penis pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Change of nephrostomy or pyelostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50398","description":"Change of nephrostomy or pyelostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain bladder by needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51100","description":"Drain bladder by needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKB1","description":"ICD-FAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAED0","description":"ICD-EAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHB0","description":"ICD-MKHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTF1","description":"ICD-KCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amnioband_ guardian 1 sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4151","description":"Amnioband_ guardian 1 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68130","description":"Remove eyelid lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX51","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adjust max prost appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5992","description":"Adjust max prost appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFB0","description":"ICD-CBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pegloticase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2507","description":"Pegloticase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVF1","description":"ICD-GBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37254","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","description":"CPT-37254","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJA1","description":"ICD-OEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKE1","description":"ICD-GAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of bladder & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51960","description":"Revision of bladder & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHE0","description":"ICD-NCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEB1","description":"ICD-MLEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19364","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKA1","description":"ICD-BCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNE1","description":"ICD-OKNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYB0","description":"ICD-KCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove nail bed/tip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11752","description":"Remove nail bed/tip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrocochleography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92584","description":"Electrocochleography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Volume deplete of harvest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38214","description":"Volume deplete of harvest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18I","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBD0","description":"ICD-CCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIA0","description":"ICD-KHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVB0","description":"ICD-OBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMA1","description":"ICD-IEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ppsv23 vacc 2 yrs+ subq/im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90732","description":"Ppsv23 vacc 2 yrs+ subq/im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHB0","description":"ICD-AFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRD0","description":"ICD-KCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA4C","description":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRA1","description":"ICD-CHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWD0","description":"ICD-ODWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transthor diaphrag hern rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43334","description":"Transthor diaphrag hern rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTE1","description":"ICD-OHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILD0","description":"ICD-IILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXF0","description":"ICD-GCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVC0","description":"ICD-GGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUB1","description":"ICD-JEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHC1","description":"ICD-BFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17271","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBE0","description":"ICD-OHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB0A","description":"Ultra High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABB1","description":"ICD-AABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal aneuploidy DNA sequencing comparative analysis_ fetal DNA from products of conception_ reported as normal (euploidy)_ monosomy_ trisomy_ or partial deletion/duplication_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0341U","description":"Fetal aneuploidy DNA sequencing comparative analysis_ fetal DNA from products of conception_ reported as normal (euploidy)_ monosomy_ trisomy_ or partial deletion/duplication_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Itch severity assessment score is reduced by 2 or more points from the initial (index) assessment score to the follow-up visit score","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1205","description":"Itch severity assessment score is reduced by 2 or more points from the initial (index) assessment score to the follow-up visit score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCE1","description":"ICD-KGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD124","description":"Clinically Complex _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JB11","description":"ICD-4JB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAA1","description":"ICD-EGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAA1","description":"ICD-CEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv 1 extrem 1-4 ea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64643","description":"Chemodenerv 1 extrem 1-4 ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9028","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","description":"HCPCS-J9028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB15","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cholera vaccine live oral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90625","description":"Cholera vaccine live oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Select picture audiometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92583","description":"Select picture audiometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autoimmune (psoriasis)_ mRNA_ next-generation sequencing_ gene expression profiling of 50-100 genes_ skin-surface collection using adhesive patch_ algorithm reported as likeli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0258U","description":"Autoimmune (psoriasis)_ mRNA_ next-generation sequencing_ gene expression profiling of 50-100 genes_ skin-surface collection using adhesive patch_ algorithm reported as likeli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wrist arthroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29840","description":"Wrist arthroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove sperm duct pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55650","description":"Remove sperm duct pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Employment Career Assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1732","description":"Employment Career Assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31755","description":"Repair of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diphenhydramine hcl 50mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0163","description":"Diphenhydramine hcl 50mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVB1","description":"ICD-NIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRC0","description":"ICD-KBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Molecular Fluorescent Imaging Of Suspicious Nevus; First Lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0700T","description":"Molecular Fluorescent Imaging Of Suspicious Nevus; First Lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX5B","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism InveniQA semantic answers in medicine _ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1014","description":"Clinical decision support mechanism InveniQA semantic answers in medicine _ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc neck tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21556","description":"Exc neck tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivitive_ genvisc 850_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7320","description":"Hyaluronan or derivitive_ genvisc 850_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove collar bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23180","description":"Remove collar bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIME0","description":"ICD-JIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIC1","description":"ICD-FAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Functional Status Was Not Measured By The Oxford Knee Score (Oks) At One Year (9 To 15 Months) Postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1141","description":"Functional Status Was Not Measured By The Oxford Knee Score (Oks) At One Year (9 To 15 Months) Postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34701","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBA1","description":"ICD-NHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHB1","description":"ICD-NKHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEE0","description":"ICD-KEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pre-op asst not doc_ rng","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9617","description":"Pre-op asst not doc_ rng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEE1","description":"ICD-ECEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQA0","description":"ICD-DEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLA1","description":"ICD-JBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQA0","description":"ICD-PJQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ diagnostic algorithm reported as a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0367U","description":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ diagnostic algorithm reported as a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCA0","description":"ICD-NLCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLB0","description":"ICD-FCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVF1","description":"ICD-OLVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFC1","description":"ICD-FAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUA1","description":"ICD-KCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUE0","description":"ICD-BGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA101","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst including t/o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58262","description":"Vag hyst including t/o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26352","description":"Repair/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDF1","description":"ICD-JFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epsd bk pain for >12 wks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1137F","description":"Epsd bk pain for >12 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUF1","description":"ICD-CEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Brexanolone_ 1Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9055","description":"Injection_ Brexanolone_ 1Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not have a net increase in pam score of at least 6 points within a 6 to 12 month period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1346","description":"Patients who did not have a net increase in pam score of at least 6 points within a 6 to 12 month period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of hip tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27001","description":"Incision of hip tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAC0","description":"ICD-BBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFB1","description":"ICD-OAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUD0","description":"ICD-EGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who died during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1342","description":"Patients who died during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITD0","description":"ICD-MITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHB1","description":"ICD-MLHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDF0","description":"ICD-ICDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plan care lipid control docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0556F","description":"Plan care lipid control docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBD1","description":"ICD-OEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81173","description":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auto tissue graft addl tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4283","description":"Auto tissue graft addl tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGA1","description":"ICD-NJGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp2 std seat elevate s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0830","description":"Pwc gp2 std seat elevate s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autologous blood op salvage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86891","description":"Autologous blood op salvage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE24D","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTD1","description":"ICD-OKTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJC1","description":"ICD-NBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCC1","description":"ICD-ICCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFD0","description":"ICD-GAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMC1","description":"ICD-ACMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCE1","description":"ICD-MGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Initial Set-Up And Patient Education On Use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98975","description":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Initial Set-Up And Patient Education On Use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Monovisc inj per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7327","description":"Monovisc inj per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair semi-recl detach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1110","description":"Wheelchair semi-recl detach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXF0","description":"ICD-JFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYC0","description":"ICD-KIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOE0","description":"ICD-GDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of pregnenolone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84140","description":"Assay of pregnenolone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLB1","description":"ICD-MFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJD1","description":"ICD-CFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL43","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBB0","description":"ICD-KCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADB1","description":"ICD-AADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esrd home pt srv p day 2-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90968","description":"Esrd home pt srv p day 2-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28D","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA20","description":"Low Rehab_ ADL Index 0-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE12A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTC0","description":"ICD-FGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ non-str_ ha_ i-125","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2634","description":"Brachytx_ non-str_ ha_ i-125","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL5A","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDD0","description":"ICD-JGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVB0","description":"ICD-CHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIED1","description":"ICD-MIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of nail fold toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11765","description":"Excision of nail fold toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc idrl imed lesn cervl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63285","description":"Bx/exc idrl imed lesn cervl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUB0","description":"ICD-ACUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD231","description":"Special Care Low _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKID0","description":"ICD-OKID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antibiotic not pres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8708","description":"Antibiotic not pres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLC1","description":"ICD-NGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTF1","description":"ICD-NKTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEE1","description":"ICD-MKEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHA1","description":"ICD-BHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGB0","description":"ICD-FIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDA0","description":"ICD-NLDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUA1","description":"ICD-IIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUA1","description":"ICD-FBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBA1","description":"ICD-IIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDA0","description":"ICD-EDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML1A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; known familial variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81258","description":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; known familial variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJA1","description":"ICD-CFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAE1","description":"ICD-OHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCD0","description":"ICD-CDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4DC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DC11","description":"ICD-4DC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC225","description":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPF0","description":"ICD-KIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCD1","description":"ICD-NCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repr per/vag pouch dbl proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46712","description":"Repr per/vag pouch dbl proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMC0","description":"ICD-KIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXD0","description":"ICD-CHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Canakinumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0638","description":"Canakinumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAB1","description":"ICD-CEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWA1","description":"ICD-LDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACA0","description":"ICD-BACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or substance (other than tobacco) abuse structured assessment (e.g._ audit_ DAST)_ and brief intervention_ 5-14 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2011","description":"Alcohol and/or substance (other than tobacco) abuse structured assessment (e.g._ audit_ DAST)_ and brief intervention_ 5-14 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVF1","description":"ICD-ODVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore wound chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20101","description":"Explore wound chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIE0","description":"ICD-CAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical site infection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9312","description":"Surgical site infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient not ambulatory_ bed ridden_ immobile_ confined to chair_ wheelchair bound_ dependent on helper pushing wheelchair_ independent in wheelchair or minimal help in wheelch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9721","description":"Patient not ambulatory_ bed ridden_ immobile_ confined to chair_ wheelchair bound_ dependent on helper pushing wheelchair_ independent in wheelchair or minimal help in wheelch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKE0","description":"ICD-CAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (accord) not therapeutically equivalent to j9305_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9296","description":"Injection_ pemetrexed (accord) not therapeutically equivalent to j9305_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stent_ non-coa/non-cov w/del","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1876","description":"Stent_ non-coa/non-cov w/del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brush biopsy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7288","description":"Brush biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iiv vacc pandemic adjuvt im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90667","description":"Iiv vacc pandemic adjuvt im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cushioned headrest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0955","description":"Cushioned headrest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vertebroplasty addl inject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22512","description":"Vertebroplasty addl inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLD0","description":"ICD-OKLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit midline cath insert kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5521","description":"Hit midline cath insert kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antepartum management","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1001","description":"Antepartum management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28436","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVA0","description":"ICD-KCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQD1","description":"ICD-OGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPD1","description":"ICD-NDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Proton trmt simple w/comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77522","description":"Proton trmt simple w/comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWC0","description":"ICD-CBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Integrated filter & holder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7507","description":"Integrated filter & holder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMA0","description":"ICD-MEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYF0","description":"ICD-PCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoe metatarsal bar between","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3410","description":"Shoe metatarsal bar between","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLF0","description":"ICD-OBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUB0","description":"ICD-GFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services for patient provided any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9718","description":"Hospice services for patient provided any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGA1","description":"ICD-JIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIB1","description":"ICD-ICIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo ablate renal mass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50542","description":"Laparo ablate renal mass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLF0","description":"ICD-CDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELC0","description":"ICD-EELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIC1","description":"ICD-MDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3HB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HB31","description":"ICD-3HB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm 12.6-20 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12055","description":"Intmd rpr face/mm 12.6-20 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; including placement and manipulation of transducer_ image acquisi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76987","description":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; including placement and manipulation of transducer_ image acquisi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Subtalar arthro w/deb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29906","description":"Subtalar arthro w/deb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26075","description":"Explore/treat finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRB0","description":"ICD-GDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foam filled propulsion tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2216","description":"Foam filled propulsion tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMC1","description":"ICD-IGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELB1","description":"ICD-BELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Influenza dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87502","description":"Influenza dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFD0","description":"ICD-GIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAA1","description":"ICD-AGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA22D","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBA0","description":"ICD-JIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0108","description":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXD1","description":"ICD-JBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Symes type poster opening so","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5634","description":"Symes type poster opening so","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQD1","description":"ICD-LDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOC0","description":"ICD-CGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXC1","description":"ICD-NEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ob us < 14 wks addl fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76802","description":"Ob us < 14 wks addl fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone replce graft first site","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4263","description":"Bone replce graft first site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2GA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GA31","description":"ICD-2GA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLB0","description":"ICD-AFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMD0","description":"ICD-KFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth sperm duct surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92251","description":"Anesth sperm duct surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPD1","description":"ICD-GEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat pleurodesis w/agent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32560","description":"Treat pleurodesis w/agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLD1","description":"ICD-KDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of anal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46922","description":"Excision of anal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial excision of lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40500","description":"Partial excision of lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0010","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPA1","description":"ICD-JBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAD0","description":"ICD-KAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28X","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ abdominal aorta_ real time with image documentation_ screening study for abdominal aortic aneurysm (AAA)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76706","description":"Ultrasound_ abdominal aorta_ real time with image documentation_ screening study for abdominal aortic aneurysm (AAA)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEC0","description":"ICD-ECEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prgrmg eval implantable dfb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93282","description":"Prgrmg eval implantable dfb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Risperidone_ long acting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2794","description":"Risperidone_ long acting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHE1","description":"ICD-BAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX2D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intro/sheath_ laser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2629","description":"Intro/sheath_ laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCC1","description":"ICD-NCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA17","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETA1","description":"ICD-GETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEA1","description":"ICD-IIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOA0","description":"ICD-GDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ethanolamine oleate 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1430","description":"Ethanolamine oleate 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJD0","description":"ICD-JEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXD1","description":"ICD-NCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMB0","description":"ICD-OEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA131","description":"Clinically Complex _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOF1","description":"ICD-PKOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of digit nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64831","description":"Repair of digit nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYC1","description":"ICD-PHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Phototherapy light w/ photom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0202","description":"Phototherapy light w/ photom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGB0","description":"ICD-CIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0671U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671U","description":"CPT-0671U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB3B","description":"High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultraviolet light therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96900","description":"Ultraviolet light therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of breast lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19020","description":"Incision of breast lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ustekinumab-auub (Wezlana)_ biosimilar_ IV_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5138","description":"Injection_ ustekinumab-auub (Wezlana)_ biosimilar_ IV_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEF1","description":"ICD-AIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFC1","description":"ICD-CAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cult epiderm grft f/n/hfg +%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15157","description":"Cult epiderm grft f/n/hfg +%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFE0","description":"ICD-CHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWB0","description":"ICD-KAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13132","description":"Cmplx rpr f/c/c/m/n/ax/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEB1","description":"ICD-GHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAE1","description":"ICD-IAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Annual nursing fac assessmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99318","description":"Annual nursing fac assessmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQB1","description":"ICD-GEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWE0","description":"ICD-GIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit hydra 2 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9375","description":"Hit hydra 2 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCC1","description":"ICD-MGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx nsclc dx unknown nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9067","description":"Onc dx nsclc dx unknown nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Loxapine_ inhalation powder_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9497","description":"Loxapine_ inhalation powder_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLE0","description":"ICD-KDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC125","description":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX41","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBE1","description":"ICD-ODBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX51","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24577","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGB0","description":"ICD-FEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMA1","description":"ICD-ACMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE205","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC3D","description":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIC0","description":"ICD-AFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For Not Screening For Tobacco Use (E.G._ Limited Life Expectancy_ Other Medical Reason)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0028","description":"Documentation Of Medical Reason(S) For Not Screening For Tobacco Use (E.G._ Limited Life Expectancy_ Other Medical Reason)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTC1","description":"ICD-IFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc type nsm lung ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9289","description":"Doc type nsm lung ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit7.6-12.5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12044","description":"Intmd rpr n-hf/genit7.6-12.5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clean rem part denture mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9935","description":"Clean rem part denture mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trauma respons w/hosp criti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0390","description":"Trauma respons w/hosp criti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCA0","description":"ICD-FCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTF0","description":"ICD-IHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"I131 tositumomab_ rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9545","description":"I131 tositumomab_ rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fecal microbiota prep instil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0455","description":"Fecal microbiota prep instil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening methadone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80358","description":"Drug screening methadone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEED0","description":"ICD-AEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High risk prostate cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3273F","description":"High risk prostate cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLF1","description":"ICD-FDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNF0","description":"ICD-FHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Denture reln cmplt max lab","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5750","description":"Denture reln cmplt max lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Programming Device Evaluation (In-Person) With Iterative Adjustment Of The Implantable Device To Test The Function Of The Device And Select Optimal Permanent Programmed Values","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0683T","description":"Programming Device Evaluation (In-Person) With Iterative Adjustment Of The Implantable Device To Test The Function Of The Device And Select Optimal Permanent Programmed Values","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUC1","description":"ICD-OBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEED1","description":"ICD-EEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair clitoris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56805","description":"Repair clitoris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWD0","description":"ICD-GEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNE1","description":"ICD-OGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLD1","description":"ICD-JHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrst x-ray urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74400","description":"Contrst x-ray urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE20D","description":"Clinically Complex _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25400","description":"Repair radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIA0","description":"ICD-NIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGF0","description":"ICD-GIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDB0","description":"ICD-CCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Uveal Melanoma)_ Mrna_ Gene Expression Profiling By Real-Time Rt-Pcr Of 15 Genes (12 Content And 3 Housekeeping)_ Utilizing Fine Needle Aspirate Or Formalin-Fixed Pa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81552","description":"Oncology (Uveal Melanoma)_ Mrna_ Gene Expression Profiling By Real-Time Rt-Pcr Of 15 Genes (12 Content And 3 Housekeeping)_ Utilizing Fine Needle Aspirate Or Formalin-Fixed Pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETB0","description":"ICD-CETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGD1","description":"ICD-NAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOF0","description":"ICD-LIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXC0","description":"ICD-OBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALA1","description":"ICD-EALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIND1","description":"ICD-GIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHC1","description":"ICD-CEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMB0","description":"ICD-JEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ped crit care transport","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99466","description":"Ped crit care transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome analys placenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88267","description":"Chromosome analys placenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJE0","description":"ICD-FEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCF1","description":"ICD-AGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ abdomen; complete acute abdomen series_ including supine_ erect_ and/or decubitus views_ single view chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74022","description":"Radiologic examination_ abdomen; complete acute abdomen series_ including supine_ erect_ and/or decubitus views_ single view chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of neck artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37605","description":"Ligation of neck artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQB1","description":"ICD-OLQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEA1","description":"ICD-CHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQA1","description":"ICD-CFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Var vaccine live subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90716","description":"Var vaccine live subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8X","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foam drg >16<=48 sq in w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6210","description":"Foam drg >16<=48 sq in w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOD1","description":"ICD-PCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABB0","description":"ICD-BABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILB0","description":"ICD-EILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4KA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KA11","description":"ICD-4KA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed semi-elect w/ mattr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0294","description":"Hosp bed semi-elect w/ mattr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Imaging coil_ mr_ insertable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1770","description":"Imaging coil_ mr_ insertable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lysis of labial lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56441","description":"Lysis of labial lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65410","description":"Biopsy of cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of cryofibrinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82585","description":"Assay of cryofibrinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL10","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of intervertebral biomechanical device(s) (eg_ synthetic cage_ mesh_ methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22859","description":"Insertion of intervertebral biomechanical device(s) (eg_ synthetic cage_ mesh_ methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5142","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","description":"HCPCS-Q5142","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62192","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"AMNIOREPAIR or AltiPly_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4235","description":"AMNIOREPAIR or AltiPly_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADB0","description":"ICD-CADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOD1","description":"ICD-OAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reusable nipple prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8032","description":"Reusable nipple prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDC1","description":"ICD-NIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE15B","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27893","description":"Decompression of leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of 17-hydroxypregneno","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84143","description":"Assay of 17-hydroxypregneno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC20C","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWF1","description":"ICD-PLWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDA1","description":"ICD-MGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"COMT (catechol-O-methyltransferase)(drug metabolism) gene analysis_ c.472G>A (rs4680) variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0032U","description":"COMT (catechol-O-methyltransferase)(drug metabolism) gene analysis_ c.472G>A (rs4680) variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCF1","description":"ICD-BBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEA1","description":"ICD-NGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove bone fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20694","description":"Remove bone fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISC1","description":"ICD-KISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPC1","description":"ICD-NEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJD0","description":"ICD-OGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental panoramic film","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0330","description":"Dental panoramic film","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFB1","description":"ICD-BHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGD1","description":"ICD-JHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ GELSYN-3_ for intra-articular injection_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7328","description":"Hyaluronan or derivative_ GELSYN-3_ for intra-articular injection_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol/substance abuse skil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1012","description":"Alcohol/substance abuse skil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHD0","description":"ICD-NDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPB1","description":"ICD-KGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETC1","description":"ICD-EETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Attempted vbac after care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59622","description":"Attempted vbac after care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGA1","description":"ICD-CBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAA0","description":"ICD-NKAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foot insert remov molded spe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3001","description":"Foot insert remov molded spe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone cutting body mandible","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7945","description":"Bone cutting body mandible","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKID1","description":"ICD-NKID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBD1","description":"ICD-ICBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRC0","description":"ICD-KFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOA0","description":"ICD-LDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMA0","description":"ICD-MHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thumb fusion with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26842","description":"Thumb fusion with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"TDD","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5272","description":"TDD","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIE0","description":"ICD-BEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ht irrigation diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9590","description":"Ht irrigation diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ankle control ortho pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4350","description":"Ankle control ortho pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repl water chamber_ pap dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7046","description":"Repl water chamber_ pap dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC3C","description":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s)_ autologous white blood cell concentrate (autologous protein solution)_ any site_ including image guidance_ harvesting and preparation_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0481T","description":"Injection(s)_ autologous white blood cell concentrate (autologous protein solution)_ any site_ including image guidance_ harvesting and preparation_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIC1","description":"ICD-NEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25101","description":"Explore/treat wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYD0","description":"ICD-GIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB221","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Add ue prost s/d ultlite mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7402","description":"Add ue prost s/d ultlite mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dx gastr intub w/asp specs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43755","description":"Dx gastr intub w/asp specs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient is dysarthric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3762F","description":"Patient is dysarthric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCD1","description":"ICD-JFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBD1","description":"ICD-JBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parvovirus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86747","description":"Parvovirus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMA1","description":"ICD-OFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25685","description":"Treat wrist fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITA1","description":"ICD-GITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (Teva) not therapeutically equivalent to J9305_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9314","description":"Injection_ pemetrexed (Teva) not therapeutically equivalent to J9305_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB25A","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXA0","description":"ICD-NCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Red blood cells unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9021","description":"Red blood cells unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHC0","description":"ICD-ABHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lung transplant double","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32853","description":"Lung transplant double","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQE0","description":"ICD-LBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27550","description":"Treat knee dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical repair of root resorption - molar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3473","description":"Surgical repair of root resorption - molar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYD1","description":"ICD-KFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFC0","description":"ICD-NEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPC0","description":"ICD-OAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEF1","description":"ICD-KGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwr seat combo pwr shear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1008","description":"Pwr seat combo pwr shear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC12C","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWC1","description":"ICD-LBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert_ pneum wheel drive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2383","description":"Insert_ pneum wheel drive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXA0","description":"ICD-JAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEC0","description":"ICD-KFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Closed treatment of posterior pelvic ring fracture(s)_ dislocation(s)_ diastasis or subluxation of the ilium_ sacroiliac joint_ and/or sacrum_ with or without anterior pelvic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27197","description":"Closed treatment of posterior pelvic ring fracture(s)_ dislocation(s)_ diastasis or subluxation of the ilium_ sacroiliac joint_ and/or sacrum_ with or without anterior pelvic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDA0","description":"ICD-KDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18G","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDF1","description":"ICD-NHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYD1","description":"ICD-DDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITC1","description":"ICD-OITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Approp digoxin tstng done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4189F","description":"Approp digoxin tstng done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUE1","description":"ICD-NGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test 3 limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95863","description":"Muscle test 3 limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61540","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE126","description":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHME1","description":"ICD-AHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSC1","description":"ICD-GFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCD0","description":"ICD-AHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1040T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1040T","description":"CPT-1040T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMB1","description":"ICD-OCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTE0","description":"ICD-MGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4EC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EC11","description":"ICD-4EC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown porcelain noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6752","description":"Crown porcelain noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWD0","description":"ICD-CBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIC1","description":"ICD-MHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLD1","description":"ICD-IHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter_ ablation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1886","description":"Catheter_ ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEA1","description":"ICD-NBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lith-ion batt elec/pneum vad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0506","description":"Lith-ion batt elec/pneum vad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB13C","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMF1","description":"ICD-NDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJE1","description":"ICD-BEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"O shoe add standard toe tap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3550","description":"O shoe add standard toe tap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWC0","description":"ICD-LCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXC0","description":"ICD-CCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43605","description":"Biopsy of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25574","description":"Treat fracture radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Traction stand free standing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0850","description":"Traction stand free standing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWC0","description":"ICD-HGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXD0","description":"ICD-GIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWF0","description":"ICD-KCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00731","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00731","description":"CPT-00731","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1053T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1053T","description":"CPT-1053T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSD0","description":"ICD-GBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIA1","description":"ICD-FFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Augmentation cheek bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21270","description":"Augmentation cheek bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Angioscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35400","description":"Angioscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colostomy with biopsies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44322","description":"Colostomy with biopsies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEC0","description":"ICD-EDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUD1","description":"ICD-BFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUB0","description":"ICD-ECUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQD1","description":"ICD-HEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sympt sten-tia/strk<120days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9006F","description":"Sympt sten-tia/strk<120days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thawing cryopresrved sperm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89353","description":"Thawing cryopresrved sperm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBA1","description":"ICD-OJBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical procedures that included the use of silicone oil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9757","description":"Surgical procedures that included the use of silicone oil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Opiate(s)_ drug and metabolites_ each procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6056","description":"Opiate(s)_ drug and metabolites_ each procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of creatinine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82565","description":"Assay of creatinine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01170","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01170","description":"CPT-01170","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth testis suspension","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93051","description":"Anesth testis suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCD1","description":"ICD-IHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tetracyclin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0120","description":"Tetracyclin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sh","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB06","description":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE224","description":"Clinically Complex _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0026","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJF1","description":"ICD-FDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneumococcal conjugate vaccine_ 21 valent (PCV21)_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90684","description":"Pneumococcal conjugate vaccine_ 21 valent (PCV21)_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCE1","description":"ICD-OJCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYC0","description":"ICD-KBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNF1","description":"ICD-NJNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incontinence garment anytype","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4520","description":"Incontinence garment anytype","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ padded textile_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6606","description":"Gradient compression bandaging supply_ padded textile_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52277","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCA1","description":"ICD-KDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4367","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","description":"HCPCS-Q4367","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXE1","description":"ICD-BCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB15D","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLB1","description":"ICD-IGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of aqueous drainage device_ without extraocular reservoir_ internal approach_ into the subconjunctival space; each additional device (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0450T","description":"Insertion of aqueous drainage device_ without extraocular reservoir_ internal approach_ into the subconjunctival space; each additional device (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC21","description":"High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD20C","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEF1","description":"ICD-FEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastric analy w/ph ea spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82930","description":"Gastric analy w/ph ea spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen quan lamotrigine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80175","description":"Drug screen quan lamotrigine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMC1","description":"ICD-GFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDE1","description":"ICD-FDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB112","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMC0","description":"ICD-MCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bp sys <140 and dias <90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8476","description":"Bp sys <140 and dias <90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGB1","description":"ICD-JAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove pelvis lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38770","description":"Remove pelvis lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove wrist joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25105","description":"Remove wrist joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUE0","description":"ICD-BFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQA1","description":"ICD-HIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKF1","description":"ICD-JEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"LW GNOTYP ICAM4 EXON 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0197U","description":"LW GNOTYP ICAM4 EXON 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transfer of iliopsoas muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27110","description":"Transfer of iliopsoas muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrode stim brain add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95962","description":"Electrode stim brain add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lead wires_ pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4557","description":"Lead wires_ pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRC1","description":"ICD-OFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHE0","description":"ICD-NBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEA0","description":"ICD-EFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHA0","description":"ICD-ADHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD20A","description":"Special Care High _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCE1","description":"ICD-JGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23184","description":"Remove humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1391","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","description":"HCPCS-M1391","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYC1","description":"ICD-CGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63270","description":"Excise intrspinl lesion crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCF0","description":"ICD-JBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIF1","description":"ICD-NIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUE1","description":"ICD-CIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion during endovascular therapy_ by abdominal or retroperitoneal incision_ unilateral (List s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34820","description":"Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion during endovascular therapy_ by abdominal or retroperitoneal incision_ unilateral (List s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc thigh/knee tum deep <5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27328","description":"Exc thigh/knee tum deep <5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVA0","description":"ICD-NKVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUC1","description":"ICD-NFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPC0","description":"ICD-NEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQE1","description":"ICD-GDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX10","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Donor lobectomy (lung)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2061","description":"Donor lobectomy (lung)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOC0","description":"ICD-CFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCF0","description":"ICD-FGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pain assessment not documented as being performed_ documentation the patient is not eligible for a pain assessment using a standardized tool at the time of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8442","description":"Pain assessment not documented as being performed_ documentation the patient is not eligible for a pain assessment using a standardized tool at the time of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUC0","description":"ICD-OGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDED0","description":"ICD-CDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE14B","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFF0","description":"ICD-OEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXE0","description":"ICD-JDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18E","description":"Clinically Complex _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9326","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","description":"HCPCS-J9326","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJB0","description":"ICD-OAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoe sole wedge outside sole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3360","description":"Shoe sole wedge outside sole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suicide risk assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3085F","description":"Suicide risk assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8A","description":"High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPA0","description":"ICD-BCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMB1","description":"ICD-OAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65150","description":"Revise ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCD1","description":"ICD-OBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUA1","description":"ICD-MIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKB0","description":"ICD-NKKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUB0","description":"ICD-EAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACC0","description":"ICD-EACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIA0","description":"ICD-KAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUD1","description":"ICD-KIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHE1","description":"ICD-MGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0806","description":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ emapalumab-lzsg_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9050","description":"Injection_ emapalumab-lzsg_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKA1","description":"ICD-JGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODND0","description":"ICD-ODND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIA1","description":"ICD-GEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE120","description":"Special Care Low _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home Delivered Meals-Frozen Entree","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1760","description":"Home Delivered Meals-Frozen Entree","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBE0","description":"ICD-NIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX45","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC115","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lyme dis dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87476","description":"Lyme dis dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision Of Chest Wall Tumor Involving Rib(S)_ With Plastic Reconstruction; With Mediastinal Lymphadenectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21603","description":"Excision Of Chest Wall Tumor Involving Rib(S)_ With Plastic Reconstruction; With Mediastinal Lymphadenectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagus surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43499","description":"Esophagus surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCD0","description":"ICD-MFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lefort i-3/> piece w/ graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21147","description":"Lefort i-3/> piece w/ graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21083","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGC1","description":"ICD-CFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWB1","description":"ICD-CAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWB1","description":"ICD-GBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBF0","description":"ICD-AIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foam drsg <=16 sq in w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6209","description":"Foam drsg <=16 sq in w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Procenta_ per 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4310","description":"Procenta_ per 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUC0","description":"ICD-NGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ko double upright pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1845","description":"Ko double upright pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28C","description":"Clinically Complex _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth nose/sinus surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16051","description":"Anesth nose/sinus surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap radical hyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58548","description":"Lap radical hyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interim implant crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6085","description":"Interim implant crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home visit est patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99349","description":"Home visit est patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig for ref oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8561","description":"Pt inelig for ref oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99155","description":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-49189","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","description":"CPT-49189","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26370","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKF0","description":"ICD-NLKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCF0","description":"ICD-NJCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Capillary blood draw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36416","description":"Capillary blood draw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBC1","description":"ICD-CFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUD0","description":"ICD-KDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPF1","description":"ICD-FHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disp fee inhal drugs/30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0513","description":"Disp fee inhal drugs/30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAE0","description":"ICD-GHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64620","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQC1","description":"ICD-OFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18G","description":"Special Care Low _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKF1","description":"ICD-GAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPC1","description":"ICD-GCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQF0","description":"ICD-OJQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRC1","description":"ICD-LHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBE0","description":"ICD-CIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVC0","description":"ICD-CIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBA1","description":"ICD-OCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHB0","description":"ICD-MLHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect prox humerus tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23220","description":"Resect prox humerus tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELA0","description":"ICD-GELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Liver and spleen imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78215","description":"Liver and spleen imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8I","description":"High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBB1","description":"ICD-AEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFID1","description":"ICD-FFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOE1","description":"ICD-LBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Programmable_ transient_ orally ingested capsule_ for use with external programmer_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9269","description":"Programmable_ transient_ orally ingested capsule_ for use with external programmer_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hh respiratory thrpy nos/day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5181","description":"Hh respiratory thrpy nos/day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNF0","description":"ICD-GFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21465","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj estrogen conjugate 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1410","description":"Inj estrogen conjugate 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEF1","description":"ICD-OHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid tumor)_ DNA (80 genes) and RNA (36 genes)_ by next-generation sequencing from plasma_ including single nucleotide variants_ insertions/deletions_ copy number a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0409U","description":"Oncology (solid tumor)_ DNA (80 genes) and RNA (36 genes)_ by next-generation sequencing from plasma_ including single nucleotide variants_ insertions/deletions_ copy number a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERD0","description":"ICD-KERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDC1","description":"ICD-EDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMA1","description":"ICD-OGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0503","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0503","description":"CDT-D0503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCD1","description":"ICD-EBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adult day center_ 8-hour unit_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0530","description":"Adult day center_ 8-hour unit_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemotherapy infusion method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96425","description":"Chemotherapy infusion method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inlay composite/resin two su","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2651","description":"Inlay composite/resin two su","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYC0","description":"ICD-PGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Metacarpophalangeal implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8630","description":"Metacarpophalangeal implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of a peritoneal ascites pump system_ including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0874T","description":"Removal of a peritoneal ascites pump system_ including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Provisional pontic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6253","description":"Provisional pontic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVD1","description":"ICD-NDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQD1","description":"ICD-DCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of protein any source","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84160","description":"Assay of protein any source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap place gastr adj device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43770","description":"Lap place gastr adj device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2100","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYD0","description":"ICD-GAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECE0","description":"ICD-KECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNF1","description":"ICD-FDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Phosphatase forensic exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84061","description":"Phosphatase forensic exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tildrakizumab_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3245","description":"Injection_ tildrakizumab_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay synovial fluid mucin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83872","description":"Assay synovial fluid mucin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLE0","description":"ICD-NCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemo intralesional up to 7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96405","description":"Chemo intralesional up to 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis one evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90935","description":"Hemodialysis one evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLD1","description":"ICD-JCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy forearm soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25066","description":"Biopsy forearm soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJB0","description":"ICD-KFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Delay flap f/c/c/n/ax/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15620","description":"Delay flap f/c/c/n/ax/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBE0","description":"ICD-IHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOF1","description":"ICD-KGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXE1","description":"ICD-OFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLD0","description":"ICD-MKLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ cholangiocarcinoma and non-small cell lung neoplasia_ DNA and RNA analysis_ 1-23 genes_ interrogation for sequence variants and rearr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0022U","description":"Targeted genomic sequence analysis panel_ cholangiocarcinoma and non-small cell lung neoplasia_ DNA and RNA analysis_ 1-23 genes_ interrogation for sequence variants and rearr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on nose and accessory sinuses; biopsy_ soft tissu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0124U","description":"Anesthesia for procedures on nose and accessory sinuses; biopsy_ soft tissu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D2005","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2005","description":"CDT-D2005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0494U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","description":"CPT-0494U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Observation care discharge day management (This code is to be utilized to report all services provided to a patient on discharge from outpatient hospital observation status if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99217","description":"Observation care discharge day management (This code is to be utilized to report all services provided to a patient on discharge from outpatient hospital observation status if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v auto redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88152","description":"Cytopath c/v auto redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUE1","description":"ICD-IIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUC0","description":"ICD-FAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ cryoablation nasal tissue(s) and/or nerve(s)_ unilateral or bilateral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9771","description":"Nasal/sinus endoscopy_ cryoablation nasal tissue(s) and/or nerve(s)_ unilateral or bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drill skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61108","description":"Drill skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat slipped epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27178","description":"Treat slipped epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCE1","description":"ICD-FHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADE0","description":"ICD-FADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUF1","description":"ICD-IEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAA0","description":"ICD-IIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKB1","description":"ICD-BHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYD0","description":"ICD-OHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Polysom 6/>yrs cpap 4/> parm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95811","description":"Polysom 6/>yrs cpap 4/> parm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMB1","description":"ICD-IDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWC0","description":"ICD-PGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of ankle ligaments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27696","description":"Repair of ankle ligaments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES134","description":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect mediastinal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39200","description":"Resect mediastinal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"I & d vag hematoma non-ob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57023","description":"I & d vag hematoma non-ob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVC1","description":"ICD-FGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIC1","description":"ICD-MBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNA0","description":"ICD-KCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD13D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-1 antibody testing of or","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3645","description":"Hiv-1 antibody testing of or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE124","description":"Special Care Low _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETC1","description":"ICD-JETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-27713","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","description":"CPT-27713","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIA1","description":"ICD-IIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLA1","description":"ICD-MJLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUB1","description":"ICD-IBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJC0","description":"ICD-CBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKA0","description":"ICD-BEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABB0","description":"ICD-EABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQC1","description":"ICD-KCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap replace gastr adj device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43773","description":"Lap replace gastr adj device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Genotype dna/rna hiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87906","description":"Genotype dna/rna hiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Total disc arthroplasty (artificial disc)_ anterior approach_ including discectomy to prepare interspace (other than for decompression); second interspace_ lumbar (List separa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22860","description":"Total disc arthroplasty (artificial disc)_ anterior approach_ including discectomy to prepare interspace (other than for decompression); second interspace_ lumbar (List separa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD25A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMB0","description":"ICD-CDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim_ excludes biosimilar_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2506","description":"Injection_ pegfilgrastim_ excludes biosimilar_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCB0","description":"ICD-EDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXA1","description":"ICD-NGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spine disk surgery thorax","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63078","description":"Spine disk surgery thorax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMA0","description":"ICD-BEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIE1","description":"ICD-ACIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor liver/arterial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47147","description":"Prep donor liver/arterial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBD1","description":"ICD-AIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE134","description":"Clinically Complex _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAD0","description":"ICD-BCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTA1","description":"ICD-ACTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKB1","description":"ICD-NDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYF1","description":"ICD-CBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAE1","description":"ICD-NKAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not having records of negative or managed positive TB screen (e.g._ patient does not return for Mantoux (PPD) skin test evaluation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9932","description":"Documentation of patient reason(s) for not having records of negative or managed positive TB screen (e.g._ patient does not return for Mantoux (PPD) skin test evaluation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGE0","description":"ICD-KIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 50 mcg/0.5 mL dosage_ for int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91309","description":"Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 50 mcg/0.5 mL dosage_ for int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Placental lactogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83632","description":"Placental lactogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-ray each vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75774","description":"Artery x-ray each vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spine fusion extra segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22614","description":"Spine fusion extra segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assessment of and care planning for a patient with cognitive impairment_ requiring an independent historian_ in the office or other outpatient_ home or domiciliary or rest hom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99483","description":"Assessment of and care planning for a patient with cognitive impairment_ requiring an independent historian_ in the office or other outpatient_ home or domiciliary or rest hom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DB11","description":"ICD-3DB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEC1","description":"ICD-GIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKE0","description":"ICD-BAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1031T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1031T","description":"CPT-1031T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0999T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","description":"CPT-0999T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOC1","description":"ICD-HAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPC1","description":"ICD-BGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEID0","description":"ICD-GEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQB1","description":"ICD-CBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMA1","description":"ICD-IFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brain imaging (pet)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78609","description":"Brain imaging (pet)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDB1","description":"ICD-BDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cat scan follow-up study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76380","description":"Cat scan follow-up study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIID1","description":"ICD-BIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL45","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialys sol fld vol > 2999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4723","description":"Dialys sol fld vol > 2999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML5B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00948","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00948","description":"CPT-00948","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No doc of neg or man pos tb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9360","description":"No doc of neg or man pos tb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEB1","description":"ICD-CBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC114","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ear impression","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5275","description":"Ear impression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA101","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6028","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","description":"HCPCS-L6028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cpm device_ other than knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0936","description":"Cpm device_ other than knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Azathioprine oral 50mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7500","description":"Azathioprine oral 50mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBA0","description":"ICD-GGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA4C","description":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esrd home pt serv p day <2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90967","description":"Esrd home pt serv p day <2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDA0","description":"ICD-CHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIC0","description":"ICD-ECIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28X","description":"Special Care High _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTF0","description":"ICD-OCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eld mal scrn pos no plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8735","description":"Eld mal scrn pos no plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8C","description":"Very High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALE1","description":"ICD-NALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28H","description":"Special Care Low _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMF0","description":"ICD-EAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pland chemo docd b/4 txmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0519F","description":"Pland chemo docd b/4 txmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect apical lung tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32503","description":"Resect apical lung tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparotomy islet cell transp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0343","description":"Laparotomy islet cell transp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient prescribed a 180-day course of treatment with beta-blockers post discharge for AMI","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9803","description":"Patient prescribed a 180-day course of treatment with beta-blockers post discharge for AMI","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA06","description":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay iga/igd/igg/igm each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82784","description":"Assay iga/igd/igg/igm each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOA1","description":"ICD-CEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59140","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Halo cerv into milwaukee typ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0830","description":"Halo cerv into milwaukee typ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTB1","description":"ICD-CDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin pneum swg frct exo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5722","description":"Knee-shin pneum swg frct exo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Temozolomide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9328","description":"Temozolomide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGC0","description":"ICD-KBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00580","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00580","description":"CPT-00580","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Harvest auto stem cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38206","description":"Harvest auto stem cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIE0","description":"ICD-JIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice in lt/non-skilled nf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5003","description":"Hospice in lt/non-skilled nf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Scr c/v cyto_autosys and md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0141","description":"Scr c/v cyto_autosys and md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laronidase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1931","description":"Laronidase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01214","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01214","description":"CPT-01214","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYB1","description":"ICD-KHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRF0","description":"ICD-KBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDE0","description":"ICD-JIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNA0","description":"ICD-NKNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRB0","description":"ICD-OHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCC1","description":"ICD-JFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscop w/esoph musc exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32665","description":"Thoracoscop w/esoph musc exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cabg vein single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33510","description":"Cabg vein single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastroenterology_ malabsorption evaluation of alpha-1-antitrypsin_ calprotectin_ pancreatic elastase and reducing substances_ feces_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0430U","description":"Gastroenterology_ malabsorption evaluation of alpha-1-antitrypsin_ calprotectin_ pancreatic elastase and reducing substances_ feces_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92637","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","description":"CPT-92637","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA52","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJB0","description":"ICD-NIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fluphenazine hcl_ 1.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2679","description":"Injection_ fluphenazine hcl_ 1.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOC0","description":"ICD-LGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18D","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIB1","description":"ICD-AAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"SC GNOTYP ERMAP EXONS 4 12","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0199U","description":"SC GNOTYP ERMAP EXONS 4 12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVF0","description":"ICD-OGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTB1","description":"ICD-JGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUE0","description":"ICD-OJUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens variab asphericity sing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2410","description":"Lens variab asphericity sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Approp oral rehyd recommd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4056F","description":"Approp oral rehyd recommd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJD1","description":"ICD-OIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECA0","description":"ICD-FECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVF0","description":"ICD-FBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHED0","description":"ICD-MHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73580","description":"Contrast x-ray of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acetaminophen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80143","description":"Acetaminophen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQB0","description":"ICD-DFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Visc & infraren abd 3 prosth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34847","description":"Visc & infraren abd 3 prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPC0","description":"ICD-JHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHE0","description":"ICD-KIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWC1","description":"ICD-GBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTD0","description":"ICD-JCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of blood/uric acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84550","description":"Assay of blood/uric acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hla class ii semiquant panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86835","description":"Hla class ii semiquant panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Thyroid)_ Mrna_ Gene Expression Analysis Of 10_196 Genes_ Utilizing Fine Needle Aspirate_ Algorithm Reported As A Categorical Result (Eg_ Benign Or Suspicious)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81546","description":"Oncology (Thyroid)_ Mrna_ Gene Expression Analysis Of 10_196 Genes_ Utilizing Fine Needle Aspirate_ Algorithm Reported As A Categorical Result (Eg_ Benign Or Suspicious)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5173","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5173","description":"HCPCS-Q5173","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUF0","description":"ICD-FCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLF1","description":"ICD-BCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1201","description":"HCPCS-B1201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTB0","description":"ICD-EBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brst prsth bra & bilat form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8002","description":"Brst prsth bra & bilat form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ascending Aorta Graft_ With Cardiopulmonary Bypass_ Includes Valve Suspension_ When Performed; For Aortic Disease Other Than Dissection (Eg_ Aneurysm)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33859","description":"Ascending Aorta Graft_ With Cardiopulmonary Bypass_ Includes Valve Suspension_ When Performed; For Aortic Disease Other Than Dissection (Eg_ Aneurysm)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens_ hydrophilic_ spherical_ photochromic additive_ per lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2524","description":"Contact lens_ hydrophilic_ spherical_ photochromic additive_ per lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acoustic cardiography_ including automated analysis of combined acoustic and electrical intervals; single_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0223T","description":"Acoustic cardiography_ including automated analysis of combined acoustic and electrical intervals; single_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFA0","description":"ICD-NHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18E","description":"Special Care Low _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLC0","description":"ICD-JFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEA0","description":"ICD-IEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTB0","description":"ICD-AHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTB1","description":"ICD-IBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGC1","description":"ICD-OLGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin exo variable frict","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5714","description":"Knee-shin exo variable frict","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUE1","description":"ICD-CGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYF0","description":"ICD-HAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endo knee-shin fluid swg/sta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5828","description":"Endo knee-shin fluid swg/sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD14B","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAME0","description":"ICD-BAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orbital prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5915","description":"Orbital prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFF0","description":"ICD-KIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPF0","description":"ICD-NDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4CC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CC31","description":"ICD-4CC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIE0","description":"ICD-JAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICF0","description":"ICD-NICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUF0","description":"ICD-CAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXE1","description":"ICD-BEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO general orthopedic intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibilit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9739","description":"Patient unable to complete the FOTO general orthopedic intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibilit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOB0","description":"ICD-CCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lt compres band >=3in <5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6449","description":"Lt compres band >=3in <5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2049","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2049","description":"HCPCS-A2049","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARD0","description":"ICD-CARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWB1","description":"ICD-GGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clean rem part denture max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9934","description":"Clean rem part denture max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCA1","description":"ICD-NCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHC0","description":"ICD-GCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUB0","description":"ICD-IIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTB1","description":"ICD-NBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLID1","description":"ICD-OLID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXF0","description":"ICD-CFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"M/phmtrc alys ishquant/semiq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88374","description":"M/phmtrc alys ishquant/semiq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45327","description":"Proctosigmoidoscopy w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCA1","description":"ICD-AHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDB1","description":"ICD-MKDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFC1","description":"ICD-OEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICA1","description":"ICD-BICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBA1","description":"ICD-KGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEB1","description":"ICD-AIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGME0","description":"ICD-IGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"replacement of restorative material used to close an access opening of a screw-retained implant supported prosthesis_ per implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6197","description":"replacement of restorative material used to close an access opening of a screw-retained implant supported prosthesis_ per implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB22","description":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Torsion mechanism knee/ankle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2861","description":"Torsion mechanism knee/ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Test urine for lactose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83633","description":"Test urine for lactose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cap bld skin piercing laser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0620","description":"Cap bld skin piercing laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bupivacaine (posimir)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9144","description":"Injection_ bupivacaine (posimir)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQC0","description":"ICD-DIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHC1","description":"ICD-IIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE101","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dna antibody single strand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86226","description":"Dna antibody single strand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4375","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","description":"HCPCS-Q4375","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLE1","description":"ICD-NBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hla ii typing 1 loc hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81382","description":"Hla ii typing 1 loc hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILC0","description":"ICD-EILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of breast lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19000","description":"Drainage of breast lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNC1","description":"ICD-ODNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of contact lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92326","description":"Replacement of contact lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Guidance for radiaj tx dlvr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77387","description":"Guidance for radiaj tx dlvr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of lower jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21244","description":"Reconstruction of lower jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGC0","description":"ICD-KIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLE1","description":"ICD-AHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKME1","description":"ICD-MKME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGND0","description":"ICD-BGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD20B","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Camp overnite waiver/session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2036","description":"Camp overnite waiver/session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUB1","description":"ICD-CDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ins endovas vena cava filtr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37191","description":"Ins endovas vena cava filtr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQA1","description":"ICD-KAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSA1","description":"ICD-PLSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Computerized Dynamic Posturography Sensory Organization Test (Cdp-Sot)_ 6 Conditions (Ie_ Eyes Open_ Eyes Closed_ Visual Sway_ Platform Sway_ Eyes Closed Platform Sway_ Platfo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92549","description":"Computerized Dynamic Posturography Sensory Organization Test (Cdp-Sot)_ 6 Conditions (Ie_ Eyes Open_ Eyes Closed_ Visual Sway_ Platform Sway_ Eyes Closed Platform Sway_ Platfo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8D","description":"Low Rehab_ ADL Index 0-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDC1","description":"ICD-EIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA160","description":"Clinically Complex _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADC1","description":"ICD-GADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWD1","description":"ICD-GEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FC21","description":"ICD-1FC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not achieve a PDC of at least 75% for their asthma controller medication","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9811","description":"Patient did not achieve a PDC of at least 75% for their asthma controller medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMD1","description":"ICD-MBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1476","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","description":"HCPCS-M1476","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18D","description":"Special Care Low _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone mineral single photon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78350","description":"Bone mineral single photon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAA0","description":"ICD-FHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Itraconazole injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1835","description":"Itraconazole injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKC0","description":"ICD-JAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFC1","description":"ICD-KBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHB1","description":"ICD-IDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9728","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVB0","description":"ICD-BDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc skin abd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15830","description":"Exc skin abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cabergoline_ oral 0.25mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8515","description":"Cabergoline_ oral 0.25mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Conformal radn thxpy rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4181F","description":"Conformal radn thxpy rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALB1","description":"ICD-JALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCF0","description":"ICD-CHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETB1","description":"ICD-AETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Isavuconazonium Sulfate_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9456","description":"Injection_ Isavuconazonium Sulfate_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKB0","description":"ICD-GCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCF0","description":"ICD-FCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2FB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FB21","description":"ICD-2FB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFE1","description":"ICD-KHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Initial (index visit) numeric rating scale (nrs)_ visual rating scale (vrs)_ or itchyquant assessment score of greater than or equal to 4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1204","description":"Initial (index visit) numeric rating scale (nrs)_ visual rating scale (vrs)_ or itchyquant assessment score of greater than or equal to 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC235","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE14D","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHE0","description":"ICD-EBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGF0","description":"ICD-KAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKB1","description":"ICD-NCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRD1","description":"ICD-GGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMC1","description":"ICD-GIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIE1","description":"ICD-ABIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAE1","description":"ICD-CGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBB0","description":"ICD-FGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUA1","description":"ICD-MFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGE1","description":"ICD-BCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFME1","description":"ICD-FFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALC1","description":"ICD-BALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTC1","description":"ICD-BDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCA1","description":"ICD-CFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES30C","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Velaglucerase alfa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3385","description":"Velaglucerase alfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection for ankle x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27648","description":"Injection for ankle x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair arm/leg nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64857","description":"Repair arm/leg nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically node negative (T1N0N0 or T2N0N0) invasive breast cancer before or after neoadjuvant systemic therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9911","description":"Clinically node negative (T1N0N0 or T2N0N0) invasive breast cancer before or after neoadjuvant systemic therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFB1","description":"ICD-KFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medical testimony","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99075","description":"Medical testimony","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKF0","description":"ICD-BDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABE1","description":"ICD-BABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFB1","description":"ICD-NLFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prothrombin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85611","description":"Prothrombin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99232","description":"Subsequent hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prepare donor heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33944","description":"Prepare donor heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWA0","description":"ICD-OEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Polysom any age 1-3> param","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95808","description":"Polysom any age 1-3> param","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQD0","description":"ICD-HAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4AB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AB21","description":"ICD-4AB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRE0","description":"ICD-DIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C7565","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7565","description":"HCPCS-C7565","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Harness figure of 8 dual con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6676","description":"Harness figure of 8 dual con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Im b1 mrw cel ther hrvst onl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0265T","description":"Im b1 mrw cel ther hrvst onl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXB1","description":"ICD-JBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTE1","description":"ICD-BFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOE1","description":"ICD-CGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00750","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00750","description":"CPT-00750","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81403","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDB1","description":"ICD-KDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKB0","description":"ICD-GAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYD1","description":"ICD-CIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB212","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQA0","description":"ICD-CAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for bone marrow_ smear interpretation (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0855T","description":"Digitization of glass microscope slides for bone marrow_ smear interpretation (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAF1","description":"ICD-MKAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1603","description":"HCPCS-C1603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEA1","description":"ICD-MFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMF1","description":"ICD-AIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICD1","description":"ICD-JICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24535","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOD0","description":"ICD-DCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01714","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01714","description":"CPT-01714","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTC0","description":"ICD-EBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neurology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4015","description":"Neurology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJME0","description":"ICD-OJME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUB1","description":"ICD-OFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBC1","description":"ICD-EEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBND0","description":"ICD-OBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radxps in end rprt4fluro pxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6045F","description":"Radxps in end rprt4fluro pxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Csf shunt reprogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62252","description":"Csf shunt reprogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC44","description":"Medium Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTD1","description":"ICD-MFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCA1","description":"ICD-MDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUD0","description":"ICD-MLUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAF1","description":"ICD-EFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTA0","description":"ICD-ABTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72190","description":"X-ray exam of pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEE0","description":"ICD-MKEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXB0","description":"ICD-JDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINF0","description":"ICD-CINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKA1","description":"ICD-JDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MLG-Complete_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4256","description":"MLG-Complete_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fitting of diaphragm/cap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57170","description":"Fitting of diaphragm/cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-49186","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","description":"CPT-49186","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ Hymovis_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9471","description":"Hyaluronan or derivative_ Hymovis_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLND1","description":"ICD-OLND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKA0","description":"ICD-BDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPF1","description":"ICD-ODPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC154","description":"Special Care Low _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYD0","description":"ICD-CEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of arm muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24330","description":"Revision of arm muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23450","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"M.tuberculo dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87555","description":"M.tuberculo dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eeg monitor technol attended","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95956","description":"Eeg monitor technol attended","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic image bone marrow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77084","description":"Magnetic image bone marrow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diagnosticmammographydigital","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0204","description":"Diagnosticmammographydigital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27894","description":"Decompression of leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orthoped ladies shoes dpth i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3216","description":"Orthoped ladies shoes dpth i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht arm ped fbrglas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4012","description":"Cast sup sht arm ped fbrglas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPA0","description":"ICD-JBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC105","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQB1","description":"ICD-PFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0597U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","description":"CPT-0597U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair tooth socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41874","description":"Repair tooth socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGF0","description":"ICD-CFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4418","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","description":"HCPCS-Q4418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIB1","description":"ICD-AGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plaelet rich plasma unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9020","description":"Plaelet rich plasma unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE156","description":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDB0","description":"ICD-CFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of bile duct tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47711","description":"Excision of bile duct tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHB1","description":"ICD-EGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lurbinectedin_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9223","description":"Injection_ lurbinectedin_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVE0","description":"ICD-FDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMC1","description":"ICD-FCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect recurrent gyn mal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58957","description":"Resect recurrent gyn mal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTD1","description":"ICD-OJTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEA1","description":"ICD-EBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Localized delivery antimicro","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4381","description":"Localized delivery antimicro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA46","description":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cannabinoids synthetic 1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80350","description":"Cannabinoids synthetic 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J8522","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","description":"HCPCS-J8522","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB104","description":"Special Care High _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOD0","description":"ICD-GIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRE1","description":"ICD-GFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA22A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANB1","description":"ICD-KANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0569U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","description":"CPT-0569U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin exo mnl lock ultra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5711","description":"Knee-shin exo mnl lock ultra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score le < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8656","description":"Fun stat score le < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart septum defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33641","description":"Repair heart septum defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"PermeaDerm C_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2018","description":"PermeaDerm C_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41800","description":"Drainage of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJE1","description":"ICD-CDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl cardiac modulj pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0412T","description":"Rmvl cardiac modulj pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUB0","description":"ICD-NJUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of silica","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84285","description":"Assay of silica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens single vision not oth c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2199","description":"Lens single vision not oth c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGC1","description":"ICD-FHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat elbow dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24605","description":"Treat elbow dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVD0","description":"ICD-OEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNA0","description":"ICD-GFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44340","description":"Revision of colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electronic wrist rotator any","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7259","description":"Electronic wrist rotator any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGC1","description":"ICD-FCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prev visit est age 12-17","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99394","description":"Prev visit est age 12-17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1482","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","description":"HCPCS-M1482","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair nasal stenosis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30465","description":"Repair nasal stenosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWB0","description":"ICD-DHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBF1","description":"ICD-KHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSE1","description":"ICD-LDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of hemoglobin heat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83065","description":"Assay of hemoglobin heat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2196","description":"Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tofersen_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9157","description":"Injection_ tofersen_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Graftjacket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4107","description":"Graftjacket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Halo cervical into jckt vest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0810","description":"Halo cervical into jckt vest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"External recharg sys extern","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8695","description":"External recharg sys extern","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMA0","description":"ICD-KIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLC1","description":"ICD-KBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove brain lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61512","description":"Remove brain lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGD1","description":"ICD-NKGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB0D","description":"High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hexagnal phosph pltlt neutrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85598","description":"Hexagnal phosph pltlt neutrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"The Number Of Adult Patient-Months In The Denominator Who Were On Maintenance Hemodialysis Under The Care Of The Same Practitioner Or Group Partner As Of The Last Hemodialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1027","description":"The Number Of Adult Patient-Months In The Denominator Who Were On Maintenance Hemodialysis Under The Care Of The Same Practitioner Or Group Partner As Of The Last Hemodialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCA1","description":"ICD-MHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth penis nodes removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93651","description":"Anesth penis nodes removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB11B","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHF1","description":"ICD-BFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA23C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINB1","description":"ICD-KINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1090","description":"Lumbar sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVC1","description":"ICD-OHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain hand tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26020","description":"Drain hand tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67808","description":"Remove eyelid lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esketamine_ nasal spray_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0013","description":"Esketamine_ nasal spray_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Egd esophagogastrc fndoplsty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43210","description":"Egd esophagogastrc fndoplsty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUA1","description":"ICD-BCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection Sulfur Hexafouride Lipid Microsphere Per Ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9457","description":"Injection Sulfur Hexafouride Lipid Microsphere Per Ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electro connect btw 2 sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2311","description":"Electro connect btw 2 sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTE1","description":"ICD-NGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLA0","description":"ICD-NLLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ligate leg veins radical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37760","description":"Ligate leg veins radical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE20D","description":"Special Care Low _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Protein e-phoresis/urine/csf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84166","description":"Protein e-phoresis/urine/csf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOB0","description":"ICD-CBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBD0","description":"ICD-GBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Multi-vitamin nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9153","description":"Multi-vitamin nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablate atria w/o bypass ext","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33255","description":"Ablate atria w/o bypass ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24538","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of a-v fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37607","description":"Ligation of a-v fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOC1","description":"ICD-OFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTF1","description":"ICD-MBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKD1","description":"ICD-JIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE11A","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental gold foil one surface","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2410","description":"Dental gold foil one surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQA1","description":"ICD-DEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKC0","description":"ICD-BGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt=d(rh)- and unsensitized","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3290F","description":"Pt=d(rh)- and unsensitized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQA1","description":"ICD-DFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ initial treatment_ with identification and marking of the treatment locat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0766T","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ initial treatment_ with identification and marking of the treatment locat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEC1","description":"ICD-JGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYE1","description":"ICD-LIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Liver disease_ analysis of 3 biomarkers (hyaluronic acid [HA]_ procollagen III amino terminal peptide [PIIINP]_ tissue inhibitor of metalloproteinase 1 [TIMP-1])_ using immuno","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81517","description":"Liver disease_ analysis of 3 biomarkers (hyaluronic acid [HA]_ procollagen III amino terminal peptide [PIIINP]_ tissue inhibitor of metalloproteinase 1 [TIMP-1])_ using immuno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD11A","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPC1","description":"ICD-CDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBA0","description":"ICD-EBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBE1","description":"ICD-BBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFC0","description":"ICD-OEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Custom gradient sleev/glov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8420","description":"Custom gradient sleev/glov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJC0","description":"ICD-JCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55710","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","description":"CPT-55710","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (ovarian)_ biochemical assays of 7 proteins (follicle stimulating hormone_ human epididymis protein 4_ apolipoprotein A-1_ transferrin_ beta-2 macroglobulin_ prealbum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0375U","description":"Oncology (ovarian)_ biochemical assays of 7 proteins (follicle stimulating hormone_ human epididymis protein 4_ apolipoprotein A-1_ transferrin_ beta-2 macroglobulin_ prealbum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQB1","description":"ICD-DGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echosclerotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2202","description":"Echosclerotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fungus nes antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86671","description":"Fungus nes antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFD1","description":"ICD-CDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC34","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDB1","description":"ICD-CHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMF1","description":"ICD-NFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant breast silicone/eq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8600","description":"Implant breast silicone/eq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABB0","description":"ICD-NABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACA0","description":"ICD-IACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5100","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","description":"HCPCS-Q5100","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4GA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GA21","description":"ICD-4GA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC3A","description":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of CHA2DS2-VASc risk score of 0 or 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9931","description":"Documentation of CHA2DS2-VASc risk score of 0 or 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"External cannula declotting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36860","description":"External cannula declotting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALE1","description":"ICD-MALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement impl pump cathet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0785","description":"Replacement impl pump cathet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIC0","description":"ICD-OBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neonate crit care subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99469","description":"Neonate crit care subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMB1","description":"ICD-NEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLC1","description":"ICD-EBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWC1","description":"ICD-OAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAC1","description":"ICD-KGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28D","description":"Clinically Complex _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFE1","description":"ICD-BIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAA0","description":"ICD-OEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardioversion electric ext","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92960","description":"Cardioversion electric ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSB1","description":"ICD-HGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0615U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","description":"CPT-0615U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of jaw 4/> views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70110","description":"X-ray exam of jaw 4/> views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services for patient occurred any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9720","description":"Hospice services for patient occurred any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation vad in person","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93750","description":"Interrogation vad in person","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt rec antivir treat hep c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8461","description":"Pt rec antivir treat hep c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGF0","description":"ICD-OJGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYB0","description":"ICD-OIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFA1","description":"ICD-KAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Optx thigh fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27269","description":"Optx thigh fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFE0","description":"ICD-OFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBF0","description":"ICD-JEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Idecabtagene Vicleucel_ Up To 460 Million Autologous B-Cell Maturation Antigen (Bcma) Directed Car-Positive T Cells_ Including Leukapheresis And Dose Preparation Procedures_ P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2055","description":"Idecabtagene Vicleucel_ Up To 460 Million Autologous B-Cell Maturation Antigen (Bcma) Directed Car-Positive T Cells_ Including Leukapheresis And Dose Preparation Procedures_ P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73610","description":"X-ray exam of ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBB0","description":"ICD-KBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eval laryngoscopy sense tst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92615","description":"Eval laryngoscopy sense tst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRC0","description":"ICD-KHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-disposable underpads_ all sizes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4553","description":"Non-disposable underpads_ all sizes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth pharyngeal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17651","description":"Anesth pharyngeal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFD0","description":"ICD-KGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chest wrap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0459","description":"Chest wrap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJD0","description":"ICD-BFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFF0","description":"ICD-CDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATD0","description":"ICD-EATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tissue exam by pathologist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88307","description":"Tissue exam by pathologist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVE0","description":"ICD-OCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISE0","description":"ICD-KISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of kneecap tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27380","description":"Repair of kneecap tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHA0","description":"ICD-BFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB23C","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVF0","description":"ICD-NAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55865","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1021T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","description":"CPT-1021T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBD0","description":"ICD-NFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIE0","description":"ICD-MKIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27532","description":"Treat knee fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgigraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4183","description":"Surgigraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLF1","description":"ICD-MHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of protein other","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84157","description":"Assay of protein other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDF1","description":"ICD-KBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESD1","description":"ICD-PESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOE0","description":"ICD-PJOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect tarsal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28171","description":"Resect tarsal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pos airway press prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8845","description":"Pos airway press prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATF1","description":"ICD-KATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVD0","description":"ICD-NLVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRF0","description":"ICD-HCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Seat lift mechanism toilet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0172","description":"Seat lift mechanism toilet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB25D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA05","description":"Default_ /SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DC31","description":"ICD-3DC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFD0","description":"ICD-KEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXC1","description":"ICD-NBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Additive for enteral formula","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4104","description":"Additive for enteral formula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8D","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHB0","description":"ICD-GIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCA0","description":"ICD-OGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLC0","description":"ICD-NDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHE1","description":"ICD-MLHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXD1","description":"ICD-KDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEB0","description":"ICD-GIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ docetaxel (ingenus) not therapeutically equivalent to j9171_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9172","description":"Injection_ docetaxel (ingenus) not therapeutically equivalent to j9171_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Caloric vstblr test w/rec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92538","description":"Caloric vstblr test w/rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFC0","description":"ICD-OGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE213","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Forearm/arm cuffs free motio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3720","description":"Forearm/arm cuffs free motio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intro windpipe wire/tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31730","description":"Intro windpipe wire/tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ hematolymphoid neoplasm or disorder_ 5-50 genes (eg_ BRAF_ CEBPA_ DNMT3A_ EZH2_ FLT3_ IDH1_ IDH2_ JAK2_ KIT_ KRAS_ MLL_ NOTCH1_ NPM1_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81451","description":"Targeted genomic sequence analysis panel_ hematolymphoid neoplasm or disorder_ 5-50 genes (eg_ BRAF_ CEBPA_ DNMT3A_ EZH2_ FLT3_ IDH1_ IDH2_ JAK2_ KIT_ KRAS_ MLL_ NOTCH1_ NPM1_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDE1","description":"ICD-JFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHB0","description":"ICD-GEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIA0","description":"ICD-EFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cus elbo skt in not con/atyp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6697","description":"Cus elbo skt in not con/atyp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L2221","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","description":"HCPCS-L2221","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCND0","description":"ICD-NCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPE0","description":"ICD-BFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEC1","description":"ICD-JBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVA0","description":"ICD-OEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc abdl tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22901","description":"Exc abdl tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove lung artery emboli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33915","description":"Remove lung artery emboli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no min inv dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8876","description":"Doc reas no min inv dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ filgrastim-ayow_ biosimilar_ (Releuko)_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5125","description":"Injection_ filgrastim-ayow_ biosimilar_ (Releuko)_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKB0","description":"ICD-GBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of larynx lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31512","description":"Removal of larynx lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJC1","description":"ICD-OGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of eardrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69421","description":"Incision of eardrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of chin nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64736","description":"Incision of chin nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGA1","description":"ICD-NKGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (pan-solid tumor)_ analysis of DNA biomarker response to anti-cancer therapy using cell-free circulating DNA_ biomarker comparison to a previous baseline pre-treatmen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0422U","description":"Oncology (pan-solid tumor)_ analysis of DNA biomarker response to anti-cancer therapy using cell-free circulating DNA_ biomarker comparison to a previous baseline pre-treatmen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chest x-ray&fluoro 4/> views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71034","description":"Chest x-ray&fluoro 4/> views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA0D","description":"Default_ /Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBB1","description":"ICD-ADBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUD1","description":"ICD-CFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTC1","description":"ICD-AFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLC0","description":"ICD-IGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAME1","description":"ICD-GAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1063T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1063T","description":"CPT-1063T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC14A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/svc dme non-oxygen eq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0739","description":"Repair/svc dme non-oxygen eq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electronic elbo simultaneous","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7181","description":"Electronic elbo simultaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWB0","description":"ICD-DDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Instillation_ ciprofloxacin otic suspension_ 6 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7342","description":"Instillation_ ciprofloxacin otic suspension_ 6 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIF0","description":"ICD-NBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADF1","description":"ICD-BADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of hip bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27151","description":"Incision of hip bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1238","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Noble Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6087","description":"Implant Supported Crown - Noble Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGB1","description":"ICD-NBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNA0","description":"ICD-BDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHA1","description":"ICD-CIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDC0","description":"ICD-NFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYF1","description":"ICD-LEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0202","description":"HCPCS-C0202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPA1","description":"ICD-JCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELD1","description":"ICD-OELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAE0","description":"ICD-IGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter implantation of coronary sinus reduction device including vascular access and closure_ right heart catheterization_ venous angiography_ coronary sinus angiograph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0645T","description":"Transcatheter implantation of coronary sinus reduction device including vascular access and closure_ right heart catheterization_ venous angiography_ coronary sinus angiograph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESB1","description":"ICD-OESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB116","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBB0","description":"ICD-EBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVB1","description":"ICD-KBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMA0","description":"ICD-MLMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUB1","description":"ICD-JCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHB0","description":"ICD-OIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOA0","description":"ICD-OEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLE0","description":"ICD-CBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDID0","description":"ICD-CDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGB0","description":"ICD-BBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSF1","description":"ICD-PKSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunosuppressive drug noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7599","description":"Immunosuppressive drug noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Embryo hatching","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89253","description":"Embryo hatching","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGC0","description":"ICD-FHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v interpret","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88141","description":"Cytopath c/v interpret","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft brchl-ulnr-rdl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35523","description":"Art byp grft brchl-ulnr-rdl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; retrieval and trans","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0554T","description":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; retrieval and trans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pathogen(s) test for platelets","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9100","description":"Pathogen(s) test for platelets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompress forearm 2 spaces","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25025","description":"Decompress forearm 2 spaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aprepitant_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0185","description":"Injection_ aprepitant_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25535","description":"Treat fracture of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home uterine monitor with or","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9001","description":"Home uterine monitor with or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Indwelling intraurethral drainage device with valve_ patient inserted_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4341","description":"Indwelling intraurethral drainage device with valve_ patient inserted_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFF0","description":"ICD-NJFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Streptococcus_ group A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87880","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Streptococcus_ group A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB10B","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELF0","description":"ICD-KELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNB0","description":"ICD-NJNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC06","description":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYA1","description":"ICD-ODYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove wrist tendon lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25111","description":"Remove wrist tendon lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJD1","description":"ICD-JIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair dislocated jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21490","description":"Repair dislocated jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mycobacteria dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87551","description":"Mycobacteria dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo-vag hyst complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58553","description":"Laparo-vag hyst complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEC0","description":"ICD-IFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMA1","description":"ICD-JBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytarabine liposome inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9098","description":"Cytarabine liposome inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of system reason(s) for not prescribing a long-acting inhaled bronchodilator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9698","description":"Documentation of system reason(s) for not prescribing a long-acting inhaled bronchodilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct vena cava","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34502","description":"Reconstruct vena cava","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral - complete series of radiographic images - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0709","description":"Intraoral - complete series of radiographic images - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup gauntlet plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4013","description":"Cast sup gauntlet plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD12B","description":"Reduced Physical Function _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ inf_ per/cent/midline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1751","description":"Cath_ inf_ per/cent/midline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of gastrostomy tube_ percutaneous_ includes removal_ when performed_ without imaging or endoscopic guidance; not requiring revision of gastrostomy tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43762","description":"Replacement of gastrostomy tube_ percutaneous_ includes removal_ when performed_ without imaging or endoscopic guidance; not requiring revision of gastrostomy tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urinary plastic pouch w fcpl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4379","description":"Urinary plastic pouch w fcpl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Test sock elbw disart/above","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6682","description":"Test sock elbw disart/above","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJA0","description":"ICD-OGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMB0","description":"ICD-MFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUD1","description":"ICD-OJUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESE0","description":"ICD-OESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFF1","description":"ICD-OEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVE0","description":"ICD-BBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB21C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis repeated eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90947","description":"Dialysis repeated eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVD0","description":"ICD-KDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHB1","description":"ICD-GBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEC1","description":"ICD-IAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore deep node(s) neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38542","description":"Explore deep node(s) neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anti-inflm/anlgsc agent rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4016F","description":"Anti-inflm/anlgsc agent rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL0C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0604","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0604","description":"CDT-D0604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low extemity neur exam docum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8404","description":"Low extemity neur exam docum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not screening for unhealthy alcohol use using a systematic screening method (e.g._ limited life expectancy_ other medical reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2198","description":"Documentation of medical reason(s) for not screening for unhealthy alcohol use using a systematic screening method (e.g._ limited life expectancy_ other medical reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC15","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD201","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed semi-elect w/o matt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0295","description":"Hosp bed semi-elect w/o matt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGD1","description":"ICD-KDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01968","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01968","description":"CPT-01968","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGF1","description":"ICD-FAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEB1","description":"ICD-BAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Arthrodesis_ interphalangeal joints_ with or without internal fixation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7506","description":"Arthrodesis_ interphalangeal joints_ with or without internal fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Socket insert above knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5658","description":"Socket insert above knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPA0","description":"ICD-NKPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCB0","description":"ICD-BHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHA1","description":"ICD-CHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release of shoulder ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23415","description":"Release of shoulder ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBA1","description":"ICD-OBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTD0","description":"ICD-KDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgimend_ neonatal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9360","description":"Surgimend_ neonatal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18G","description":"Special Care High _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQF1","description":"ICD-KDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis blood pressure cuff","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4663","description":"Dialysis blood pressure cuff","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21268","description":"Revise eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCND1","description":"ICD-GCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRA0","description":"ICD-GBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMC0","description":"ICD-KBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of thyroid (t3 or t4)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84479","description":"Assay of thyroid (t3 or t4)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCE1","description":"ICD-CGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHA0","description":"ICD-MCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neuroendoscopy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62160","description":"Neuroendoscopy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBD0","description":"ICD-AIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace cvad cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36580","description":"Replace cvad cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXD0","description":"ICD-BAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBD0","description":"ICD-OLBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilate tear duct opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68801","description":"Dilate tear duct opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFD1","description":"ICD-GHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJD0","description":"ICD-GFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUB1","description":"ICD-EIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB136","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDE1","description":"ICD-IDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytogenetic study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88299","description":"Cytogenetic study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABF0","description":"ICD-NABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIF1","description":"ICD-MAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nonpneumatic compression controller without calibrated gradient pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1031","description":"Nonpneumatic compression controller without calibrated gradient pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18C","description":"Special Care High _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMD0","description":"ICD-JCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGB0","description":"ICD-KFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing loss sequence analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81430","description":"Hearing loss sequence analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18E","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home health aide or certifie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9122","description":"Home health aide or certifie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANA0","description":"ICD-NANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lowr extremity prosthes nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5999","description":"Lowr extremity prosthes nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy and transluminal s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9767","description":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy and transluminal s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWC0","description":"ICD-OBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth abdomen vessel surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88051","description":"Anesth abdomen vessel surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Preventive counseling indiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99402","description":"Preventive counseling indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"BTK (Bruton_s tyrosine kinase) (eg_ chronic lymphocytic leukemia) gene analysis_ common variants (eg_ C481S_ C481R_ C481F)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81233","description":"BTK (Bruton_s tyrosine kinase) (eg_ chronic lymphocytic leukemia) gene analysis_ common variants (eg_ C481S_ C481R_ C481F)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAC0","description":"ICD-GAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHD1","description":"ICD-JGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI lower extremity w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73718","description":"MRI lower extremity w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Physician Direct Care - Must be provided by a hospice physician and must be related to the patient_s terminal illness","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0607","description":"Physician Direct Care - Must be provided by a hospice physician and must be related to the patient_s terminal illness","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWE1","description":"ICD-PBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar derotation pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1240","description":"Lumbar derotation pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML40","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSC0","description":"ICD-KDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHC1","description":"ICD-CAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBC1","description":"ICD-AEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Fluoroscopic Guidance_ Lumbar; Each Add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0628T","description":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Fluoroscopic Guidance_ Lumbar; Each Add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEB1","description":"ICD-KCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab-dttb_ biosimilar_ (Ontruzant)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5112","description":"Injection_ trastuzumab-dttb_ biosimilar_ (Ontruzant)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTF0","description":"ICD-JHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEA1","description":"ICD-CAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59855","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVC1","description":"ICD-FHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Occupational therapy evaluation_ low complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes a brief history including","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97165","description":"Occupational therapy evaluation_ low complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes a brief history including","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infratemporal approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61591","description":"Infratemporal approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSE0","description":"ICD-OBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart septum defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33688","description":"Repair heart septum defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGED1","description":"ICD-OGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ank symes mold sckt sach ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5050","description":"Ank symes mold sckt sach ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Complete removal of vulva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56625","description":"Complete removal of vulva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB121","description":"Special Care Low _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assess dyspnea present","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1019F","description":"Assess dyspnea present","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of vitamin a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84590","description":"Assay of vitamin a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablation_ Benign Thyroid Nodule(S)_ Percutaneous_ Laser_ Including Imaging Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0673T","description":"Ablation_ Benign Thyroid Nodule(S)_ Percutaneous_ Laser_ Including Imaging Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOF1","description":"ICD-PDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ patisiran_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9036","description":"Injection_ patisiran_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDB0","description":"ICD-OFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXF1","description":"ICD-OKXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTC1","description":"ICD-GFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUE0","description":"ICD-NDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol/drug service 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0050","description":"Alcohol/drug service 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adhesive remover per ounce","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4455","description":"Adhesive remover per ounce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm 7.6-12.5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12054","description":"Intmd rpr face/mm 7.6-12.5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biodfence 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4140","description":"Biodfence 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVA1","description":"ICD-FHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ factor VIII_ (antihemophilic factor_ recombinant)_ PEGylated_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7207","description":"Injection_ factor VIII_ (antihemophilic factor_ recombinant)_ PEGylated_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis g dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87525","description":"Hepatitis g dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art pancreas ext transmitter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1036","description":"Art pancreas ext transmitter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Man w/c push-rim powr system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0986","description":"Man w/c push-rim powr system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth abdominal wall surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82051","description":"Anesth abdominal wall surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBC1","description":"ICD-CHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0901","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0901","description":"CDT-D0901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAE1","description":"ICD-OAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx nsclc stg3a no progre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9065","description":"Onc dx nsclc stg3a no progre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRA0","description":"ICD-HHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chylmd pneum dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87487","description":"Chylmd pneum dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pathology report diagnosing cutaneous basal cell carcinoma or squamous cell carcinoma (to include in situ disease) sent from the pathologist/dermatopathologist to the biopsyin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9785","description":"Pathology report diagnosing cutaneous basal cell carcinoma or squamous cell carcinoma (to include in situ disease) sent from the pathologist/dermatopathologist to the biopsyin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJC1","description":"ICD-JBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAD0","description":"ICD-ECAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYB0","description":"ICD-PIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAB1","description":"ICD-JEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prev cardrehab qualcardevent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4510F","description":"Prev cardrehab qualcardevent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Renin stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80416","description":"Renin stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Debride genitalia & perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11004","description":"Debride genitalia & perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRD1","description":"ICD-PGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMC1","description":"ICD-ABMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive surgery of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42842","description":"Extensive surgery of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1203","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1203","description":"HCPCS-A1203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGD0","description":"ICD-GGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGE0","description":"ICD-BEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tubular dressing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6457","description":"Tubular dressing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ADAMTS13_ recombinant-krhn_ 10 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7171","description":"Injection_ ADAMTS13_ recombinant-krhn_ 10 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNB0","description":"ICD-KCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Arthroscop rotator cuff repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29827","description":"Arthroscop rotator cuff repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEB1","description":"ICD-OCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEB1","description":"ICD-OFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup gauntlet ped plster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4015","description":"Cast sup gauntlet ped plster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQD1","description":"ICD-PJQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHF1","description":"ICD-NEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX2B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC2A","description":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYD0","description":"ICD-GCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTA0","description":"ICD-FFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC44","description":"High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMC0","description":"ICD-ACMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0009","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruct premalg les 2-14","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17003","description":"Destruct premalg les 2-14","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIE1","description":"ICD-MIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBED1","description":"ICD-JBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGD1","description":"ICD-JIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX45","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUE1","description":"ICD-BGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCE1","description":"ICD-BGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUD1","description":"ICD-GHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRB0","description":"ICD-KDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JB21","description":"ICD-4JB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRE0","description":"ICD-CDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"NFCT DS DNA&RNA 21 TARGETS SARS-COV-2 AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0225U","description":"NFCT DS DNA&RNA 21 TARGETS SARS-COV-2 AMP PROBE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDF0","description":"ICD-IGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTF1","description":"ICD-OHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antipsychotics nos 4-6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80343","description":"Antipsychotics nos 4-6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJB1","description":"ICD-NCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECE0","description":"ICD-EECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Systemic antimicrobials not prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9959","description":"Systemic antimicrobials not prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull/brain surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61720","description":"Incise skull/brain surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1119","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNE0","description":"ICD-OHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1BC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BC21","description":"ICD-1BC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHF1","description":"ICD-OJHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSF0","description":"ICD-KBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJB1","description":"ICD-GAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exhaled carbon dioxide test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94770","description":"Exhaled carbon dioxide test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44120","description":"Removal of small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CT/MRI chest/neck no thy nod","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9557","description":"CT/MRI chest/neck no thy nod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elec knee-shin swing only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5857","description":"Elec knee-shin swing only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Male sling procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53440","description":"Male sling procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7513","description":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYC1","description":"ICD-LAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neostim membrane_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4266","description":"Neostim membrane_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDB1","description":"ICD-NGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63091","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQC0","description":"ICD-PEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 4 vhd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0871","description":"Pwc gp 4 vhd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB40","description":"Medium Rehab _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPC1","description":"ICD-JEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANB1","description":"ICD-GANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8C","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of bladder opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51880","description":"Repair of bladder opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPD0","description":"ICD-BDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgery to stop leg growth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27485","description":"Surgery to stop leg growth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hm preeclamp per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9213","description":"Hm preeclamp per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47051","description":"Anesth removal of rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rebond/cement/repair retain","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8693","description":"Rebond/cement/repair retain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Take-home supply of nasal naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2215","description":"Take-home supply of nasal naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHE1","description":"ICD-BIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUB1","description":"ICD-CGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD112","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHD1","description":"ICD-FHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKB1","description":"ICD-KDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB14A","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES350","description":"Extensive Services _ ADL Index 2-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX1A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31240","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB256","description":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRA1","description":"ICD-GFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise inner ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69801","description":"Incise inner ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYE0","description":"ICD-DCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEED0","description":"ICD-BEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQD1","description":"ICD-DEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat elbow dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24640","description":"Treat elbow dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMF1","description":"ICD-JHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])_ amplified probe techniq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"U0005","description":"Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])_ amplified probe techniq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETC1","description":"ICD-AETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain shoulder lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23030","description":"Drain shoulder lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAED0","description":"ICD-AAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUF1","description":"ICD-FCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOC0","description":"ICD-PAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision addl breast lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19126","description":"Excision addl breast lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKF1","description":"ICD-JIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home vent non-invasive inter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0466","description":"Home vent non-invasive inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hep c screen high risk/other","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0472","description":"Hep c screen high risk/other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Barbiturates_ not elsewhere specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6043","description":"Barbiturates_ not elsewhere specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC211","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IDH2 (isocitrate dehydrogenase 2 [NADP+]_ mitochondrial) (eg_ glioma)_ common variants (eg_ R140W_ R172M)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81121","description":"IDH2 (isocitrate dehydrogenase 2 [NADP+]_ mitochondrial) (eg_ glioma)_ common variants (eg_ R140W_ R172M)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUA1","description":"ICD-ACUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8E","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bortezomib (fresenius kabi)_ not therapeutically equivalent to j9041_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9048","description":"Injection_ bortezomib (fresenius kabi)_ not therapeutically equivalent to j9041_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glucose blood test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82962","description":"Glucose blood test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPC0","description":"ICD-CCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neurology autism_ 32 amines by LC-MS/MS_ using plasma_ algorithm reported as metabolic signature associated with autism spectrum disorder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0063U","description":"Neurology autism_ 32 amines by LC-MS/MS_ using plasma_ algorithm reported as metabolic signature associated with autism spectrum disorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Positioning cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0190","description":"Positioning cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWD1","description":"ICD-DDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCF1","description":"ICD-AHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFB1","description":"ICD-FBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWF1","description":"ICD-LCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAB1","description":"ICD-NLAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAF1","description":"ICD-NKAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAB1","description":"ICD-BDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01939","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","description":"CPT-01939","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Telescop/othr compound lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2615","description":"Telescop/othr compound lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJB0","description":"ICD-CCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHD1","description":"ICD-MEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLF0","description":"ICD-MDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0665U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0665U","description":"CPT-0665U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTE1","description":"ICD-MJTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Filter_ non disposable w pap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7039","description":"Filter_ non disposable w pap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOB1","description":"ICD-CDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath smear prep & report","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0480","description":"Cytopath smear prep & report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWA0","description":"ICD-DDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNA1","description":"ICD-JBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67916","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exoskeletal ak ultra-light m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5790","description":"Exoskeletal ak ultra-light m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWD1","description":"ICD-GFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIA1","description":"ICD-FAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27884","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQE1","description":"ICD-PJQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Outside state ambulance serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0021","description":"Outside state ambulance serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFE0","description":"ICD-FBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVB0","description":"ICD-GAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTD1","description":"ICD-NDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGF1","description":"ICD-KDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transfer tendon to pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27098","description":"Transfer tendon to pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIC1","description":"ICD-BBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKD1","description":"ICD-FDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQF0","description":"ICD-GHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of methemalbumin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83857","description":"Assay of methemalbumin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1498","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","description":"HCPCS-M1498","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYE1","description":"ICD-LHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGB1","description":"ICD-GAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOD0","description":"ICD-HDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9761","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ravulizumab-cwvz_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9052","description":"Injection_ ravulizumab-cwvz_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVF1","description":"ICD-BCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt recvd inhal anesthetic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4554F","description":"Pt recvd inhal anesthetic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D7259","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D7259","description":"CDT-D7259","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0879T","description":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLF0","description":"ICD-MLLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"DuoAmnion_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4327","description":"DuoAmnion_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIF0","description":"ICD-IIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCC1","description":"ICD-OHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPF1","description":"ICD-NJPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNF1","description":"ICD-NHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOB1","description":"ICD-KEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL32","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKA1","description":"ICD-OEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX4C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGE0","description":"ICD-GAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Drug-Delivery Device(S)_ Intramedullary (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20703","description":"Removal Of Drug-Delivery Device(S)_ Intramedullary (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bilat dil retinal exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3000","description":"Bilat dil retinal exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXC1","description":"ICD-OFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELF0","description":"ICD-GELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHD1","description":"ICD-IGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE220","description":"Special Care Low _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect thigh/knee tum 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27364","description":"Resect thigh/knee tum 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBA0","description":"ICD-AGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Upper ext fx orthosis rad/ul","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3982","description":"Upper ext fx orthosis rad/ul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27310","description":"Exploration of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49614","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAF0","description":"ICD-KEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal function studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92512","description":"Nasal function studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOC1","description":"ICD-DIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair standard detach a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1140","description":"Wheelchair standard detach a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ercp w/optical endomicroscpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0397T","description":"Ercp w/optical endomicroscpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert brain-fluid device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61215","description":"Insert brain-fluid device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOA0","description":"ICD-DBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJB1","description":"ICD-BCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNA0","description":"ICD-OBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGF1","description":"ICD-NJGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laminotomy single lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63042","description":"Laminotomy single lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJE0","description":"ICD-FHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWF1","description":"ICD-PDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAA0","description":"ICD-NHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC42","description":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRE0","description":"ICD-PFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Family (With The Patient Present)_ Face-To-Face; Initial 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96167","description":"Health Behavior Intervention_ Family (With The Patient Present)_ Face-To-Face; Initial 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression wrap with adjustable straps_ below knee_ 30-50 mmhg_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6583","description":"Gradient compression wrap with adjustable straps_ below knee_ 30-50 mmhg_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEB1","description":"ICD-BHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ high density foam sheet_ per 250 square centimeters_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6600","description":"Gradient compression bandaging supply_ high density foam sheet_ per 250 square centimeters_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACA1","description":"ICD-NACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hep a vac series prev recvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4155F","description":"Hep a vac series prev recvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient pregnancy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1061","description":"Patient pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ercp remove forgn body duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43275","description":"Ercp remove forgn body duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ext line w easy lock connect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4673","description":"Ext line w easy lock connect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVE1","description":"ICD-FCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Analysis skeletal muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88355","description":"Analysis skeletal muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWF1","description":"ICD-HHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC60","description":"Ultra High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFC1","description":"ICD-FEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28F","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Sage Health Management Solutions_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1009","description":"Clinical Decision Support Mechanism Sage Health Management Solutions_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Internal eye photography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92287","description":"Internal eye photography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILF0","description":"ICD-AILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injectable poly-l-lactic acid_ restorative implant_ 1 ml_ face (deep dermis_ subcutaneous layers)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0196","description":"Injectable poly-l-lactic acid_ restorative implant_ 1 ml_ face (deep dermis_ subcutaneous layers)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Volume control ventilator_ without pressure support mode_ may include pressure control mode_ used with noninvasive interface (e.g._ mask)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0461","description":"Volume control ventilator_ without pressure support mode_ may include pressure control mode_ used with noninvasive interface (e.g._ mask)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coch implant headset replace","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8615","description":"Coch implant headset replace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJC1","description":"ICD-BGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainable plstic pch w/o fp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4377","description":"Drainable plstic pch w/o fp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35091","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLF1","description":"ICD-ECLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious Agent Detection By Nucleic Acid (Dna Or Rna)_ Bartonella Henselae And Bartonella Quintana_ Droplet Digital Pcr (Ddpcr); Following Liquid Enrichment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0302U","description":"Infectious Agent Detection By Nucleic Acid (Dna Or Rna)_ Bartonella Henselae And Bartonella Quintana_ Droplet Digital Pcr (Ddpcr); Following Liquid Enrichment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Personal Emergency Response System (Monthly Maintenance)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1895","description":"Personal Emergency Response System (Monthly Maintenance)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Forehead flap w/vasc pedicle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15731","description":"Forehead flap w/vasc pedicle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])_ any specimen source)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9803","description":"Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])_ any specimen source)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHB1","description":"ICD-GIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACF0","description":"ICD-CACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA3C","description":"Default_ /PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABC0","description":"ICD-OABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEA1","description":"ICD-NLEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKB1","description":"ICD-GHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPA1","description":"ICD-OAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFF0","description":"ICD-BAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADE1","description":"ICD-OADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBA1","description":"ICD-MLBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient reason for not screening for food insecurity_ housing instability_ transportation needs_ utility difficulties_ and interpersonal safety (e.g._ patient declined or othe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1237","description":"Patient reason for not screening for food insecurity_ housing instability_ transportation needs_ utility difficulties_ and interpersonal safety (e.g._ patient declined or othe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fresnell prism press-on lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2718","description":"Fresnell prism press-on lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair fistula w/colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45825","description":"Repair fistula w/colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICE0","description":"ICD-BICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oral device/appliance prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0485","description":"Oral device/appliance prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHD0","description":"ICD-OAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB40","description":"Low Rehab_ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDC1","description":"ICD-FEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPE0","description":"ICD-JAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB20A","description":"Clinically Complex _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAF0","description":"ICD-EFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67974","description":"Reconstruction of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ artesunate_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0391","description":"Injection_ artesunate_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTD0","description":"ICD-FGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAB1","description":"ICD-JIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9329","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","description":"HCPCS-J9329","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise cerv artific disc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22861","description":"Revise cerv artific disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis_ microsatellite instability","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81457","description":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis_ microsatellite instability","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of serum albumin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82040","description":"Assay of serum albumin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNC1","description":"ICD-NDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44145","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28570","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQF1","description":"ICD-GBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQA0","description":"ICD-GGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo guide for amniocentesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76946","description":"Echo guide for amniocentesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGE0","description":"ICD-KFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8A","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOF1","description":"ICD-KBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0305","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0305","description":"CDT-D0305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOB1","description":"ICD-KFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB160","description":"Reduced Physical Function _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plnning pt spec fenest graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34839","description":"Plnning pt spec fenest graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPB1","description":"ICD-BFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pedicle soft tissue graft pr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4270","description":"Pedicle soft tissue graft pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB43","description":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37265","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","description":"CPT-37265","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHD0","description":"ICD-JGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCID0","description":"ICD-FCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQE1","description":"ICD-LDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision hyperplastic tissue","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7970","description":"Excision hyperplastic tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLF1","description":"ICD-OHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Myelography lumbar injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62304","description":"Myelography lumbar injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJD0","description":"ICD-BBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home std case rate 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0270","description":"Home std case rate 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIC1","description":"ICD-FDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGC0","description":"ICD-JAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDC0","description":"ICD-BHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home visit new pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99327","description":"Domicil/r-home visit new pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemipelvect canad sing axis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5280","description":"Hemipelvect canad sing axis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMC0","description":"ICD-EAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1071T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1071T","description":"CPT-1071T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGA0","description":"ICD-CHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFND0","description":"ICD-NFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQA0","description":"ICD-DGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2DC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DC31","description":"ICD-2DC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epsd bk pain for 12 wks/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1136F","description":"Epsd bk pain for 12 wks/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system_ including placement of an oral device_ monitoring of patient tolerance to treatment_ and remov","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0881T","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system_ including placement of an oral device_ monitoring of patient tolerance to treatment_ and remov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth corneal transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14451","description":"Anesth corneal transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kerecis Omega3_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4158","description":"Kerecis Omega3_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-rays for bone age","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77072","description":"X-rays for bone age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ven blood coll snf/hha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0471","description":"Ven blood coll snf/hha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Custom fab w/c back cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2617","description":"Custom fab w/c back cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOE0","description":"ICD-PAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Translum dil eye canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66174","description":"Translum dil eye canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Moderna Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC mRNA 50mcg/0.25mL IM DOSE BOOSTER)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1711","description":"Moderna Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC mRNA 50mcg/0.25mL IM DOSE BOOSTER)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSE1","description":"ICD-OLSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIA1","description":"ICD-NLIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDC1","description":"ICD-AHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCB1","description":"ICD-KHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWE0","description":"ICD-HGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc hand tum deep < 1.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26116","description":"Exc hand tum deep < 1.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEF1","description":"ICD-AGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUA1","description":"ICD-EAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of topiramate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80201","description":"Assay of topiramate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Annual gynecological examina","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0610","description":"Annual gynecological examina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ther/proph/diag inj iv push","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96374","description":"Ther/proph/diag inj iv push","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrivalent (qIRV)_ mRNA; 60 mcg/0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90638","description":"Influenza virus vaccine_ quadrivalent (qIRV)_ mRNA; 60 mcg/0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUE0","description":"ICD-IAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laminotomy addl lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63044","description":"Laminotomy addl lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSE1","description":"ICD-OHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTC1","description":"ICD-GCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disk/foam pad +or- adhesive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5126","description":"Disk/foam pad +or- adhesive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Positional nystagmus test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92542","description":"Positional nystagmus test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWF1","description":"ICD-KIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA24A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVE0","description":"ICD-FBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXE0","description":"ICD-GCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place needles h&n for rt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41019","description":"Place needles h&n for rt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17280","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tear sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68520","description":"Removal of tear sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast ductal carcinoma in situ)_ mRNA_ gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping)_ utilizing formalin-fixed paraffin-e","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0045U","description":"Oncology (breast ductal carcinoma in situ)_ mRNA_ gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping)_ utilizing formalin-fixed paraffin-e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCA1","description":"ICD-FDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Relese_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4257","description":"Relese_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJF1","description":"ICD-FBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJA0","description":"ICD-BAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDE0","description":"ICD-IHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01682","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01682","description":"CPT-01682","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLA1","description":"ICD-FGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTB0","description":"ICD-MDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28X","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUC0","description":"ICD-OBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRB1","description":"ICD-OCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8A","description":"Medium Rehab _ ADL Index 0-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aud brainstem implt programg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92640","description":"Aud brainstem implt programg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BC21","description":"ICD-2BC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHB1","description":"ICD-BAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXF1","description":"ICD-CIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTD1","description":"ICD-FFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2CB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CB31","description":"ICD-2CB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX43","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27303","description":"Drainage of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ glofitamab-gxbm_ 2.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9286","description":"Injection_ glofitamab-gxbm_ 2.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRE1","description":"ICD-PBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGD1","description":"ICD-CEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCC1","description":"ICD-NHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC221","description":"Special Care Low _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rem exostosis any site","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7471","description":"Rem exostosis any site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJD0","description":"ICD-FDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNF0","description":"ICD-GGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAC0","description":"ICD-GCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo removal donor kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50547","description":"Laparo removal donor kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUA1","description":"ICD-BAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMA1","description":"ICD-NIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOA1","description":"ICD-HHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUE0","description":"ICD-JAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQF1","description":"ICD-DDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No pharm ther osteo rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8635","description":"No pharm ther osteo rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67145","description":"Treatment of retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDA0","description":"ICD-ECDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Detach adjust armrest base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0017","description":"Detach adjust armrest base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0660","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","description":"HCPCS-G0660","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCF1","description":"ICD-OLCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASD1","description":"ICD-PASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMB0","description":"ICD-AEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRA0","description":"ICD-ODRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUC0","description":"ICD-KFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILB1","description":"ICD-AILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHE1","description":"ICD-JAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYB0","description":"ICD-LDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQC0","description":"ICD-LCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cuffs adj lock w/ active con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3740","description":"Cuffs adj lock w/ active con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKA0","description":"ICD-CBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQD1","description":"ICD-DHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGB0","description":"ICD-GGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANE1","description":"ICD-BANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTA1","description":"ICD-IDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDE0","description":"ICD-MGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repl alkaline battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8622","description":"Repl alkaline battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFC1","description":"ICD-NIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD120","description":"Special Care Low _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBD1","description":"ICD-FDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cltx post ankle fx w/mnpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27768","description":"Cltx post ankle fx w/mnpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat trigeminal nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61790","description":"Treat trigeminal nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18D","description":"Clinically Complex _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEF1","description":"ICD-JEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIA1","description":"ICD-KHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCD0","description":"ICD-EHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDC1","description":"ICD-ODDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEA1","description":"ICD-CIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEC1","description":"ICD-AIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLD1","description":"ICD-FBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEA0","description":"ICD-GBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27244","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interferon alfa-n3 inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9215","description":"Interferon alfa-n3 inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1019T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","description":"CPT-1019T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Management of new patient-caregiver dyad with dementia_ moderate complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0520","description":"Management of new patient-caregiver dyad with dementia_ moderate complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp4 std sing pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0878","description":"Pwc gp4 std sing pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychia sympts assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1181F","description":"Neuropsychia sympts assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKE1","description":"ICD-FFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES10C","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKC1","description":"ICD-OIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lympho venereum antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86729","description":"Lympho venereum antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transfer tub rail attachment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0246","description":"Transfer tub rail attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWC1","description":"ICD-LIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIA0","description":"ICD-BHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMA0","description":"ICD-KDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASF1","description":"ICD-KASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of interbody biomechanical device(s) (eg_ synthetic cage_ mesh) with integral anterior instrumentation for device anchoring (eg_ screws_ flanges)_ when performed_ to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22853","description":"Insertion of interbody biomechanical device(s) (eg_ synthetic cage_ mesh) with integral anterior instrumentation for device anchoring (eg_ screws_ flanges)_ when performed_ to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKE0","description":"ICD-KCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/bx pleura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32609","description":"Thoracoscopy w/bx pleura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostomy cleaning brush","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4626","description":"Tracheostomy cleaning brush","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOD1","description":"ICD-HBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHC1","description":"ICD-OGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIC0","description":"ICD-IEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx sclc/nsclc ext unknwn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9070","description":"Onc dx sclc/nsclc ext unknwn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28820","description":"Amputation of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrast exam thoracic aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75600","description":"Contrast exam thoracic aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sulfamethoxazole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0039","description":"Injection_ sulfamethoxazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Combined anteroposterior colporrhaphy_ including cystourethroscopy_ when performed; with enterocele repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57265","description":"Combined anteroposterior colporrhaphy_ including cystourethroscopy_ when performed; with enterocele repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJD1","description":"ICD-OLJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fluvirin vacc_ 3 yrs & >_ im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2037","description":"Fluvirin vacc_ 3 yrs & >_ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJE1","description":"ICD-KFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQE0","description":"ICD-CHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug/substance nos 4-6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80376","description":"Drug/substance nos 4-6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilate esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43453","description":"Dilate esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not providing brief counseling (e.g._ limited life expectancy_ other medical reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2201","description":"Documentation of medical reason(s) for not providing brief counseling (e.g._ limited life expectancy_ other medical reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chloramphenicol sodium injec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0720","description":"Chloramphenicol sodium injec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28X","description":"Clinically Complex _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGB1","description":"ICD-BDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX17","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBF0","description":"ICD-OKBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hand restoration no fingers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6910","description":"Hand restoration no fingers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNA0","description":"ICD-FHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBB0","description":"ICD-OKBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGA0","description":"ICD-GAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILC0","description":"ICD-GILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoe heel new rubber standar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3460","description":"Shoe heel new rubber standar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC22D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSF1","description":"ICD-PHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPB0","description":"ICD-KEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECF0","description":"ICD-IECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1102","description":"HCPCS-A1102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQE1","description":"ICD-GBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1822","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","description":"HCPCS-E1822","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC154","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40652","description":"Repair lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC24C","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB20B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bx breast 1st lesion us imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19083","description":"Bx breast 1st lesion us imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ avacincaptad pegol_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9162","description":"Injection_ avacincaptad pegol_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMA1","description":"ICD-GAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vital capacity test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94150","description":"Vital capacity test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHD1","description":"ICD-GEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Manual pump enema_ reusable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4459","description":"Manual pump enema_ reusable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4365","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","description":"HCPCS-Q4365","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AA21","description":"ICD-3AA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAE0","description":"ICD-KHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWA1","description":"ICD-DGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00541","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00541","description":"CPT-00541","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDE1","description":"ICD-JEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Serial tonometry exam(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92100","description":"Serial tonometry exam(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWA1","description":"ICD-LIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHE0","description":"ICD-MAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove ventricular device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33978","description":"Remove ventricular device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDC0","description":"ICD-GEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Edetate disodium per 150 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3520","description":"Edetate disodium per 150 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAF1","description":"ICD-MEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98979","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","description":"CPT-98979","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYC1","description":"ICD-PAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINA1","description":"ICD-KINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hm gest dm per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9214","description":"Hm gest dm per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wrst mold sock w/exp interfa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6055","description":"Wrst mold sock w/exp interfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of quinine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84228","description":"Assay of quinine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAE0","description":"ICD-BIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (congenital neutropenia)_ genomic sequence analysis of 23 genes_ blood_ buccal swab_ or amniotic fluid (Versitiā„¢ Congenital Neutropenia Panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0271U","description":"Hematology (congenital neutropenia)_ genomic sequence analysis of 23 genes_ blood_ buccal swab_ or amniotic fluid (Versitiā„¢ Congenital Neutropenia Panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE156","description":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHE1","description":"ICD-NDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of progesterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84144","description":"Assay of progesterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice_ inpatient hospital","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5005","description":"Hospice_ inpatient hospital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ binaural_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5248","description":"Hearing aid_ binaural_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Screw retained plate","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7292","description":"Screw retained plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC0B","description":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDA1","description":"ICD-FBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC234","description":"Special Care High _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYC1","description":"ICD-HHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apply multlay comprs lwr leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29581","description":"Apply multlay comprs lwr leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBA0","description":"ICD-OGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARD0","description":"ICD-OARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Health club membership yr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9970","description":"Health club membership yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYF1","description":"ICD-GIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dexamethasone intra implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7312","description":"Dexamethasone intra implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone marrow imaging mult","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78103","description":"Bone marrow imaging mult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITE1","description":"ICD-NITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWB1","description":"ICD-HIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMD0","description":"ICD-KAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC236","description":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSA1","description":"ICD-OCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay ph body fluid nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83986","description":"Assay ph body fluid nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement breastpump cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4283","description":"Replacement breastpump cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25441","description":"Reconstruct wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJC0","description":"ICD-NIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMF0","description":"ICD-AIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Walker seat attachment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0156","description":"Walker seat attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKF1","description":"ICD-KAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRF0","description":"ICD-DBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB3D","description":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPB1","description":"ICD-KCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sewho erbs palsey design abd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3962","description":"Sewho erbs palsey design abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct urethra stage 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53425","description":"Reconstruct urethra stage 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"2019-nCoV Coronavirus_ SARS-CoV-2/2019-nCoV (COVID-19)_ any technique_ multiple types or subtypes (includes all targets)_ non-CDC_ making use of high throughput technologies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"U0004","description":"2019-nCoV Coronavirus_ SARS-CoV-2/2019-nCoV (COVID-19)_ any technique_ multiple types or subtypes (includes all targets)_ non-CDC_ making use of high throughput technologies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGD0","description":"ICD-NLGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment aid(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77334","description":"Radiation treatment aid(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEC1","description":"ICD-NAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRC0","description":"ICD-OHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCD1","description":"ICD-CCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASA0","description":"ICD-HASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJF0","description":"ICD-GEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 7-9 under the MDPP","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9876","description":"Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 7-9 under the MDPP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx orbit fx periorbital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21386","description":"Opn tx orbit fx periorbital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8I","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUD0","description":"ICD-KGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXB1","description":"ICD-CCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFC1","description":"ICD-NJFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXC0","description":"ICD-KGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILE1","description":"ICD-OILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRA0","description":"ICD-DBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx nose fx w/o stablj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21315","description":"Closed tx nose fx w/o stablj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC121","description":"Special Care Low _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJA1","description":"ICD-CEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extended culture of oocytes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89272","description":"Extended culture of oocytes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy stone removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52325","description":"Cystoscopy stone removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFA1","description":"ICD-CIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Temproromandibular Joint Dysfunction - non-invasive physical therapies","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9130","description":"Temproromandibular Joint Dysfunction - non-invasive physical therapies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIF0","description":"ICD-CFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lifts elevation metal extens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3330","description":"Lifts elevation metal extens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO foot or ankle intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9731","description":"Patient unable to complete the FOTO foot or ankle intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABE1","description":"ICD-CABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iliac revasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37220","description":"Iliac revasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIC0","description":"ICD-KGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHD0","description":"ICD-AGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC1B","description":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHE0","description":"ICD-OCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUF0","description":"ICD-NFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiological examination_ surgical specimen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76098","description":"Radiological examination_ surgical specimen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mastoid surgery revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69605","description":"Mastoid surgery revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hf assessment tool completed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3117F","description":"Hf assessment tool completed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33425","description":"Repair of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSA1","description":"ICD-OKSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lymphocytotoxicity assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86805","description":"Lymphocytotoxicity assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES144","description":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cntct lens hydrophilic toric","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2521","description":"Cntct lens hydrophilic toric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemotherapy by infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0084","description":"Chemotherapy by infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLD0","description":"ICD-JBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFE1","description":"ICD-NKFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI orbt/fac/nck w/o &w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70543","description":"MRI orbt/fac/nck w/o &w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTF0","description":"ICD-NDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMB0","description":"ICD-KIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMD1","description":"ICD-ABMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pet imaging initial dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0252","description":"Pet imaging initial dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB151","description":"Clinically Complex _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIC0","description":"ICD-OEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Methylprednisolone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2920","description":"Methylprednisolone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hosp grade elec breast pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0604","description":"Hosp grade elec breast pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE225","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBC1","description":"ICD-AHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAB1","description":"ICD-AGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGED0","description":"ICD-MGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWD0","description":"ICD-KCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE235","description":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HA31","description":"ICD-4HA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILD1","description":"ICD-NILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMB1","description":"ICD-KFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC234","description":"Clinically Complex _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBME0","description":"ICD-NBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJE0","description":"ICD-OLJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Calibrator solution/chips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4256","description":"Calibrator solution/chips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHD1","description":"ICD-OGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2116","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAB1","description":"ICD-NFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB34","description":"Low Rehab_ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWD1","description":"ICD-GBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSC1","description":"ICD-HHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUB0","description":"ICD-GBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUC1","description":"ICD-EBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC12D","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXE0","description":"ICD-NCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim-pbbk (fylnetra)_ biosimilar_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5130","description":"Injection_ pegfilgrastim-pbbk (fylnetra)_ biosimilar_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMF1","description":"ICD-MEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HTR2A (5-hydroxytryptamine receptor 2A)_ HTR2C (5-hydroxytryptamine receptor 2C) (eg_ citalopram metabolism) gene analysis_ common variants (ie_ HTR2A rs7997012 [c.614-2211T>C","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0033U","description":"HTR2A (5-hydroxytryptamine receptor 2A)_ HTR2C (5-hydroxytryptamine receptor 2C) (eg_ citalopram metabolism) gene analysis_ common variants (ie_ HTR2A rs7997012 [c.614-2211T>C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYD1","description":"ICD-OJYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Miro3D_ per cu cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2025","description":"Miro3D_ per cu cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagectomy_ total or near total_ with thoracoscopic mobilization of the upper_ middle_ and lower mediastinal esophagus_ with separate laparoscopic proximal gastrectomy_ wit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43288","description":"Esophagectomy_ total or near total_ with thoracoscopic mobilization of the upper_ middle_ and lower mediastinal esophagus_ with separate laparoscopic proximal gastrectomy_ wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUC1","description":"ICD-KEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hysterectomy/bladder repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51925","description":"Hysterectomy/bladder repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of blood lipoprotein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83721","description":"Assay of blood lipoprotein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIF0","description":"ICD-CDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD114","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHE0","description":"ICD-BDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB0D","description":"Very High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0469","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","description":"HCPCS-E0469","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Grp a strep test performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3210F","description":"Grp a strep test performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fit spectacles single system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92354","description":"Fit spectacles single system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m gluceptate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9550","description":"Tc99m gluceptate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERE0","description":"ICD-KERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXF1","description":"ICD-KFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology (coronary artery disease [CAD])_ analysis of 3 proteins (high sensitivity [hs] troponin_ adiponectin_ and kidney injury molecule-1 [KIM-1])_ plasma_ algorithm repor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0308U","description":"Cardiology (coronary artery disease [CAD])_ analysis of 3 proteins (high sensitivity [hs] troponin_ adiponectin_ and kidney injury molecule-1 [KIM-1])_ plasma_ algorithm repor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLE1","description":"ICD-AGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19368","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 81 Years Of Age And Older With Evidence Of Frailty During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2125","description":"Patients 81 Years Of Age And Older With Evidence Of Frailty During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIME1","description":"ICD-FIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score shdl not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8666","description":"Fun stat score shdl not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28540","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUC0","description":"ICD-KIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clin symp vol ovrld assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1004F","description":"Clin symp vol ovrld assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCC1","description":"ICD-EDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoplasty; for laryngeal stenosis_ with graft_ with indwelling stent placement_ younger than 12 years of age","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31553","description":"Laryngoplasty; for laryngeal stenosis_ with graft_ with indwelling stent placement_ younger than 12 years of age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Water softening system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1625","description":"Water softening system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr f/e/e/n/l/m >30.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12018","description":"Rpr f/e/e/n/l/m >30.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRA0","description":"ICD-OLRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-70473","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","description":"CPT-70473","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYE0","description":"ICD-KGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIE0","description":"ICD-ECIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pet image w/ct lmtd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78814","description":"Pet image w/ct lmtd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Office consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99243","description":"Office consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOE1","description":"ICD-CEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHF1","description":"ICD-NDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat dislocation/fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23670","description":"Treat dislocation/fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMC1","description":"ICD-EHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUF0","description":"ICD-KDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25415","description":"Repair radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAF0","description":"ICD-IHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHD1","description":"ICD-GGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSD1","description":"ICD-DFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA0C","description":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOC0","description":"ICD-HEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Close bronchial fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32815","description":"Close bronchial fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHF0","description":"ICD-FBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Placement of seton","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46020","description":"Placement of seton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDD0","description":"ICD-FHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX3A","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAB1","description":"ICD-FCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace chest compress vest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7025","description":"Replace chest compress vest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABA1","description":"ICD-NABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDB1","description":"ICD-MHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2043","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","description":"HCPCS-A2043","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD214","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQF0","description":"ICD-HHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB124","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD217","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSA1","description":"ICD-CFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMF1","description":"ICD-GIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00218","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00218","description":"CPT-00218","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medical conference by physic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0220","description":"Medical conference by physic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clin tx mdd comm to tx clin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8959","description":"Clin tx mdd comm to tx clin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD15A","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPF0","description":"ICD-CFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-imaging heart function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78414","description":"Non-imaging heart function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iv oct for proc addl vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0292T","description":"Iv oct for proc addl vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient received anti-EGFR monoclonal antibody therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9845","description":"Patient received anti-EGFR monoclonal antibody therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kafo fem fx cast molded to p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2128","description":"Kafo fem fx cast molded to p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No reason for no hep c geno","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9208","description":"No reason for no hep c geno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJD1","description":"ICD-JGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MOST_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4328","description":"MOST_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCD1","description":"ICD-BDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9053","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9053","description":"HCPCS-J9053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo-vag hyst w/t/o compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58554","description":"Laparo-vag hyst w/t/o compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28B","description":"Clinically Complex _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIE0","description":"ICD-NIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHD1","description":"ICD-OKHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRC0","description":"ICD-PIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0601","description":"HCPCS-A0601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHC1","description":"ICD-NEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWD1","description":"ICD-OKWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBF1","description":"ICD-CFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIC1","description":"ICD-NHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB250","description":"Special Care Low _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N-et; patient attend/escort","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2001","description":"N-et; patient attend/escort","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-96041","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","description":"CPT-96041","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0921T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","description":"CPT-0921T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGD1","description":"ICD-KAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transparent film > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6259","description":"Transparent film > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCB1","description":"ICD-CFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE256","description":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQA1","description":"ICD-KBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELB1","description":"ICD-GELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQA1","description":"ICD-DHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPC1","description":"ICD-JBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transplant of thigh tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27396","description":"Transplant of thigh tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00930","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00930","description":"CPT-00930","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANE1","description":"ICD-FANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWF0","description":"ICD-PEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection into brain canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61026","description":"Injection into brain canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEB0","description":"ICD-FGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (atypical hemolytic uremic syndrome [aHUS])_ genomic sequence analysis of 15 genes_ blood_ buccal swab_ or amniotic fluid (Versitiā„¢ aHUS Genetic Evaluation)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0268U","description":"Hematology (atypical hemolytic uremic syndrome [aHUS])_ genomic sequence analysis of 15 genes_ blood_ buccal swab_ or amniotic fluid (Versitiā„¢ aHUS Genetic Evaluation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stent placemt retro carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37217","description":"Stent placemt retro carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFA1","description":"ICD-JEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJC0","description":"ICD-KDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAB0","description":"ICD-JDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pulp vitality test","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0460","description":"Pulp vitality test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHD1","description":"ICD-OIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64728","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","description":"CPT-64728","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth w/o gen/neurax anesth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4560F","description":"Anesth w/o gen/neurax anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEE0","description":"ICD-AAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQE0","description":"ICD-HGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKC1","description":"ICD-CFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial proctectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45123","description":"Partial proctectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens_ hydrophilic_ dual focus_ per lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2525","description":"Contact lens_ hydrophilic_ dual focus_ per lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOC1","description":"ICD-GEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2033","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","description":"HCPCS-A2033","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICE0","description":"ICD-EICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ligation hemorrhoid w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0249T","description":"Ligation hemorrhoid w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMD0","description":"ICD-OCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOA0","description":"ICD-HAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUA0","description":"ICD-MDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB25","description":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of estrone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82679","description":"Assay of estrone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVC0","description":"ICD-OBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ipilimumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9228","description":"Ipilimumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Igh gene rearrange amp meth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81261","description":"Igh gene rearrange amp meth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMD1","description":"ICD-IFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Virus inoculate eggs/animal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87250","description":"Virus inoculate eggs/animal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1EB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EB11","description":"ICD-1EB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tibial arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29856","description":"Tibial arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD156","description":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment mouth roof lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42160","description":"Treatment mouth roof lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg_ touch preparation_ squash preparation)_ initial site (List separa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0843T","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg_ touch preparation_ squash preparation)_ initial site (List separa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNC1","description":"ICD-BGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIME1","description":"ICD-AIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDF0","description":"ICD-NKDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFD1","description":"ICD-KFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBB1","description":"ICD-BHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adult electric hand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7007","description":"Adult electric hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGE1","description":"ICD-JBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98000","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","description":"CPT-98000","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOF1","description":"ICD-PAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHC1","description":"ICD-NHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGC1","description":"ICD-KGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abut support crown titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6094","description":"Abut support crown titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ disp_ monaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5262","description":"Hearing aid_ disp_ monaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUE1","description":"ICD-KHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFD1","description":"ICD-JGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQB1","description":"ICD-PDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth skull drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21251","description":"Anesth skull drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSD1","description":"ICD-LHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic shoe w/roller/rockr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5503","description":"Diabetic shoe w/roller/rockr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOA1","description":"ICD-LFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LA31","description":"ICD-2LA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5944","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5944","description":"CDT-D5944","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVE1","description":"ICD-OHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVA1","description":"ICD-KEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQB0","description":"ICD-PHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHE0","description":"ICD-EAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bridge resin w/high noble","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6250","description":"Bridge resin w/high noble","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASE1","description":"ICD-PASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRC1","description":"ICD-HIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKA1","description":"ICD-OLKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dementia severity classified_ moderate (DEM)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2033F","description":"Dementia severity classified_ moderate (DEM)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0800T","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAF0","description":"ICD-EEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHND1","description":"ICD-OHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDC1","description":"ICD-ICDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic vein harvest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33508","description":"Endoscopic vein harvest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95726","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laser treatment of retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67039","description":"Laser treatment of retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient pressure wrap with adjustable straps_ foot_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6587","description":"Gradient pressure wrap with adjustable straps_ foot_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQC1","description":"ICD-LGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDD1","description":"ICD-GCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision/drain abscess extra","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7521","description":"Incision/drain abscess extra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJE0","description":"ICD-JAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acne surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10040","description":"Acne surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI neck spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72142","description":"MRI neck spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exposure adaptive behavior treatment with protocol modification requiring two or more technicians for severe maladaptive behavior(s); each additional 30 minutes of technicians","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0374T","description":"Exposure adaptive behavior treatment with protocol modification requiring two or more technicians for severe maladaptive behavior(s); each additional 30 minutes of technicians","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB255","description":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPD1","description":"ICD-NCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHD0","description":"ICD-EHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA0D","description":"Medium Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUA0","description":"ICD-EAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNA1","description":"ICD-FBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB13B","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dstrj extensive retinopathy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67227","description":"Dstrj extensive retinopathy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES35A","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Add pwr leg elevation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1010","description":"Add pwr leg elevation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIB1","description":"ICD-GFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEF1","description":"ICD-FGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sphincteroplasty_ anal_ for incontinence_ adult; implantation artificial sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46762","description":"Sphincteroplasty_ anal_ for incontinence_ adult; implantation artificial sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Andrology (infertility)_ sperm-capacitation assessment of ganglioside GM1 distribution patterns_ fluorescence microscopy_ fresh/ frozen specimen_ reported as % of capacitated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0255U","description":"Andrology (infertility)_ sperm-capacitation assessment of ganglioside GM1 distribution patterns_ fluorescence microscopy_ fresh/ frozen specimen_ reported as % of capacitated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRC0","description":"ICD-LBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-adjunctive_ non-implanted continuous glucose monitor or receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2103","description":"Non-adjunctive_ non-implanted continuous glucose monitor or receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBB1","description":"ICD-CHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVB1","description":"ICD-OCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKD1","description":"ICD-OLKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGB0","description":"ICD-KBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25515","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUD0","description":"ICD-GFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHA1","description":"ICD-AFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPE1","description":"ICD-GIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision/drain abscess intra","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7511","description":"Incision/drain abscess intra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81249","description":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCA0","description":"ICD-MJCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"External urinary catheter; non-disposable_ for use with suction pump_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6591","description":"External urinary catheter; non-disposable_ for use with suction pump_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"5% dextrose/normal saline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7042","description":"5% dextrose/normal saline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBE0","description":"ICD-FHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSA0","description":"ICD-DFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8H","description":"Very High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXB0","description":"ICD-OFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTC1","description":"ICD-BCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTC0","description":"ICD-AGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWB0","description":"ICD-PKWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of mesentery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44850","description":"Repair of mesentery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enema tube_ any type_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1013","description":"Enema tube_ any type_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXF0","description":"ICD-BDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBA1","description":"ICD-CGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUB0","description":"ICD-IEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLC0","description":"ICD-GCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELA1","description":"ICD-GELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Riboflavin 5_-phosphate_ ophthalmic solution_ up to 3 mL","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2787","description":"Riboflavin 5_-phosphate_ ophthalmic solution_ up to 3 mL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPC1","description":"ICD-KBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","description":"HCPCS-J3402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj milrinone lactate / 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2260","description":"Inj milrinone lactate / 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVA0","description":"ICD-OAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIB0","description":"ICD-IGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWE1","description":"ICD-GGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTB0","description":"ICD-OLTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBF1","description":"ICD-OHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHB0","description":"ICD-GDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oximeter device for measuring bloodk osygen levels noninvasively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0445","description":"Oximeter device for measuring bloodk osygen levels noninvasively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGE1","description":"ICD-OFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO shoulder intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9735","description":"Patient unable to complete the FOTO shoulder intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYA0","description":"ICD-KHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth pelvis surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84451","description":"Anesth pelvis surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTD1","description":"ICD-EGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMF1","description":"ICD-CCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aldosterone suppression eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80408","description":"Aldosterone suppression eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (urothelial)_ mRNA_ gene-expression profiling by real-time quantitative PCR of 5 genes (MDK_ HOXA13_ CDC2 [CDK1]_ IGFBP5_ and CXCR2)_ utilizing urine_ algorithm incor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0363U","description":"Oncology (urothelial)_ mRNA_ gene-expression profiling by real-time quantitative PCR of 5 genes (MDK_ HOXA13_ CDC2 [CDK1]_ IGFBP5_ and CXCR2)_ utilizing urine_ algorithm incor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":">85y no hx colo ca/rsn scope","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9659","description":">85y no hx colo ca/rsn scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19367","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Testicular imaging w/flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78761","description":"Testicular imaging w/flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-82234","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","description":"CPT-82234","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Deb skin bone at fx site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11012","description":"Deb skin bone at fx site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUD1","description":"ICD-OIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENB0","description":"ICD-CENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLD0","description":"ICD-EDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQD1","description":"ICD-PBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orthopedic Surgery Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4021","description":"Orthopedic Surgery Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc rsn no preop assmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9616","description":"Doc rsn no preop assmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandage roll_ elastic medium stretch_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6598","description":"Gradient compression bandage roll_ elastic medium stretch_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCC1","description":"ICD-MJCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ nicardipine_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2404","description":"Injection_ nicardipine_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD106","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA50","description":"Ultra High Rehab _ ADL Index 0-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJE0","description":"ICD-FIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not prescribing a long-acting inhaled bronchodilator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9696","description":"Documentation of medical reason(s) for not prescribing a long-acting inhaled bronchodilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJD0","description":"ICD-KEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJA1","description":"ICD-KFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transperineal laser ablation of benign prostatic hyperplasia_ including imaging guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0714T","description":"Transperineal laser ablation of benign prostatic hyperplasia_ including imaging guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No doc comm risk calc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9317","description":"No doc comm risk calc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKA1","description":"ICD-GFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXE0","description":"ICD-OKXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRF0","description":"ICD-CDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment planning for magnetic field induction ablation of malignant prostate tissue_ using data from previously performed magnetic resonance imaging (MRI) examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0738T","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue_ using data from previously performed magnetic resonance imaging (MRI) examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCB0","description":"ICD-FBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1304","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVC1","description":"ICD-NCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Methadone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1230","description":"Methadone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoe heel wedge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3350","description":"Shoe heel wedge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYF1","description":"ICD-CAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXC1","description":"ICD-GAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36906","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Admit w/in 180d req remov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9410","description":"Admit w/in 180d req remov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"PreTRMĀ®_ Sera Prognostics_ Sera Prognostics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0247U","description":"PreTRMĀ®_ Sera Prognostics_ Sera Prognostics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nail bed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11750","description":"Removal of nail bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOF1","description":"ICD-PLOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB21","description":"Very High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX31","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Florbetapir f18","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9586","description":"Florbetapir f18","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSE1","description":"ICD-OJSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of breast tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19300","description":"Removal of breast tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPB1","description":"ICD-GIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acetylcholine receptor (AChR); blocking antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86042","description":"Acetylcholine receptor (AChR); blocking antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICB0","description":"ICD-GICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCF1","description":"ICD-OBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient receiving hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9690","description":"Patient receiving hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLC0","description":"ICD-EFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft aorcel/aormesen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35531","description":"Art byp grft aorcel/aormesen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUB1","description":"ICD-BBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suspend bowel w/prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44700","description":"Suspend bowel w/prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ hydroxyprogesterone caproate_ not otherwise specified_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1729","description":"Injection_ hydroxyprogesterone caproate_ not otherwise specified_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUC0","description":"ICD-BHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1094T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1094T","description":"CPT-1094T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWF0","description":"ICD-CDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reposition venous catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36597","description":"Reposition venous catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMF1","description":"ICD-KIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKA1","description":"ICD-CFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct angio abdom w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74175","description":"Ct angio abdom w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1319","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOE0","description":"ICD-CHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTE1","description":"ICD-NFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQB1","description":"ICD-OAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Norsn no ct rpt to reg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9326","description":"Norsn no ct rpt to reg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHED0","description":"ICD-BHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEA1","description":"ICD-JIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQE0","description":"ICD-GGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18E","description":"Clinically Complex _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary venous angiography of each distinct pulmo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93574","description":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary venous angiography of each distinct pulmo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNE1","description":"ICD-OJNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA03","description":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bmt harv/transpl 28d pkg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2150","description":"Bmt harv/transpl 28d pkg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQE1","description":"ICD-CIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Direct advanced life support","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99288","description":"Direct advanced life support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0304","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0304","description":"HCPCS-B0304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urgent Care Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4036","description":"Urgent Care Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRD0","description":"ICD-DFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reshaping bone orthognathic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7940","description":"Reshaping bone orthognathic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPB0","description":"ICD-JDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3310","description":"Anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prothrombin time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85610","description":"Prothrombin time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE25A","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"RAS (KRAS or NRAS) gene mutation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9843","description":"RAS (KRAS or NRAS) gene mutation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA2B","description":"High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANA0","description":"ICD-GANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSC0","description":"ICD-HFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXB1","description":"ICD-OHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Intermittent Monitoring And Maintenan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95709","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Intermittent Monitoring And Maintenan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLE0","description":"ICD-OKLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABF1","description":"ICD-KABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53000","description":"Incision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1426","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","description":"HCPCS-M1426","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKC0","description":"ICD-OFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPA0","description":"ICD-KHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Meckels divert exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78290","description":"Meckels divert exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOD1","description":"ICD-LEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVC1","description":"ICD-GFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc foot/toe tum deep <1.5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28045","description":"Exc foot/toe tum deep <1.5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIE1","description":"ICD-FBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDA1","description":"ICD-IHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair degenerated kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27418","description":"Repair degenerated kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Paraffin bath unit portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0235","description":"Paraffin bath unit portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5008","description":"Hearing screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCE0","description":"ICD-ADCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJB1","description":"ICD-CEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1004","description":"HCPCS-B1004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) antibody_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86413","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) antibody_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAB1","description":"ICD-EHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAE1","description":"ICD-JCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIC0","description":"ICD-BAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATB0","description":"ICD-CATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA5C","description":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC221","description":"Clinically Complex _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC23D","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYA0","description":"ICD-PJYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASC1","description":"ICD-CASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUA1","description":"ICD-JIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXB1","description":"ICD-BDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Single lens spectacle mount","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2610","description":"Single lens spectacle mount","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBD1","description":"ICD-GFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQC0","description":"ICD-DEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0506","description":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Evaluation for wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9156","description":"Evaluation for wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFA1","description":"ICD-BCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNF0","description":"ICD-NLNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Corneal tissue transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65767","description":"Corneal tissue transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAA0","description":"ICD-ECAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL0A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFF1","description":"ICD-OFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLD0","description":"ICD-NBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4384","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","description":"HCPCS-Q4384","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crgvr prov w/ ed addl rsrcs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4322F","description":"Crgvr prov w/ ed addl rsrcs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88027","description":"Autopsy (necropsy) complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB46","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); image acquisiti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0641T","description":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); image acquisiti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0602","description":"HCPCS-A0602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHE1","description":"ICD-EEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECE1","description":"ICD-EECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKC0","description":"ICD-FAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPC0","description":"ICD-GBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKE1","description":"ICD-KFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUD0","description":"ICD-AHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0904","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0904","description":"CDT-D0904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90612","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","description":"CPT-90612","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC13","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Durable medical equipment mi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1399","description":"Durable medical equipment mi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Galectin-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82777","description":"Galectin-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Closure of eyelid by suture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67875","description":"Closure of eyelid by suture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTD1","description":"ICD-MLTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDD1","description":"ICD-FBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDC1","description":"ICD-GEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES33B","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELA0","description":"ICD-EELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB0C","description":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRD1","description":"ICD-KGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACE0","description":"ICD-AACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (hematolymphoid neoplasia)_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ whole blood or bone marrow_ report of specific gene rearra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0014U","description":"Hematology (hematolymphoid neoplasia)_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ whole blood or bone marrow_ report of specific gene rearra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEE1","description":"ICD-MHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAC1","description":"ICD-OEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB32","description":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHE1","description":"ICD-MDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEF1","description":"ICD-IBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documented reason for not assessing hepatitis B virus (HBV) status (e.g._ patient not initiating anti-TNF therapy_ patient declined) prior to initiating anti-TNF therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9504","description":"Documented reason for not assessing hepatitis B virus (HBV) status (e.g._ patient not initiating anti-TNF therapy_ patient declined) prior to initiating anti-TNF therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17273","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL1A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Functional brain mapping","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96020","description":"Functional brain mapping","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0904","description":"HCPCS-B0904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFE0","description":"ICD-BHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL33","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKF1","description":"ICD-CAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise two eye muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67316","description":"Revise two eye muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18B","description":"Clinically Complex _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Obstetrics/Gynecology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4018","description":"Obstetrics/Gynecology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental case management - care coordination","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9992","description":"Dental case management - care coordination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m succimer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9551","description":"Tc99m succimer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No unpln rup post cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9390","description":"No unpln rup post cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACC1","description":"ICD-BACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cancer treatment plan change","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0354","description":"Cancer treatment plan change","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE125","description":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE150","description":"Reduced Physical Function _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJE1","description":"ICD-OCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFD1","description":"ICD-KAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interleukin-6 (Il-6)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83529","description":"Interleukin-6 (Il-6)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Donor hysterectomy (including cold preservation); open_ from cadaver donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0664T","description":"Donor hysterectomy (including cold preservation); open_ from cadaver donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair spec seat depth/w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1298","description":"Wheelchair spec seat depth/w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKD0","description":"ICD-GAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLB0","description":"ICD-KFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQA0","description":"ICD-GHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61690","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leg pain was measured by the Visual Analog Scale (VAS) within three months preoperatively and at one year (9 to 15 months) post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1053","description":"Leg pain was measured by the Visual Analog Scale (VAS) within three months preoperatively and at one year (9 to 15 months) post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVA1","description":"ICD-GEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXC0","description":"ICD-NGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27470","description":"Repair of thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPA0","description":"ICD-KDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"So hard plas stabili pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3678","description":"So hard plas stabili pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of long leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29365","description":"Application of long leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36013","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBF1","description":"ICD-FEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISA1","description":"ICD-CISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPE1","description":"ICD-CDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oversize lens/es","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2780","description":"Oversize lens/es","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPE0","description":"ICD-ODPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary retinal disorders","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81434","description":"Hereditary retinal disorders","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mod compres band w>=3in<5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6451","description":"Mod compres band w>=3in<5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOB0","description":"ICD-CIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPF0","description":"ICD-CCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXF1","description":"ICD-JDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRD0","description":"ICD-GCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC213","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contracted services per day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1022","description":"Contracted services per day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOE1","description":"ICD-PDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXD1","description":"ICD-NGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tmj manipulation under anest","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7830","description":"Tmj manipulation under anest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAE1","description":"ICD-BIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ avelumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9023","description":"Injection_ avelumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDE0","description":"ICD-JHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUA1","description":"ICD-CGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diaphragm surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39599","description":"Diaphragm surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0685U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685U","description":"CPT-0685U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intensive outpatient services; weekly bundle_ minimum of 9 services over a 7 contiguous day period_ which can include individual and group therapy with physicians or psycholog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0137","description":"Intensive outpatient services; weekly bundle_ minimum of 9 services over a 7 contiguous day period_ which can include individual and group therapy with physicians or psycholog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTA0","description":"ICD-OKTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE125","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair rectourethral fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45820","description":"Repair rectourethral fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEE1","description":"ICD-FDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat odontoid fx w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22318","description":"Treat odontoid fx w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25676","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAE1","description":"ICD-EHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Re-Cement Or Re-Bond Fixed Retainer - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8698","description":"Re-Cement Or Re-Bond Fixed Retainer - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQF1","description":"ICD-GDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who are receiving comfort care only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9930","description":"Patients who are receiving comfort care only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablate atria x10sv endo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33266","description":"Ablate atria x10sv endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDF1","description":"ICD-FFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYF0","description":"ICD-KIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDD0","description":"ICD-GIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBF0","description":"ICD-IGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antibiot not rxd/given","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4124F","description":"Antibiot not rxd/given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBF1","description":"ICD-ECBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBE0","description":"ICD-FCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKA0","description":"ICD-KHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Family adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (with or without the patient present)_ face-to-face with gua","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97156","description":"Family adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (with or without the patient present)_ face-to-face with gua","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Omental flap intra-abdom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49905","description":"Omental flap intra-abdom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISA1","description":"ICD-LISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVB0","description":"ICD-JFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hhc occup therapy ea 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0160","description":"Hhc occup therapy ea 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Multi den insert direct form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5512","description":"Multi den insert direct form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAF0","description":"ICD-KCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMA0","description":"ICD-JFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA24","description":"Default_ /14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE120","description":"Reduced Physical Function _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMA1","description":"ICD-AEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJB1","description":"ICD-OHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUE0","description":"ICD-KHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTD0","description":"ICD-CCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect distal humerus tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24150","description":"Resect distal humerus tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIC1","description":"ICD-MAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSD1","description":"ICD-OFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28E","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Occupational therapy evaluation_ moderate complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes an expanded review of","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97166","description":"Occupational therapy evaluation_ moderate complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes an expanded review of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace pump_ alt press pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0182","description":"Replace pump_ alt press pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWA0","description":"ICD-DFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00104","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00104","description":"CPT-00104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNE0","description":"ICD-GGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of rectum and colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45121","description":"Removal of rectum and colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nushield 1 square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4160","description":"Nushield 1 square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLE0","description":"ICD-NGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHME0","description":"ICD-FHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aducanumab-avwa_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0172","description":"Injection_ aducanumab-avwa_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIB1","description":"ICD-ADIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Imm admin by intramuscular injection of (SARS-CoV-2) ([COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3 mL dosage_ tris-sucrose formula_ second dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0052A","description":"Imm admin by intramuscular injection of (SARS-CoV-2) ([COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3 mL dosage_ tris-sucrose formula_ second dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84651","description":"Anesth hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sewho cap design w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3961","description":"Sewho cap design w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLA0","description":"ICD-JGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ins device for rt guide open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49412","description":"Ins device for rt guide open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMB1","description":"ICD-MHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIA1","description":"ICD-AFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLC1","description":"ICD-OGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CSTB (cystatin B) (eg_ progressive myoclonic epilepsy type 1A_ Unverricht-Lundborg disease)_ full gene analysis_ including small sequence changes in exonic and intronic region","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0232U","description":"CSTB (cystatin B) (eg_ progressive myoclonic epilepsy type 1A_ Unverricht-Lundborg disease)_ full gene analysis_ including small sequence changes in exonic and intronic region","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHF1","description":"ICD-GAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEA1","description":"ICD-MEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOD0","description":"ICD-PEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00400","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00400","description":"CPT-00400","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDA0","description":"ICD-NHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEC1","description":"ICD-NJEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1805","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1805","description":"HCPCS-B1805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOD0","description":"ICD-KBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYB1","description":"ICD-KAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXC0","description":"ICD-BGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lang express current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9162","description":"Lang express current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDD0","description":"ICD-JHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28H","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAE1","description":"ICD-MJAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKF0","description":"ICD-JBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTE0","description":"ICD-IBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA14","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ melphalan flufenamide_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9247","description":"Injection_ melphalan flufenamide_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA4A","description":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA41","description":"Very High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCC0","description":"ICD-EBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69641","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat neck spine fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22326","description":"Treat neck spine fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKD0","description":"ICD-GFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPC0","description":"ICD-ODPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noc retail items andsupplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1999","description":"Noc retail items andsupplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA32","description":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50120","description":"Exploration of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ bin_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5258","description":"Hearing aid_ digit_ bin_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant brain electrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61531","description":"Implant brain electrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPD1","description":"ICD-OCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCE1","description":"ICD-OLCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair nerve/shorten bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64876","description":"Repair nerve/shorten bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepatobiliary system imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78226","description":"Hepatobiliary system imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGA1","description":"ICD-NFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release of midfoot joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28264","description":"Release of midfoot joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole lauroxil (Aristada Initio)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9035","description":"Injection_ aripiprazole lauroxil (Aristada Initio)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSF0","description":"ICD-DBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA10D","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Connection of liver allograft to normothermic machine perfusion device_ hemostasis control; each additional hour_ including physiological and laboratory assessments (eg_ perfu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0896T","description":"Connection of liver allograft to normothermic machine perfusion device_ hemostasis control; each additional hour_ including physiological and laboratory assessments (eg_ perfu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replantation digit complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20822","description":"Replantation digit complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"1 cc sterile syringe&needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4206","description":"1 cc sterile syringe&needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICD0","description":"ICD-BICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOF0","description":"ICD-DHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00550","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00550","description":"CPT-00550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autologous prp for ulcers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0460","description":"Autologous prp for ulcers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt dischg <=2d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9255","description":"Doc pt dischg <=2d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anl sp inf pmp w/mdreprg&fil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62370","description":"Anl sp inf pmp w/mdreprg&fil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICE0","description":"ICD-MICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX55","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecg record/review","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93268","description":"Ecg record/review","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23615","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAF0","description":"ICD-MCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8X","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1072T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1072T","description":"CPT-1072T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBC0","description":"ICD-GCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC212","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVD0","description":"ICD-NIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPB1","description":"ICD-JHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXE0","description":"ICD-NAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elbow stump activated lock h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6130","description":"Elbow stump activated lock h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKC1","description":"ICD-FIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJF0","description":"ICD-OBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECF0","description":"ICD-KECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ givosiran_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0223","description":"Injection_ givosiran_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB141","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES21A","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUE0","description":"ICD-NCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiopharmaceutical Quantification Measurement(S) Single Area (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78835","description":"Radiopharmaceutical Quantification Measurement(S) Single Area (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSD0","description":"ICD-HFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDE0","description":"ICD-GEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSC1","description":"ICD-CDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBB0","description":"ICD-JFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gel-one","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7326","description":"Gel-one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX5A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat hand dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26686","description":"Treat hand dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Busulfan injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0594","description":"Busulfan injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath smear other source","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88162","description":"Cytopath smear other source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA212","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCD1","description":"ICD-KDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTE0","description":"ICD-JGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTC0","description":"ICD-FFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUA1","description":"ICD-GCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNE0","description":"ICD-BBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fixed patient lift system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0640","description":"Fixed patient lift system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB1B","description":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTB1","description":"ICD-IDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCME1","description":"ICD-FCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHE1","description":"ICD-MBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMD0","description":"ICD-CIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAE0","description":"ICD-OGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resin three surfaces-anterio","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2332","description":"Resin three surfaces-anterio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABC1","description":"ICD-KABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKA1","description":"ICD-BIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACB0","description":"ICD-JACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVD1","description":"ICD-BAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFID1","description":"ICD-OFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE124","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81413","description":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s)_ bone-substitute material for bone and/or soft tissue hardware fixation augmentation_ including intraoperative imaging guidance_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0869T","description":"Injection(s)_ bone-substitute material for bone and/or soft tissue hardware fixation augmentation_ including intraoperative imaging guidance_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTE0","description":"ICD-ECTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood platelet aggregation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85576","description":"Blood platelet aggregation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0106","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0106","description":"HCPCS-A0106","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPF0","description":"ICD-JHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIF0","description":"ICD-GBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFA1","description":"ICD-JFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVC0","description":"ICD-BEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFA0","description":"ICD-BHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EB31","description":"ICD-2EB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSE1","description":"ICD-ODSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt asst re end life issues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4553F","description":"Pt asst re end life issues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILA0","description":"ICD-IILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMD0","description":"ICD-ACMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Integra flowable wound matri","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4114","description":"Integra flowable wound matri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66625","description":"Removal of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc lack perm&cont&parox fib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1061F","description":"Doc lack perm&cont&parox fib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLC1","description":"ICD-BFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHF0","description":"ICD-FDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDB0","description":"ICD-KDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDE1","description":"ICD-EIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNE1","description":"ICD-GHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQB1","description":"ICD-HFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hair removal by electrolysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17380","description":"Hair removal by electrolysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth pelvic organ surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84851","description":"Anesth pelvic organ surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTF1","description":"ICD-GHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBD0","description":"ICD-EGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dual layer impax membrane_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4262","description":"Dual layer impax membrane_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEC1","description":"ICD-GDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intermittent urinary cath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4353","description":"Intermittent urinary cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPB0","description":"ICD-JEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCC0","description":"ICD-GBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion >2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11308","description":"Shave skin lesion >2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MYD88 (myeloid differentiation primary response 88) (eg_ Waldenstrom_s macroglobulinemia_ lymphoplasmacytic leukemia) gene analysis_ p.Leu265Pro (L265P) variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81305","description":"MYD88 (myeloid differentiation primary response 88) (eg_ Waldenstrom_s macroglobulinemia_ lymphoplasmacytic leukemia) gene analysis_ p.Leu265Pro (L265P) variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rem odontogen cyst to 1.25cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7450","description":"Rem odontogen cyst to 1.25cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Deliver placenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59414","description":"Deliver placenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18X","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0701","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0701","description":"CDT-D0701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPD1","description":"ICD-GIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Synvisc or synvisc-one","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7325","description":"Synvisc or synvisc-one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDC0","description":"ICD-JDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXD1","description":"ICD-GFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOD0","description":"ICD-PLOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAD0","description":"ICD-MDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL24","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJC1","description":"ICD-CEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove cva device obstruct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75901","description":"Remove cva device obstruct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary peripheral neuropathies (eg_ Charcot-Marie-Tooth_ spastic paraplegia)_ genomic sequence analysis panel_ must include sequencing of at least 5 peripheral neuropathy-","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81448","description":"Hereditary peripheral neuropathies (eg_ Charcot-Marie-Tooth_ spastic paraplegia)_ genomic sequence analysis panel_ must include sequencing of at least 5 peripheral neuropathy-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Locm >= 400 mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9951","description":"Locm >= 400 mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5946","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5946","description":"CDT-D5946","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA20","description":"Ultra High Rehab _ ADL Index 0-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML42","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQB0","description":"ICD-PJQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRE1","description":"ICD-LBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJE1","description":"ICD-JGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPC0","description":"ICD-NLPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBE0","description":"ICD-EFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1602","description":"HCPCS-C1602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEA0","description":"ICD-MIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay chondroitin sulfate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82485","description":"Assay chondroitin sulfate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1121","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMD1","description":"ICD-GBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extrnl counterpulse_ per tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0166","description":"Extrnl counterpulse_ per tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKB1","description":"ICD-OBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQD0","description":"ICD-LIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMA1","description":"ICD-ODMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Islet cell tissue transplant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2102","description":"Islet cell tissue transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYE1","description":"ICD-KAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKF0","description":"ICD-JEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8E","description":"Medium Rehab _ ADL Index 0-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA5C","description":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAED1","description":"ICD-AAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHB0","description":"ICD-MCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83051","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKB1","description":"ICD-OLKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of urethra lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53265","description":"Treatment of urethra lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFA1","description":"ICD-FAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA213","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC12C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBND1","description":"ICD-FBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTF1","description":"ICD-ABTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMC0","description":"ICD-JFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Toc tool incl key elem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9655","description":"Toc tool incl key elem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLB1","description":"ICD-FBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tagraxofusp-erzs_ 10mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9049","description":"Injection_ tagraxofusp-erzs_ 10mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/orogastric w/tube plmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43752","description":"Nasal/orogastric w/tube plmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy retro balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43213","description":"Esophagoscopy retro balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAE0","description":"ICD-CHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXF1","description":"ICD-JCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inject skin lesions >7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11901","description":"Inject skin lesions >7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair deformity of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28313","description":"Repair deformity of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mlh1 gene dup/delete variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81294","description":"Mlh1 gene dup/delete variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB212","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFB1","description":"ICD-CHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Herpes simplex 2 ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87273","description":"Herpes simplex 2 ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBF1","description":"ICD-ADBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHA1","description":"ICD-GEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRA0","description":"ICD-OBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDD0","description":"ICD-NCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESA1","description":"ICD-PESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"YT GNOTYP ACHE EXON 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0201U","description":"YT GNOTYP ACHE EXON 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9277","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","description":"HCPCS-J9277","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYC0","description":"ICD-DHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat hand dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26670","description":"Treat hand dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEF0","description":"ICD-GIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPA0","description":"ICD-GIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMB0","description":"ICD-KDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduction of eye prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2626","description":"Reduction of eye prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Smear special stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87207","description":"Smear special stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARD0","description":"ICD-PARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES32A","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair major blood vessel(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33322","description":"Repair major blood vessel(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCC0","description":"ICD-AFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cabg vein six or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33516","description":"Cabg vein six or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v auto fluid redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88175","description":"Cytopath c/v auto fluid redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDA0","description":"ICD-MKDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARB1","description":"ICD-DARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anaphylaxis due to the vaccine on or before the date of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1219","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYE0","description":"ICD-LBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVA0","description":"ICD-NCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Composite drsg <= 16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6203","description":"Composite drsg <= 16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGD0","description":"ICD-OCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Xylose tolerance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84620","description":"Xylose tolerance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB22C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCE1","description":"ICD-CCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC17","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACID1","description":"ICD-ACID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBD1","description":"ICD-EBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ bal dil_ non-vascular","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1726","description":"Cath_ bal dil_ non-vascular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJE1","description":"ICD-JEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive (75 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0080","description":"Extensive (75 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUC0","description":"ICD-IFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dentures adjust cmplt maxil","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5410","description":"Dentures adjust cmplt maxil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5158","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","description":"HCPCS-Q5158","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt disch home day #2 cea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8834","description":"Pt disch home day #2 cea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bed safety enclosure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0316","description":"Bed safety enclosure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 2ND DOSE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0012A","description":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 2ND DOSE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYB0","description":"ICD-PLYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX5D","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Attempted vbac delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59618","description":"Attempted vbac delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not prescribing a long-acting inhaled bronchodilator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9697","description":"Documentation of patient reason(s) for not prescribing a long-acting inhaled bronchodilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGED1","description":"ICD-CGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC55","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low-level laser therapy_ dynamic photonic and dynamic thermokinetic energies_ provided by a physician or other qualified health care professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0552T","description":"Low-level laser therapy_ dynamic photonic and dynamic thermokinetic energies_ provided by a physician or other qualified health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coping","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2975","description":"Coping","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35281","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVF0","description":"ICD-BHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOC0","description":"ICD-PKOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABA1","description":"ICD-IABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNA1","description":"ICD-NLNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASE1","description":"ICD-HASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Csit perf sx or high chd rsk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8966","description":"Csit perf sx or high chd rsk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Optimal care for kidney health mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0002","description":"Optimal care for kidney health mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ glucarpidase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9293","description":"Injection_ glucarpidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter delivery of enhanced fixation device(s) to the endograft (eg_ anchor_ screw_ tack) and all associated radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34712","description":"Transcatheter delivery of enhanced fixation device(s) to the endograft (eg_ anchor_ screw_ tack) and all associated radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE21B","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDD1","description":"ICD-GGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQC1","description":"ICD-LEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Delivery comp imrt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6016","description":"Delivery comp imrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cntct gas permeable sphericl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2510","description":"Cntct gas permeable sphericl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOC1","description":"ICD-GAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADB0","description":"ICD-EADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of pelvic abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57010","description":"Drainage of pelvic abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4347","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","description":"HCPCS-Q4347","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylindr 7.25d/4.25-6d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2113","description":"Spherocylindr 7.25d/4.25-6d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUF1","description":"ICD-EFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart-vein defect(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33730","description":"Repair heart-vein defect(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBD0","description":"ICD-CEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHA1","description":"ICD-ACHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lift assist for elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6635","description":"Lift assist for elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQC0","description":"ICD-PLQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens lenticular bifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2215","description":"Lens lenticular bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMA0","description":"ICD-MCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD156","description":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCED1","description":"ICD-JCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE24B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace skull plate/flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62143","description":"Replace skull plate/flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hematology_ Red Blood Cell (Rbc) Functionality And Deformity As A Function Of Shear Stress_ Whole Blood_ Reported As A Maximum Elongation Index","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0305U","description":"Hematology_ Red Blood Cell (Rbc) Functionality And Deformity As A Function Of Shear Stress_ Whole Blood_ Reported As A Maximum Elongation Index","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytogenetics 100-300","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88275","description":"Cytogenetics 100-300","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antithymocyte globuln rabbit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7511","description":"Antithymocyte globuln rabbit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIB0","description":"ICD-CEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLE1","description":"ICD-ECLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydralazine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0360","description":"Hydralazine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dynamic cavernosometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54231","description":"Dynamic cavernosometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sgd prerec msg > 40 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2506","description":"Sgd prerec msg > 40 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE146","description":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESD1","description":"ICD-KESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUF1","description":"ICD-BEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOE1","description":"ICD-OJOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEA0","description":"ICD-ACEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vaccine toxoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90749","description":"Vaccine toxoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHB1","description":"ICD-JBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0540U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","description":"CPT-0540U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18H","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAD0","description":"ICD-NBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBB0","description":"ICD-ABBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBD0","description":"ICD-MCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRE1","description":"ICD-LHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD101","description":"Special Care Low _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFE0","description":"ICD-CDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE23B","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXB1","description":"ICD-KBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC22","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ padded foam_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6605","description":"Gradient compression bandaging supply_ padded foam_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc reass appr remo filt 3ms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9542","description":"Doc reass appr remo filt 3ms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trb@ gene rearrange amplify","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81340","description":"Trb@ gene rearrange amplify","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOA1","description":"ICD-KBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMA1","description":"ICD-IDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2101","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00626","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00626","description":"CPT-00626","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPC0","description":"ICD-JAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foot foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28193","description":"Removal of foot foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIID1","description":"ICD-FIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXE1","description":"ICD-KHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEC1","description":"ICD-NHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOA1","description":"ICD-GHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYC1","description":"ICD-CCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTA0","description":"ICD-EGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hrdtry brst ca-rlatd dsordrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81433","description":"Hrdtry brst ca-rlatd dsordrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVC0","description":"ICD-OCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB234","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18H","description":"Clinically Complex _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAC0","description":"ICD-FCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64605","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCC0","description":"ICD-NBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diab manage trn ind/group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0109","description":"Diab manage trn ind/group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAA0","description":"ICD-ABAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBB0","description":"ICD-ODBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At One Year (9 To 15 Months) Postoperatively Was Greater Than 22 And Functional Status Measured","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2143","description":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At One Year (9 To 15 Months) Postoperatively Was Greater Than 22 And Functional Status Measured","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Manual diff wbc count b-coat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85009","description":"Manual diff wbc count b-coat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC136","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSE1","description":"ICD-PGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTB0","description":"ICD-OJTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJE0","description":"ICD-KBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28C","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEF0","description":"ICD-BDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBA1","description":"ICD-BIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dev interrog remote 1/2/mlt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93295","description":"Dev interrog remote 1/2/mlt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKD0","description":"ICD-KGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc xdrl spine lesn lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63277","description":"Bx/exc xdrl spine lesn lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35472","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental inlay metl 3/more sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2530","description":"Dental inlay metl 3/more sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILD0","description":"ICD-JILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cyclophosphamide_ (dr. reddy_s)_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9072","description":"Injection_ cyclophosphamide_ (dr. reddy_s)_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJD1","description":"ICD-JFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc back les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21931","description":"Exc back les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vibrate quant sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0107T","description":"Vibrate quant sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFB1","description":"ICD-NAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Egd w/thrml txmnt gerd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43257","description":"Egd w/thrml txmnt gerd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGA0","description":"ICD-CAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAB0","description":"ICD-KBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFB0","description":"ICD-NFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cd4+ cell >=15% (hiv)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3498F","description":"Cd4+ cell >=15% (hiv)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL02","description":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ligation nasal sinus artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30915","description":"Ligation nasal sinus artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of corticosteroids 17","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83491","description":"Assay of corticosteroids 17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGD0","description":"ICD-CDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATC0","description":"ICD-BATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB22D","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHD0","description":"ICD-FHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECC0","description":"ICD-AECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25426","description":"Repair/graft radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLF0","description":"ICD-CFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIF0","description":"ICD-GIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXD1","description":"ICD-JAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAA0","description":"ICD-MEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPC1","description":"ICD-OEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCB1","description":"ICD-OCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment aid(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77332","description":"Radiation treatment aid(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBA0","description":"ICD-CDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYB1","description":"ICD-HIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYA1","description":"ICD-KAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of hematoma/fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10140","description":"Drainage of hematoma/fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMB0","description":"ICD-EDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPC0","description":"ICD-KGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRC1","description":"ICD-GDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRF1","description":"ICD-LBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB24","description":"Low Rehab_ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36902","description":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cabg artery-vein single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33517","description":"Cabg artery-vein single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_ home monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9006","description":"Mccd_ home monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTD1","description":"ICD-NCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXB1","description":"ICD-ODXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nursing assessment/evaluatn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1001","description":"Nursing assessment/evaluatn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv musc migraine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64615","description":"Chemodenerv musc migraine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA260","description":"Clinically Complex _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No syst antimicrobial thx rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4132F","description":"No syst antimicrobial thx rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNE1","description":"ICD-NKNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGE1","description":"ICD-CEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAD1","description":"ICD-JAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKC0","description":"ICD-JGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHE0","description":"ICD-MHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGA0","description":"ICD-BGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNA1","description":"ICD-OBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0204","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0204","description":"CDT-D0204","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBE1","description":"ICD-JEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBA1","description":"ICD-CDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDD0","description":"ICD-FDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQB0","description":"ICD-HDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat dislocation/fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23675","description":"Treat dislocation/fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUF1","description":"ICD-CCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal foot fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28060","description":"Partial removal foot fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHC0","description":"ICD-GEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid sup/access/dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5267","description":"Hearing aid sup/access/dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Custom shape cover bk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5704","description":"Custom shape cover bk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscope w/vc inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31570","description":"Laryngoscope w/vc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJA0","description":"ICD-BIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of peripherally inserted central venous catheter (PICC)_ without subcutaneous port or pump_ including all imaging guidance_ image documentation_ and all associated r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36573","description":"Insertion of peripherally inserted central venous catheter (PICC)_ without subcutaneous port or pump_ including all imaging guidance_ image documentation_ and all associated r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); image acquisiti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0640T","description":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); image acquisiti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUB1","description":"ICD-KHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKE1","description":"ICD-NBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHC1","description":"ICD-EDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath indw foley 2 way silicn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4344","description":"Cath indw foley 2 way silicn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27232","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rolapitant_ oral_ 1mg (Varubi)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9981","description":"Rolapitant_ oral_ 1mg (Varubi)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUA0","description":"ICD-JHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPF0","description":"ICD-GFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove hip bone les deep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27066","description":"Remove hip bone les deep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRB1","description":"ICD-HHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUC1","description":"ICD-IIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMB1","description":"ICD-BAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lesion destruction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7465","description":"Lesion destruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC23A","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVD0","description":"ICD-BCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0703","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0703","description":"HCPCS-B0703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHA0","description":"ICD-JAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUA1","description":"ICD-GAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHME1","description":"ICD-JHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46615","description":"Anoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp common ipsi carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35601","description":"Art byp common ipsi carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3KC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KC31","description":"ICD-3KC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2080","description":"Laup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQF0","description":"ICD-DDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging_ breast_ without contrast material; bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77047","description":"Magnetic resonance imaging_ breast_ without contrast material; bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay tumor other","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86316","description":"Immunoassay tumor other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJD0","description":"ICD-JIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cold agglutinin titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86157","description":"Cold agglutinin titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tb ag response t-cell susp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86481","description":"Tb ag response t-cell susp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXA1","description":"ICD-NCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove cranial cavity fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61000","description":"Remove cranial cavity fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB56","description":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJF0","description":"ICD-CAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHB0","description":"ICD-BGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBID0","description":"ICD-NBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOA0","description":"ICD-DFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Protein analysis w/probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88372","description":"Protein analysis w/probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXE0","description":"ICD-OIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPE0","description":"ICD-OLPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE201","description":"Clinically Complex _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5098","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","description":"HCPCS-Q5098","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDE0","description":"ICD-MJDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ext antenna phren nerve stim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8696","description":"Ext antenna phren nerve stim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGA0","description":"ICD-OKGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJD0","description":"ICD-BHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJC0","description":"ICD-OGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67971","description":"Reconstruction of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXC1","description":"ICD-ODXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTA0","description":"ICD-OHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBA1","description":"ICD-MHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"General Surgery Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4007","description":"General Surgery Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKE0","description":"ICD-NBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDC0","description":"ICD-MJDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28C","description":"Special Care High _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAB0","description":"ICD-EDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVD1","description":"ICD-NAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENE1","description":"ICD-JENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise wrist/forearm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25280","description":"Revise wrist/forearm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILF1","description":"ICD-OILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX3A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDF1","description":"ICD-MEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (urothelial cancer)_ RNA_ analysis by real-time RT-PCR of the FGFR3 (fibroblast growth factor receptor 3) gene analysis (ie_ p.R248C [c.742C>T]_ p.S249C [c.746C>G]_ p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0154U","description":"Oncology (urothelial cancer)_ RNA_ analysis by real-time RT-PCR of the FGFR3 (fibroblast growth factor receptor 3) gene analysis (ie_ p.R248C [c.742C>T]_ p.S249C [c.746C>G]_ p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSF0","description":"ICD-KDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Physical therapy evaluation: low complexity_ requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97161","description":"Physical therapy evaluation: low complexity_ requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25263","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISD0","description":"ICD-DISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37283","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","description":"CPT-37283","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA20","description":"High Rehab _ ADL Index 0-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ex arm/elbow tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24073","description":"Ex arm/elbow tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC11","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLB0","description":"ICD-JBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCF1","description":"ICD-CHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16073","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16073","description":"CPT-16073","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLC0","description":"ICD-GBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lower extremity orthosis nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2999","description":"Lower extremity orthosis nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSA0","description":"ICD-LBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Goserelin acetate implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9202","description":"Goserelin acetate implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCD0","description":"ICD-KHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGF1","description":"ICD-BAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of sperm duct(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55250","description":"Removal of sperm duct(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gi endoscopic ultrasound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76975","description":"Gi endoscopic ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laser Interstitial Thermal Therapy (Litt) Of Lesion_ Intracranial_ Including Burr Hole(S)_ With Magnetic Resonance Imaging Guidance_ When Performed; Single Trajectory For 1 Si","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61736","description":"Laser Interstitial Thermal Therapy (Litt) Of Lesion_ Intracranial_ Including Burr Hole(S)_ With Magnetic Resonance Imaging Guidance_ When Performed; Single Trajectory For 1 Si","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace ureter by bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50840","description":"Replace ureter by bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain cerebro spinal fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62272","description":"Drain cerebro spinal fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHD1","description":"ICD-CFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWA0","description":"ICD-HBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove forearm foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25248","description":"Remove forearm foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB22D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aspa gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81200","description":"Aspa gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUE0","description":"ICD-IHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLD0","description":"ICD-OGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNE0","description":"ICD-CHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g._ patients with dementia or tracheostomy)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1215","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g._ patients with dementia or tracheostomy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neurosurgical Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4016","description":"Neurosurgical Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBF1","description":"ICD-MJBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBID1","description":"ICD-IBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No recd cortico>=10mg/d >60d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9468","description":"No recd cortico>=10mg/d >60d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYE1","description":"ICD-DHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home visit postnatal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99501","description":"Home visit postnatal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLE0","description":"ICD-KHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elec stim other than wound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0283","description":"Elec stim other than wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgery of pancreatic cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48500","description":"Surgery of pancreatic cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biofeedback Training_ Perineal Muscles_ Anorectal Or Urethral Sphincter_ Including Emg And/Or Manometry_ When Performed; Initial 15 Minutes Of One-On-One Physician Or Other Qu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90912","description":"Biofeedback Training_ Perineal Muscles_ Anorectal Or Urethral Sphincter_ Including Emg And/Or Manometry_ When Performed; Initial 15 Minutes Of One-On-One Physician Or Other Qu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYA1","description":"ICD-KEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vein access cutdown > 1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36425","description":"Vein access cutdown > 1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC124","description":"Special Care Low _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCF1","description":"ICD-ABCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTF1","description":"ICD-JBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate (e.g._ salvage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9895","description":"Documentation of medical reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate (e.g._ salvage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18H","description":"Special Care High _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFC1","description":"ICD-JCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX24","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"O&p supply/accessory/service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L9900","description":"O&p supply/accessory/service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFC0","description":"ICD-FAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKC1","description":"ICD-BAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ deoxycholic acid_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0591","description":"Injection_ deoxycholic acid_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bebtelovimab_ 175 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0222","description":"Injection_ bebtelovimab_ 175 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGF0","description":"ICD-NGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aqueous shunt eye w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66179","description":"Aqueous shunt eye w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMF1","description":"ICD-EFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPA0","description":"ICD-GEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNF0","description":"ICD-FCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTE0","description":"ICD-ICTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69662","description":"Revise middle ear bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE120","description":"Special Care High _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIF1","description":"ICD-NGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGD1","description":"ICD-OIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQE1","description":"ICD-OCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 6 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP06","description":"Auto.test pane pricing code_ 6 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3386","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3386","description":"HCPCS-J3386","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPC0","description":"ICD-GAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWF1","description":"ICD-PKWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADA0","description":"ICD-NADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tcd emboli detect w/o inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93892","description":"Tcd emboli detect w/o inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB4A","description":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUE1","description":"ICD-MKUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADB0","description":"ICD-MADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUA1","description":"ICD-KDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"L colectomy/coloproctostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44208","description":"L colectomy/coloproctostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYC0","description":"ICD-ODYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nose allergy test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95065","description":"Nose allergy test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of amputation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24935","description":"Revision of amputation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of prostate abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52700","description":"Drainage of prostate abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLE0","description":"ICD-KGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mcp joint arthroscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29900","description":"Mcp joint arthroscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC17","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ureter endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50976","description":"Ureter endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assessment for hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5010","description":"Assessment for hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat thumb dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26641","description":"Treat thumb dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leg Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 3.0 And Leg Pain Measured By The Visual Analog Scale (Vas) W","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2141","description":"Leg Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 3.0 And Leg Pain Measured By The Visual Analog Scale (Vas) W","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILE1","description":"ICD-EILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHE0","description":"ICD-JIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA1A","description":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRE1","description":"ICD-CDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electro-uroflowmetry first","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51741","description":"Electro-uroflowmetry first","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIF1","description":"ICD-NBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUB0","description":"ICD-GIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (genetic hyperfibrinolysis_ delayed bleeding)_ genomic sequence analysis of 8 genes (F13A1_ F13B_ FGA_ FGB_ FGG_ SERPINA1_ SERPINE1_ SERPINF2_ PLAU)_ blood_ buccal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0273U","description":"Hematology (genetic hyperfibrinolysis_ delayed bleeding)_ genomic sequence analysis of 8 genes (F13A1_ F13B_ FGA_ FGB_ FGG_ SERPINA1_ SERPINE1_ SERPINF2_ PLAU)_ blood_ buccal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59150","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of calf tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27687","description":"Revision of calf tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQE0","description":"ICD-HFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCF0","description":"ICD-OGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9066","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9066","description":"HCPCS-J9066","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHF1","description":"ICD-EHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ald_ tv caption decoder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5271","description":"Ald_ tv caption decoder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oral fludarabine phosphate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8562","description":"Oral fludarabine phosphate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removable partial denture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5281","description":"Removable partial denture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC4A","description":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Na ferric gluconate complex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2916","description":"Na ferric gluconate complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHB1","description":"ICD-EBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0966T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","description":"CPT-0966T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPC1","description":"ICD-KCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-ophthalmic fva","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9733","description":"Non-ophthalmic fva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eye service or procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92499","description":"Eye service or procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB110","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVF1","description":"ICD-OFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDD0","description":"ICD-ICDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBC1","description":"ICD-EFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERD0","description":"ICD-GERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAC0","description":"ICD-GHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKE1","description":"ICD-JFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJC1","description":"ICD-CFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Longevity And Mortality Risk_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 18 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0294U","description":"Longevity And Mortality Risk_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 18 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ins lt atrl press monitor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0293T","description":"Ins lt atrl press monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAA0","description":"ICD-BFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICD1","description":"ICD-KICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng arm splnt ped f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4020","description":"Cast sup lng arm splnt ped f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHND0","description":"ICD-BHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRD1","description":"ICD-LDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCB1","description":"ICD-IDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1390","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","description":"HCPCS-M1390","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTB1","description":"ICD-NHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mobilize erupted/malpos toot","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7282","description":"Mobilize erupted/malpos toot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWE0","description":"ICD-HFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2105","description":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBC1","description":"ICD-JIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hand interface joystick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2321","description":"Hand interface joystick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJD1","description":"ICD-BCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tib/per revasc stnt & ather","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37235","description":"Tib/per revasc stnt & ather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOE0","description":"ICD-OKOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0500U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","description":"CPT-0500U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablative laser treatment_ non-contact_ full field and fractional ablation_ open wound_ per day_ total treatment surface area; each additional 20 sq cm_ or part thereof (List s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0492T","description":"Ablative laser treatment_ non-contact_ full field and fractional ablation_ open wound_ per day_ total treatment surface area; each additional 20 sq cm_ or part thereof (List s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELC0","description":"ICD-FELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove bladder/revise tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51580","description":"Remove bladder/revise tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKF0","description":"ICD-NEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIF1","description":"ICD-CDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUE0","description":"ICD-FAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Custom power whlchr base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0013","description":"Custom power whlchr base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAE1","description":"ICD-FAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JA21","description":"ICD-4JA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLA1","description":"ICD-OJLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGC0","description":"ICD-FFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIE0","description":"ICD-NDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ef complet w/intact nutrient","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4150","description":"Ef complet w/intact nutrient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63272","description":"Excise intrspinl lesion lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kt/v >/= 1.7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3084F","description":"Kt/v >/= 1.7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0073A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKE1","description":"ICD-JGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYA0","description":"ICD-OHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLE1","description":"ICD-KDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUF0","description":"ICD-OFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXD1","description":"ICD-CHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Speech audiometry threshold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0210T","description":"Speech audiometry threshold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIID1","description":"ICD-JIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLA0","description":"ICD-MCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abl1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81170","description":"Abl1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRF0","description":"ICD-LGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA111","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEE0","description":"ICD-EDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJF0","description":"ICD-KFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nonpower mattress overlay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0371","description":"Nonpower mattress overlay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc spleen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38129","description":"Laparoscope proc spleen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPA1","description":"ICD-OHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLF0","description":"ICD-JFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of knuckle joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26518","description":"Fusion of knuckle joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOA1","description":"ICD-OEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWB0","description":"ICD-DGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bamlanivimab_ 700 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0239","description":"Bamlanivimab_ 700 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bendamustine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9033","description":"Bendamustine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIID1","description":"ICD-EIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin full graft een & lips","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15260","description":"Skin full graft een & lips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB113","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Icar ischm mntr interr eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0306T","description":"Icar ischm mntr interr eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0603","description":"HCPCS-B0603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prq coronary mech thrombect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92973","description":"Prq coronary mech thrombect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA0B","description":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGF1","description":"ICD-NCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Methotrexate (Xatmep)_ oral_ 2.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8612","description":"Methotrexate (Xatmep)_ oral_ 2.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove intrvas foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37197","description":"Remove intrvas foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alginate dressing <=16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6196","description":"Alginate dressing <=16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking garter belt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6544","description":"Gc stocking garter belt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB236","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD10B","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADD1","description":"ICD-AADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBF1","description":"ICD-NJBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOE0","description":"ICD-KHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBB0","description":"ICD-MIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAF1","description":"ICD-ECAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSD0","description":"ICD-PCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amino acids mult qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82128","description":"Amino acids mult qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRE1","description":"ICD-OGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous islet celltrans","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0341","description":"Percutaneous islet celltrans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of an implantable_ patient-activated cardiac event recorder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33284","description":"Removal of an implantable_ patient-activated cardiac event recorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXE0","description":"ICD-OJXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHE1","description":"ICD-KHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of umbilicus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49250","description":"Excision of umbilicus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exercise w/hemodynamic meas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93464","description":"Exercise w/hemodynamic meas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy_ includes angiopla","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9764","description":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy_ includes angiopla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQF1","description":"ICD-CBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUF0","description":"ICD-NKUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC41","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct neck spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72127","description":"Ct neck spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD117","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone srgry cmptr fluor image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0054T","description":"Bone srgry cmptr fluor image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIF0","description":"ICD-MFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37292","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","description":"CPT-37292","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prgrmg eval implantable dfb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93284","description":"Prgrmg eval implantable dfb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKD0","description":"ICD-CAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pelvic structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51597","description":"Removal of pelvic structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE216","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANF1","description":"ICD-NANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adj skin pro w/c cus wd<22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2622","description":"Adj skin pro w/c cus wd<22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHF1","description":"ICD-MEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98011","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","description":"CPT-98011","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACA1","description":"ICD-KACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHC0","description":"ICD-NDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC15A","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB3A","description":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB36","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBB0","description":"ICD-JIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA201","description":"Clinically Complex _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suture bile duct injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47900","description":"Suture bile duct injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHND0","description":"ICD-CHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1LC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LC31","description":"ICD-1LC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIE1","description":"ICD-BEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKC0","description":"ICD-JDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPA0","description":"ICD-CBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAE1","description":"ICD-NAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Image cath fluid trns/vgnl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49407","description":"Image cath fluid trns/vgnl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA22","description":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIF0","description":"ICD-MIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB36","description":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKB1","description":"ICD-OHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Impact tooth rem bony w/comp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7241","description":"Impact tooth rem bony w/comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND E","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX14","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND E","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45520","description":"Treatment of rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-waterproof tape","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4450","description":"Non-waterproof tape","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKC1","description":"ICD-FGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/wedge resect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32666","description":"Thoracoscopy w/wedge resect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUE1","description":"ICD-MLUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBD1","description":"ICD-MEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGF1","description":"ICD-CGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCD0","description":"ICD-CGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Y set tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4719","description":"Y set tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Meas lung vol thru 2 yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94013","description":"Meas lung vol thru 2 yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMC1","description":"ICD-NFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Carbamazepine; -10_11-Epoxide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80161","description":"Carbamazepine; -10_11-Epoxide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIA0","description":"ICD-OGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Appendectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44960","description":"Appendectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical place mini implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6013","description":"Surgical place mini implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARC1","description":"ICD-LARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain thigh/knee lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27301","description":"Drain thigh/knee lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATB0","description":"ICD-KATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50572","description":"Kidney endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFD0","description":"ICD-FEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTB1","description":"ICD-BGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBD0","description":"ICD-OKBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVB0","description":"ICD-JBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVD0","description":"ICD-BGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDA0","description":"ICD-BFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lower jaw bone graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21215","description":"Lower jaw bone graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of wrist capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25085","description":"Incision of wrist capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIC0","description":"ICD-GCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"NFCT DS RNA 3 TARGETS UPPER RESPIRATORY SPECIMEN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0240U","description":"NFCT DS RNA 3 TARGETS UPPER RESPIRATORY SPECIMEN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt doc to have fall in asc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8910","description":"Pt doc to have fall in asc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Monoclonal antibodies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7505","description":"Monoclonal antibodies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTC0","description":"ICD-OLTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28B","description":"Special Care Low _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABE0","description":"ICD-JABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDB1","description":"ICD-BEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKA1","description":"ICD-KFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Embolization endpoints are documented separately for each embolized vessel and ovarian artery angiography or embolization performed in the presence of variant uterine artery a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9962","description":"Embolization endpoints are documented separately for each embolized vessel and ovarian artery angiography or embolization performed in the presence of variant uterine artery a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMF1","description":"ICD-GEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWF1","description":"ICD-KCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj dexamethasone acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1094","description":"Inj dexamethasone acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Voice amplifier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8510","description":"Voice amplifier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQD0","description":"ICD-LDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBA0","description":"ICD-BBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr s/a/t/ext 20.1-30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12036","description":"Intmd rpr s/a/t/ext 20.1-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJF0","description":"ICD-NIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALE0","description":"ICD-EALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD12B","description":"Special Care High _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9038","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","description":"HCPCS-J9038","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBD0","description":"ICD-KDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCA0","description":"ICD-ACCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCF0","description":"ICD-IHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pres antibiotic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8711","description":"Pres antibiotic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD241","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNB0","description":"ICD-GGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Emr hd pmp elec/combo_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0494","description":"Emr hd pmp elec/combo_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPC0","description":"ICD-CAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNB1","description":"ICD-FCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQE0","description":"ICD-KAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pd catheter anchor belt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4653","description":"Pd catheter anchor belt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOF1","description":"ICD-LAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXF1","description":"ICD-OIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD226","description":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE226","description":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJA0","description":"ICD-OKJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPA0","description":"ICD-JHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mpsv4 vaccine subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90733","description":"Mpsv4 vaccine subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug hotline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0030","description":"Alcohol and/or drug hotline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBE0","description":"ICD-BGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVD1","description":"ICD-JEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC113","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD14B","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB126","description":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQC0","description":"ICD-OGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRE1","description":"ICD-LFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE20B","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDA0","description":"ICD-JEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIB1","description":"ICD-JCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fuse pancreas cyst and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48540","description":"Fuse pancreas cyst and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMD1","description":"ICD-NAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9247","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9247","description":"CDT-D9247","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Regadenoson injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2785","description":"Regadenoson injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB2B","description":"High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXA1","description":"ICD-NAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRB0","description":"ICD-PLRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-da","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB36","description":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28665","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0509U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0509U","description":"CPT-0509U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Estradiol response panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80415","description":"Estradiol response panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ non-str_ gold-198","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1716","description":"Brachytx_ non-str_ gold-198","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"implant/abutment supported interim fixed denture for edentulous arch ā€“ maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6119","description":"implant/abutment supported interim fixed denture for edentulous arch ā€“ maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVD0","description":"ICD-JIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUF0","description":"ICD-NEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Meals per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9977","description":"Meals per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLE0","description":"ICD-FDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERB1","description":"ICD-CERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKD1","description":"ICD-OIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove mesh from abd wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11008","description":"Remove mesh from abd wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home visit nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99600","description":"Home visit nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGB0","description":"ICD-OHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice long term care_ r&b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2046","description":"Hospice long term care_ r&b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inlay composite/resin one su","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2650","description":"Inlay composite/resin one su","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hand/chin ctrl std joystick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2374","description":"Hand/chin ctrl std joystick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of breast open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19101","description":"Biopsy of breast open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Card MRI w/stress img & dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75563","description":"Card MRI w/stress img & dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of tibia fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27759","description":"Treatment of tibia fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB4B","description":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUB1","description":"ICD-BGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Us exam pelvic complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76856","description":"Us exam pelvic complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autogenous Av Fistula Received","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8530","description":"Autogenous Av Fistula Received","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Growth hormone panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80428","description":"Growth hormone panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXA1","description":"ICD-CHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJF0","description":"ICD-JAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMA0","description":"ICD-EHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESA0","description":"ICD-GESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUF0","description":"ICD-OJUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEC0","description":"ICD-ODEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECB1","description":"ICD-CECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who have a diagnosis of pregnancy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9778","description":"Patients who have a diagnosis of pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSB1","description":"ICD-KBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMD1","description":"ICD-BDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJF0","description":"ICD-FAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1472","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","description":"HCPCS-M1472","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFME1","description":"ICD-JFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUB1","description":"ICD-JAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADA1","description":"ICD-AADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFD0","description":"ICD-FIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE112","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone/skin graft great toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20973","description":"Bone/skin graft great toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce shoulder bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23491","description":"Reinforce shoulder bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAB0","description":"ICD-CAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Screening_ diagnostic_ film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1302","description":"Screening_ diagnostic_ film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTA1","description":"ICD-KHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENA0","description":"ICD-GENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breathing circuits","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4618","description":"Breathing circuits","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dentures rebase cmplt mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5711","description":"Dentures rebase cmplt mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHE0","description":"ICD-KGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bilirubin total transcut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88720","description":"Bilirubin total transcut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE216","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone biopsy excisional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20240","description":"Bone biopsy excisional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFE0","description":"ICD-FAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with pregnancy during adjuvant treatment course","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2205","description":"Patients with pregnancy during adjuvant treatment course","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC22B","description":"Clinically Complex _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD11B","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tamoxifen 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0187","description":"Tamoxifen 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSC0","description":"ICD-DBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hip clevis/thrust bearing fr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2600","description":"Hip clevis/thrust bearing fr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prev visit est age 5-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99393","description":"Prev visit est age 5-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOE1","description":"ICD-HGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJD1","description":"ICD-OEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGF0","description":"ICD-FDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1332","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYE0","description":"ICD-PAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKB1","description":"ICD-BDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of phenytoin total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80185","description":"Assay of phenytoin total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBE1","description":"ICD-NJBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flulaval vacc_ 3 yrs & >_ im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2036","description":"Flulaval vacc_ 3 yrs & >_ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Miscellaneous component_ supply or accessory for use with total artificial heart system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8698","description":"Miscellaneous component_ supply or accessory for use with total artificial heart system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMB0","description":"ICD-IFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rbc leukocytes reduced","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9016","description":"Rbc leukocytes reduced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHC0","description":"ICD-NFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBB1","description":"ICD-MHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAC0","description":"ICD-ADAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Carry current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8984","description":"Carry current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWF0","description":"ICD-ODWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWF0","description":"ICD-GGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injections of stem cell product into perianal perifistular soft tissue_ including fistula preparation (eg_ removal of setons_ fistula curettage_ closure of internal openings)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0748T","description":"Injections of stem cell product into perianal perifistular soft tissue_ including fistula preparation (eg_ removal of setons_ fistula curettage_ closure of internal openings)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft of tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27722","description":"Repair/graft of tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Qty act mcc mg perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9670","description":"Qty act mcc mg perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHE0","description":"ICD-OAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBD0","description":"ICD-GEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis_ administered by","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96202","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis_ administered by","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61313","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD210","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKB0","description":"ICD-OHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemotherapy unspecified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96549","description":"Chemotherapy unspecified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heart image (pet) multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78492","description":"Heart image (pet) multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALC0","description":"ICD-JALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSA0","description":"ICD-CHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHF0","description":"ICD-BHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXB1","description":"ICD-GGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIF0","description":"ICD-OBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0622U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","description":"CPT-0622U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ther fostercare child /month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5146","description":"Ther fostercare child /month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSF1","description":"ICD-DBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHID1","description":"ICD-BHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dispense fee initial 30 day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0333","description":"Dispense fee initial 30 day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA251","description":"Clinically Complex _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA24B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iv pole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0776","description":"Iv pole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28I","description":"Clinically Complex _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4FA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FA11","description":"ICD-4FA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5153","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","description":"HCPCS-Q5153","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSC0","description":"ICD-KGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis via catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4054F","description":"Hemodialysis via catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA14D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acute hepatitis panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80074","description":"Acute hepatitis panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Io radiation tx management","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77469","description":"Io radiation tx management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL3B","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTF1","description":"ICD-GCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy control bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46614","description":"Anoscopy control bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy for treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31527","description":"Laryngoscopy for treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYD1","description":"ICD-KGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Group health education","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99078","description":"Group health education","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj gadoterate meglumi 0.1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9575","description":"Inj gadoterate meglumi 0.1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOD1","description":"ICD-KBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB23D","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental film skull/facial bon","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0290","description":"Dental film skull/facial bon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAB0","description":"ICD-JBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALD0","description":"ICD-NALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFB0","description":"ICD-NIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUC0","description":"ICD-JIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA160","description":"Reduced Physical Function _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECF1","description":"ICD-IECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp3 std sing pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0857","description":"Pwc gp3 std sing pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Signature APatch_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4260","description":"Signature APatch_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOE1","description":"ICD-OLOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATC1","description":"ICD-BATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGED1","description":"ICD-NGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc funct no deficiencies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8542","description":"Doc funct no deficiencies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVA0","description":"ICD-FCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Calc bmi blw low param f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8418","description":"Calc bmi blw low param f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of ileostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44314","description":"Revision of ileostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTD0","description":"ICD-JDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion_ bamlanivimab and etesevimab_ includes infusion and post administration monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0245","description":"Intravenous infusion_ bamlanivimab and etesevimab_ includes infusion and post administration monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCB0","description":"ICD-AGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth 60 min/> as docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4255F","description":"Anesth 60 min/> as docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGD1","description":"ICD-BEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD13C","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE21B","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEED0","description":"ICD-NEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEE1","description":"ICD-EAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28I","description":"Special Care Low _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adrenalin epinephrine inject","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0171","description":"Adrenalin epinephrine inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC10","description":"High Rehab _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMC1","description":"ICD-ECMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRE0","description":"ICD-LCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUB0","description":"ICD-OIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITD0","description":"ICD-JITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCE0","description":"ICD-IDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEB0","description":"ICD-BHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Strapping of knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29530","description":"Strapping of knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBA0","description":"ICD-MIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUF1","description":"ICD-OIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine lamina 1/2 thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63003","description":"Remove spine lamina 1/2 thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAF1","description":"ICD-AHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"FLT3 (fms-related tyrosine kinase 3) (eg_ acute myeloid leukemia) internal tandem duplication (ITD) variants_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0046U","description":"FLT3 (fms-related tyrosine kinase 3) (eg_ acute myeloid leukemia) internal tandem duplication (ITD) variants_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education_ include microprocessor_ all components and accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0738","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education_ include microprocessor_ all components and accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDB0","description":"ICD-NKDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ aicd_ endo single coil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1777","description":"Lead_ aicd_ endo single coil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27252","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASF1","description":"ICD-DASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYA1","description":"ICD-OBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC4C","description":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUE1","description":"ICD-BIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPC0","description":"ICD-GEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay metallic 3 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2543","description":"Dental onlay metallic 3 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0670","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0670","description":"HCPCS-G0670","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray liver w/hemodynam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75889","description":"Vein x-ray liver w/hemodynam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCA1","description":"ICD-KHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath eval fna report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88173","description":"Cytopath eval fna report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHA1","description":"ICD-JEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFA0","description":"ICD-KHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAD1","description":"ICD-IIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGD0","description":"ICD-BHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA02","description":"High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj protirelin per 250 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2725","description":"Inj protirelin per 250 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES317","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHC1","description":"ICD-EEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA54","description":"Low Rehab_ ADL Index 0-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHE0","description":"ICD-MIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELD0","description":"ICD-AELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAA1","description":"ICD-FBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRD1","description":"ICD-CGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flutemetamol F18_ diagnostic_ per study dose_ up to 5 millicuries","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9459","description":"Flutemetamol F18_ diagnostic_ per study dose_ up to 5 millicuries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFC0","description":"ICD-BBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat knuckle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26700","description":"Treat knuckle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX2B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adhere pos air press therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8851","description":"Adhere pos air press therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Basic vestibular evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92540","description":"Basic vestibular evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFB0","description":"ICD-GBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNA1","description":"ICD-KDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB50","description":"Very High Rehab _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUD0","description":"ICD-NKUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1414","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","description":"HCPCS-M1414","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy vagus nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43652","description":"Laparoscopy vagus nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-1 quant&revrse trnscrpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87536","description":"Hiv-1 quant&revrse trnscrpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heart image (pet) single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78491","description":"Heart image (pet) single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immntx 2 sting insects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95131","description":"Immntx 2 sting insects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA125","description":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPA1","description":"ICD-NHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAA0","description":"ICD-MJAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove elbow lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24120","description":"Remove elbow lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary colon ca dsordrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81435","description":"Hereditary colon ca dsordrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHE1","description":"ICD-ICHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chronic care management services_ provided personally by a physician or other qualified health care professional_ at least 30 minutes of physician or other qualified health ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99491","description":"Chronic care management services_ provided personally by a physician or other qualified health care professional_ at least 30 minutes of physician or other qualified health ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPC0","description":"ICD-BGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kafo sng solid stirrup w/o j","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2010","description":"Kafo sng solid stirrup w/o j","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mediskin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4135","description":"Mediskin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEF0","description":"ICD-ECEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOC1","description":"ICD-GDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSD0","description":"ICD-DBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAA1","description":"ICD-FIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAME1","description":"ICD-NAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sinusitis intent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9463","description":"Sinusitis intent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLB0","description":"ICD-BBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCE0","description":"ICD-GBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB3D","description":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25370","description":"Revise radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTB1","description":"ICD-GCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood pressure recorded during inpatient stays_ emergency room visits_ urgent care visits_ and patient self-reported BP_s (home and health fair BP results)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9789","description":"Blood pressure recorded during inpatient stays_ emergency room visits_ urgent care visits_ and patient self-reported BP_s (home and health fair BP results)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMC0","description":"ICD-KEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERA1","description":"ICD-LERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUD1","description":"ICD-EAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4438","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","description":"HCPCS-Q4438","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHA0","description":"ICD-OAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlso 2 shl symphys-stern cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0460","description":"Tlso 2 shl symphys-stern cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orthopedic/Device/Drug Matrix For Opposing Bone-To-Bone Or Soft Tissue-To Bone (Implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1734","description":"Orthopedic/Device/Drug Matrix For Opposing Bone-To-Bone Or Soft Tissue-To Bone (Implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen system liquid station","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0440","description":"Oxygen system liquid station","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJE0","description":"ICD-BBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACF0","description":"ICD-KACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUD0","description":"ICD-IHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCC0","description":"ICD-KHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brca1&2 seq & full dup/del","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81162","description":"Brca1&2 seq & full dup/del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWA0","description":"ICD-CDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFB0","description":"ICD-NAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69635","description":"Repair eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARC1","description":"ICD-CARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLD0","description":"ICD-BDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX5B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE12C","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00220","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00220","description":"CPT-00220","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCF1","description":"ICD-BHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDME1","description":"ICD-KDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise parotid gland/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42420","description":"Excise parotid gland/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOF1","description":"ICD-OFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy trifocal 4.0/2.25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2304","description":"Lens sphcy trifocal 4.0/2.25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87637","description":"IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0405","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0405","description":"CDT-D0405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYF0","description":"ICD-LHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure for contrast knee arthrography or contrast enhanced CT/MRI knee arthrography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27369","description":"Injection procedure for contrast knee arthrography or contrast enhanced CT/MRI knee arthrography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Renal scope w/tumor resect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50562","description":"Renal scope w/tumor resect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYD1","description":"ICD-GHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor ii prothrom spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85210","description":"Clot factor ii prothrom spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CT/MRI brain done w/in 24hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3111F","description":"CT/MRI brain done w/in 24hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUA0","description":"ICD-BIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJE0","description":"ICD-KCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAB1","description":"ICD-JBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exemestane_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0156","description":"Exemestane_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMB1","description":"ICD-KHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACE0","description":"ICD-KACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTE0","description":"ICD-BDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High energy neutron radiation treatment delivery_ 1 or more isocenter(s) with coplanar or non-coplanar geometry with blocking and/or wedge_ and/or compensator(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77423","description":"High energy neutron radiation treatment delivery_ 1 or more isocenter(s) with coplanar or non-coplanar geometry with blocking and/or wedge_ and/or compensator(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation Device Evaluation(S)_ (Remote) Up To 30 Days; Implantable Cardiovascular Physiologic Monitor System_ Implantable Loop Recorder System_ Or Subcutaneous Cardiac Rh","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2066","description":"Interrogation Device Evaluation(S)_ (Remote) Up To 30 Days; Implantable Cardiovascular Physiologic Monitor System_ Implantable Loop Recorder System_ Or Subcutaneous Cardiac Rh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESB0","description":"ICD-GESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fosaprepitant injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1453","description":"Fosaprepitant injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUA1","description":"ICD-JCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2098","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epidrm autogrft t/a/l add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15111","description":"Epidrm autogrft t/a/l add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of windpipe defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31825","description":"Repair of windpipe defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAB0","description":"ICD-EIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEA1","description":"ICD-BEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEA1","description":"ICD-EDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTC1","description":"ICD-FDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPB0","description":"ICD-OFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove hepatic shunt (tips)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37183","description":"Remove hepatic shunt (tips)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLB0","description":"ICD-NFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC155","description":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tissue exam for fungi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87220","description":"Tissue exam for fungi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMF1","description":"ICD-MIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spec coll non-blood:a/d test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0048","description":"Spec coll non-blood:a/d test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBC1","description":"ICD-JGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHA0","description":"ICD-FDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hand-held pefr meter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4614","description":"Hand-held pefr meter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHA1","description":"ICD-JCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostomy care kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4629","description":"Tracheostomy care kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRB1","description":"ICD-HFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVC1","description":"ICD-BCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDA1","description":"ICD-EIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUC1","description":"ICD-MAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Degarelix injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9155","description":"Degarelix injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBB0","description":"ICD-EEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCC0","description":"ICD-ICCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB224","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSB0","description":"ICD-LGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Four total Medicare Diabetes Prevention Program (MDPP) core sessions were attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP servi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9874","description":"Four total Medicare Diabetes Prevention Program (MDPP) core sessions were attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP servi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKD1","description":"ICD-GCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct pelvis w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72194","description":"Ct pelvis w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMA1","description":"ICD-CDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTD0","description":"ICD-GHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACE1","description":"ICD-CACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDE1","description":"ICD-FHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Split flat caliper stirr & p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2230","description":"Split flat caliper stirr & p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHF0","description":"ICD-MAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB120","description":"Special Care Low _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DA21","description":"ICD-3DA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRD0","description":"ICD-PHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fast/dir ldl = 190 mg/dl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9663","description":"Fast/dir ldl = 190 mg/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kyphosis pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1020","description":"Kyphosis pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQD1","description":"ICD-PEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ldct for lung ca screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0297","description":"Ldct for lung ca screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAF0","description":"ICD-OFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGE0","description":"ICD-JAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNA0","description":"ICD-KDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJD0","description":"ICD-FBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D6193","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D6193","description":"CDT-D6193","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-25448","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","description":"CPT-25448","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBF1","description":"ICD-EGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPF0","description":"ICD-GIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTC1","description":"ICD-NLTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Advncd care plan 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99497","description":"Advncd care plan 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABF1","description":"ICD-MABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHF0","description":"ICD-EEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ekg for initial prevent exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0403","description":"Ekg for initial prevent exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of thymus gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60520","description":"Removal of thymus gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of sexual activity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9818","description":"Documentation of sexual activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt no ref oto reas no spec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8563","description":"Pt no ref oto reas no spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chest wall manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94668","description":"Chest wall manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBA1","description":"ICD-NKBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Waterproof tape","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4452","description":"Waterproof tape","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of impacted wax md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0268","description":"Removal of impacted wax md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVC1","description":"ICD-BIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialys sol fld vol > 5999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4726","description":"Dialys sol fld vol > 5999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCF0","description":"ICD-CFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ drainage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1729","description":"Cath_ drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial or viral respiratory tract infection)_ pathogen specific nucleic acid (DNA or RNA)_ 33 targets_ real-time semi-quantitative PCR_ bronchoalveolar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0151U","description":"Infectious disease (bacterial or viral respiratory tract infection)_ pathogen specific nucleic acid (DNA or RNA)_ 33 targets_ real-time semi-quantitative PCR_ bronchoalveolar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection for breast x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19030","description":"Injection for breast x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical revision intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44680","description":"Surgical revision intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSD0","description":"ICD-GDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUD0","description":"ICD-AEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oral antral fistula closure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7260","description":"Oral antral fistula closure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GA21","description":"ICD-3GA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"SkinTE_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4200","description":"SkinTE_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUA0","description":"ICD-IGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eribulin mesylate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9179","description":"Eribulin mesylate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAA1","description":"ICD-JBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Q fever antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86638","description":"Q fever antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDF0","description":"ICD-NHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPF1","description":"ICD-BFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft of thigh muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27386","description":"Repair/graft of thigh muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMA0","description":"ICD-CEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGED1","description":"ICD-JGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMC1","description":"ICD-CCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYF0","description":"ICD-OGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBD0","description":"ICD-EEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chorionic gonadotropin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84702","description":"Chorionic gonadotropin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lightweight wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0003","description":"Lightweight wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKA1","description":"ICD-GEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD25A","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fit spectacles compound lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92355","description":"Fit spectacles compound lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient had only urgent care visits during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1054","description":"Patient had only urgent care visits during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGF1","description":"ICD-BHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replantation arm complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20802","description":"Replantation arm complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCA0","description":"ICD-NBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1072","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","description":"HCPCS-J1072","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVF1","description":"ICD-CDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKF0","description":"ICD-GFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELF1","description":"ICD-NELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHF1","description":"ICD-ECHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1077T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1077T","description":"CPT-1077T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPD1","description":"ICD-GCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Preorthodontic tx visit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8660","description":"Preorthodontic tx visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"3d predictive model generation for pre-planning of a cardiac procedure_ using data from cardiac computed tomographic angiography with report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9793","description":"3d predictive model generation for pre-planning of a cardiac procedure_ using data from cardiac computed tomographic angiography with report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITC1","description":"ICD-KITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1BB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BB11","description":"ICD-1BB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX3C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise/remove electrd antrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43882","description":"Revise/remove electrd antrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC226","description":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBB0","description":"ICD-CBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMA1","description":"ICD-GEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRE1","description":"ICD-DGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAD1","description":"ICD-FHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ thigh length_ 40 mmhg or greater_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6558","description":"Gradient compression stocking_ thigh length_ 40 mmhg or greater_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWB0","description":"ICD-PIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Protein western blot test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84182","description":"Protein western blot test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDED0","description":"ICD-GDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKC0","description":"ICD-GAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4336","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","description":"HCPCS-Q4336","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKF0","description":"ICD-NFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Donor pancreatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48550","description":"Donor pancreatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc face les sc <2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21011","description":"Exc face les sc <2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHE1","description":"ICD-AGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWE1","description":"ICD-HGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE21B","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSB1","description":"ICD-PDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHD1","description":"ICD-BFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; known familial variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81174","description":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; known familial variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEE1","description":"ICD-AAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVA0","description":"ICD-NFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55882","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","description":"CPT-55882","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27786","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA20C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explr/decompress eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67414","description":"Explr/decompress eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGF1","description":"ICD-GGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect hip/pelv tum 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27059","description":"Resect hip/pelv tum 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEA0","description":"ICD-GIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARF0","description":"ICD-HARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Indium in-111 auto platelet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9571","description":"Indium in-111 auto platelet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrst x-ray urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74425","description":"Contrst x-ray urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB16","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eia hiv-1/hiv-2 screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0432","description":"Eia hiv-1/hiv-2 screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUC0","description":"ICD-IBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of spinal nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64772","description":"Incision of spinal nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0305","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0305","description":"HCPCS-B0305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEB1","description":"ICD-KGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVE0","description":"ICD-OEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGB1","description":"ICD-OHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct capture tmj","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0384","description":"Cone beam ct capture tmj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGC0","description":"ICD-OBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0696U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696U","description":"CPT-0696U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMC1","description":"ICD-ICMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDME1","description":"ICD-IDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29895","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATB1","description":"ICD-AATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES213","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDE0","description":"ICD-ICDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRC0","description":"ICD-GFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBE1","description":"ICD-CHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01782","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01782","description":"CPT-01782","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBID0","description":"ICD-JBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bio mtrls to aid soft/os reg","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4265","description":"Bio mtrls to aid soft/os reg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAB0","description":"ICD-MEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA113","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJD0","description":"ICD-GHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX17","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNC1","description":"ICD-FCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24565","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDE1","description":"ICD-OLDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLE0","description":"ICD-AGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWB0","description":"ICD-CHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVF1","description":"ICD-CEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHE0","description":"ICD-OEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcvng ace/arb blker <3mos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4481F","description":"Pt rcvng ace/arb blker <3mos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8I","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shldr disartic switch contro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6960","description":"Shldr disartic switch contro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDC1","description":"ICD-GDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of jaw muscle/bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21295","description":"Revision of jaw muscle/bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICD1","description":"ICD-NICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTA1","description":"ICD-IGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTB1","description":"ICD-FDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD110","description":"Special Care High _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWD0","description":"ICD-GDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYE0","description":"ICD-CBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIF1","description":"ICD-NFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD214","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alveoplasty w/o extraction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7320","description":"Alveoplasty w/o extraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for level VI_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0755T","description":"Digitization of glass microscope slides for level VI_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IV Injection_ bebtelovimab_ includes injection and post administration monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0222","description":"IV Injection_ bebtelovimab_ includes injection and post administration monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ conivaptan hydrochloride_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9488","description":"Injection_ conivaptan hydrochloride_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVE1","description":"ICD-GAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27052","description":"Biopsy of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD160","description":"Special Care Low _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPC0","description":"ICD-GHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Close kidney-skin fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50520","description":"Close kidney-skin fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0805","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0805","description":"HCPCS-B0805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMB0","description":"ICD-MGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87812","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","description":"CPT-87812","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ udenyca 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5111","description":"Injection_ udenyca 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLA1","description":"ICD-EHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0532","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","description":"HCPCS-G0532","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLC1","description":"ICD-FCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"K flow/funct image multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78709","description":"K flow/funct image multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDE1","description":"ICD-FIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBE1","description":"ICD-JIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQE1","description":"ICD-PCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIE0","description":"ICD-OIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intragastric hypothermia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0100","description":"Intragastric hypothermia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTB1","description":"ICD-CFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAB1","description":"ICD-EBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUE1","description":"ICD-MAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Speech lang d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9176","description":"Speech lang d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55810","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYA1","description":"ICD-PLYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCF1","description":"ICD-OGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEC1","description":"ICD-MHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAB0","description":"ICD-KAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx cml blast phase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9125","description":"Onc dx cml blast phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCE1","description":"ICD-OKCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB25A","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93970","description":"Extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGF1","description":"ICD-JCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALD1","description":"ICD-AALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lyme dis dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87477","description":"Lyme dis dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISF1","description":"ICD-HISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ATXN7 (ataxin 7) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81181","description":"ATXN7 (ataxin 7) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Admission to mccm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9480","description":"Admission to mccm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMA1","description":"ICD-IIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Care level rationale doc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6005F","description":"Care level rationale doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant total heart system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0051T","description":"Implant total heart system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLD0","description":"ICD-GFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMD0","description":"ICD-EGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63088","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDD1","description":"ICD-EHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Small animal inoculation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87003","description":"Small animal inoculation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIE0","description":"ICD-EHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27427","description":"Reconstruction knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepb vacc 2 dose adult im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90739","description":"Hepb vacc 2 dose adult im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGA0","description":"ICD-BIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22850","description":"Remove spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0902","description":"HCPCS-A0902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKB1","description":"ICD-JBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINC0","description":"ICD-OINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGND0","description":"ICD-GGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHA0","description":"ICD-CGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Restorigin_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4191","description":"Restorigin_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0656U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0656U","description":"CPT-0656U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOE0","description":"ICD-DCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPC1","description":"ICD-FHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFE0","description":"ICD-JBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Genetic test brugada","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3861","description":"Genetic test brugada","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCC0","description":"ICD-KGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Procenta_ per 200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4244","description":"Procenta_ per 200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELB0","description":"ICD-CELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSC1","description":"ICD-LFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair amputee heavy dut","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1195","description":"Wheelchair amputee heavy dut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acetaminophen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6039","description":"Acetaminophen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD260","description":"Clinically Complex _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLF1","description":"ICD-KFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEE1","description":"ICD-NHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including CT guidance; first lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10009","description":"Fine needle aspiration biopsy_ including CT guidance; first lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUD0","description":"ICD-MJUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL06","description":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Itraconazole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80189","description":"Itraconazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foot plas heel stabi pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3170","description":"Foot plas heel stabi pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLF0","description":"ICD-NJLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMC1","description":"ICD-FIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5157","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","description":"HCPCS-Q5157","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUA1","description":"ICD-BBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDC Novel Coronavirus Real Time RT-PCR Diagnostic Test Panel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"U0001","description":"CDC Novel Coronavirus Real Time RT-PCR Diagnostic Test Panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29823","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIA0","description":"ICD-MAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCE1","description":"ICD-IGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFB0","description":"ICD-NJFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIE0","description":"ICD-OCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3IB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IB11","description":"ICD-3IB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECE0","description":"ICD-GECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Buttock fasciotomy w/dbrdmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27057","description":"Buttock fasciotomy w/dbrdmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYC0","description":"ICD-GBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alarm symp assessed-absent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1070F","description":"Alarm symp assessed-absent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemagglutination inhibition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86280","description":"Hemagglutination inhibition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cantharidin for topical administration_ 0.7%_ single unit dose applicator (3.2 mg)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7354","description":"Cantharidin for topical administration_ 0.7%_ single unit dose applicator (3.2 mg)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDB0","description":"ICD-KIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special service/proc/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99199","description":"Special service/proc/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOC1","description":"ICD-DGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIF1","description":"ICD-OAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSD0","description":"ICD-GGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp3 vhd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0860","description":"Pwc gp3 vhd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Femoral lgth sock fx or equa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2850","description":"Femoral lgth sock fx or equa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOC0","description":"ICD-PGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Respite not-in-home per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0045","description":"Respite not-in-home per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXA0","description":"ICD-FEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54060","description":"Excision of penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNE0","description":"ICD-KFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Methylprednisolone oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7509","description":"Methylprednisolone oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4DC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DC31","description":"ICD-4DC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay for phencyclidine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83992","description":"Assay for phencyclidine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEE0","description":"ICD-CHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXB0","description":"ICD-JBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBA0","description":"ICD-GBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFC1","description":"ICD-KFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGD0","description":"ICD-NHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1398","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","description":"HCPCS-M1398","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPE0","description":"ICD-KHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCF1","description":"ICD-GGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA11B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX43","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACF1","description":"ICD-FACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47620","description":"Removal of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPF1","description":"ICD-BHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIF0","description":"ICD-ADIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98007","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","description":"CPT-98007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDD0","description":"ICD-MIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQD0","description":"ICD-HHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD24A","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKA0","description":"ICD-KFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3EC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EC31","description":"ICD-3EC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Toxoplasma antibody igm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86778","description":"Toxoplasma antibody igm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0497U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","description":"CPT-0497U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous electrical nerve field stimulation_ cranial nerves_ without implantation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0720T","description":"Percutaneous electrical nerve field stimulation_ cranial nerves_ without implantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Moderna Covid-19 vaccine administration - third dose (SARSCOV2 COVID-19 VAC mRNA 100mcg/0.5mL IM DOSE 3)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1710","description":"Moderna Covid-19 vaccine administration - third dose (SARSCOV2 COVID-19 VAC mRNA 100mcg/0.5mL IM DOSE 3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33305","description":"Repair of heart wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNA1","description":"ICD-FFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC25C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBF1","description":"ICD-EDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0504","description":"HCPCS-A0504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBB0","description":"ICD-JHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFA0","description":"ICD-NKFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD11B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Uterine Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1104","description":"Radiation Therapy For Uterine Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown 3/4 cast noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6782","description":"Crown 3/4 cast noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft hand/foot 1 sinus ct w 90d dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9353","description":"Medrsn >1 sinus ct w 90d dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mra_ w/dye_ spinal canal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8931","description":"Mra_ w/dye_ spinal canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N block inj brachial plexus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64415","description":"N block inj brachial plexus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrodes_ pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4556","description":"Electrodes_ pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove eltrd/thoracotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33243","description":"Remove eltrd/thoracotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDB1","description":"ICD-OGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVD0","description":"ICD-OAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCB0","description":"ICD-BCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGE1","description":"ICD-JHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB41","description":"Very High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTD0","description":"ICD-IHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAC0","description":"ICD-FFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUA1","description":"ICD-OAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHA0","description":"ICD-FHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBE0","description":"ICD-NDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stimulation pacing heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93623","description":"Stimulation pacing heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBD0","description":"ICD-OEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHA1","description":"ICD-GIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATB0","description":"ICD-BATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0977T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","description":"CPT-0977T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIF0","description":"ICD-JIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWE0","description":"ICD-KGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEND1","description":"ICD-FEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of skull & brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62145","description":"Repair of skull & brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE22B","description":"Special Care Low _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVD1","description":"ICD-NJVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apc gene known fam variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81202","description":"Apc gene known fam variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth cabg w/o pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56651","description":"Anesth cabg w/o pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4KB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KB31","description":"ICD-4KB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18I","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of arm nerve(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64713","description":"Revision of arm nerve(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Asympt carot/vrtbrbas sten","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9005F","description":"Asympt carot/vrtbrbas sten","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAF0","description":"ICD-GGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2091","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEB1","description":"ICD-CHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61543","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fluoroscopic procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76496","description":"Fluoroscopic procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTA1","description":"ICD-JHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQF1","description":"ICD-KBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Myelography l-s spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72265","description":"Myelography l-s spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD124","description":"Special Care High _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCC0","description":"ICD-GCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOD1","description":"ICD-GHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18G","description":"Clinically Complex _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amnicore pro_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4298","description":"Amnicore pro_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAA0","description":"ICD-AHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24362","description":"Reconstruct elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of lumbar idiopathic or congenital scoliosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1040","description":"Patients with a diagnosis of lumbar idiopathic or congenital scoliosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILC0","description":"ICD-IILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0493U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","description":"CPT-0493U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOF1","description":"ICD-HHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLA1","description":"ICD-KHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBE0","description":"ICD-EHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJF1","description":"ICD-NBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVE1","description":"ICD-FAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A6611","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","description":"HCPCS-A6611","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQD1","description":"ICD-OHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRA1","description":"ICD-PBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIB1","description":"ICD-GDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99156","description":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPE0","description":"ICD-GCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52315","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mometasone furoate sinus implant_ 10 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7401","description":"Mometasone furoate sinus implant_ 10 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Postop dsg cast chg shlder/t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6384","description":"Postop dsg cast chg shlder/t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/clin ascvd dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9674","description":"Pt w/clin ascvd dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTC0","description":"ICD-EHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPD1","description":"ICD-GHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLE1","description":"ICD-OFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB22D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD136","description":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKF0","description":"ICD-GGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA17","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKF0","description":"ICD-NHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient Had Prior Adverse Reaction Caused By Zoster Vaccine Or Its Components Any Time During Or Before The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2161","description":"Patient Had Prior Adverse Reaction Caused By Zoster Vaccine Or Its Components Any Time During Or Before The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise ovarian tube(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58752","description":"Revise ovarian tube(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYE1","description":"ICD-PGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18H","description":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35303","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCB1","description":"ICD-BGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA22","description":"Default_ /14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBA0","description":"ICD-MFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUA0","description":"ICD-FAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBA1","description":"ICD-IBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQA0","description":"ICD-PFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glucagon tolerance panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80422","description":"Glucagon tolerance panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMF0","description":"ICD-FBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGB1","description":"ICD-CAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ost urine pch w b/bltin conv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4430","description":"Ost urine pch w b/bltin conv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWF0","description":"ICD-KIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETB1","description":"ICD-KETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hdr rdncl skn surf brachytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77768","description":"Hdr rdncl skn surf brachytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ost pouch drain high output","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4412","description":"Ost pouch drain high output","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"guided tissue regeneration_ edentulous area - non-resorbable barrier_ per site","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7957","description":"guided tissue regeneration_ edentulous area - non-resorbable barrier_ per site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary pan-cancer (eg_ hereditary sarcomas_ hereditary endocrine tumors_ hereditary neuroendocrine tumors_ hereditary cutaneous melanoma)_ genomic sequence analysis panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0474U","description":"Hereditary pan-cancer (eg_ hereditary sarcomas_ hereditary endocrine tumors_ hereditary neuroendocrine tumors_ hereditary cutaneous melanoma)_ genomic sequence analysis panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLC0","description":"ICD-NLLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAA1","description":"ICD-NKAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFE0","description":"ICD-OHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUA0","description":"ICD-GAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUB0","description":"ICD-MCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urinary pouch w/o barrier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5072","description":"Urinary pouch w/o barrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAD0","description":"ICD-OCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATB1","description":"ICD-IATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0499U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","description":"CPT-0499U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTB1","description":"ICD-CGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEF0","description":"ICD-KFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB1C","description":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQC0","description":"ICD-OBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of collarbone joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23106","description":"Incision of collarbone joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain shoulder bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23035","description":"Drain shoulder bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sanopellis_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4308","description":"Sanopellis_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spirom doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3023F","description":"Spirom doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKC1","description":"ICD-NJKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOD1","description":"ICD-KIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovas aaa repr w/long tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34805","description":"Endovas aaa repr w/long tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDA0","description":"ICD-GGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0644U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0644U","description":"CPT-0644U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cad cxr with interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0174T","description":"Cad cxr with interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown resin w/noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6722","description":"Crown resin w/noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMB1","description":"ICD-GIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0605U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","description":"CPT-0605U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of arm bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24140","description":"Partial removal of arm bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUF0","description":"ICD-NLUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQC1","description":"ICD-CHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Multiple-family group adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0371T","description":"Multiple-family group adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Not initial eval for cond","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1501F","description":"Not initial eval for cond","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE24B","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8G","description":"Medium Rehab _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pathologist(s)/dermatopathologist(s) is the same clinician who performed the biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9939","description":"Pathologist(s)/dermatopathologist(s) is the same clinician who performed the biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1003","description":"HCPCS-B1003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMA0","description":"ICD-JBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTC1","description":"ICD-ABTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDF1","description":"ICD-OHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEE1","description":"ICD-ICEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTF0","description":"ICD-EFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rubella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86762","description":"Rubella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/o fol w/cont_ chest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8911","description":"Mra w/o fol w/cont_ chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0552","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","description":"HCPCS-G0552","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEID0","description":"ICD-BEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABB1","description":"ICD-NABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray urethra/bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74450","description":"X-ray urethra/bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Finasteride_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0138","description":"Finasteride_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHC1","description":"ICD-KBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQD1","description":"ICD-PLQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3KB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KB11","description":"ICD-3KB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTE1","description":"ICD-IDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABF1","description":"ICD-OABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interest escort in non er","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0090","description":"Interest escort in non er","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58960","description":"Exploration of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMF1","description":"ICD-OBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intermittent asthma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1039F","description":"Intermittent asthma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDC0","description":"ICD-CCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAB1","description":"ICD-BEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJB0","description":"ICD-JHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWE0","description":"ICD-LIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin protect wc cus wd <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2603","description":"Skin protect wc cus wd <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDF0","description":"ICD-BIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPA0","description":"ICD-CFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v auto rescreen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88148","description":"Cytopath c/v auto rescreen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPA1","description":"ICD-CBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCD0","description":"ICD-ADCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKE0","description":"ICD-CBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTB1","description":"ICD-GHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Influenza virus vaccine quadrivalent (IIV4)_ inactivated_ adjuvanted_ preservative free_ 0.25 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90689","description":"Influenza virus vaccine quadrivalent (IIV4)_ inactivated_ adjuvanted_ preservative free_ 0.25 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD21A","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPC1","description":"ICD-NJPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICC0","description":"ICD-KICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMD1","description":"ICD-EBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIB0","description":"ICD-BEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove tendon sheath lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26160","description":"Remove tendon sheath lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUB1","description":"ICD-NEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDD1","description":"ICD-KCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA12","description":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of external ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69100","description":"Biopsy of external ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tmj excisn of joint membrane","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7854","description":"Tmj excisn of joint membrane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXB0","description":"ICD-NKXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8H","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEED1","description":"ICD-NEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ teprotumumab-trbw_10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9061","description":"Injection_ teprotumumab-trbw_10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ gemcitabine hydrochloride_ (Infugem)_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9198","description":"Injection_ gemcitabine hydrochloride_ (Infugem)_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVE1","description":"ICD-CAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neurobehavioral status exam (clinical assessment of thinking_ reasoning and judgment_ [eg_ acquired knowledge_ attention_ language_ memory_ planning and problem solving_ and v","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96121","description":"Neurobehavioral status exam (clinical assessment of thinking_ reasoning and judgment_ [eg_ acquired knowledge_ attention_ language_ memory_ planning and problem solving_ and v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18D","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1001","description":"HCPCS-C1001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYC1","description":"ICD-GIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSC0","description":"ICD-CFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFID1","description":"ICD-GFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLE0","description":"ICD-NLLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insulin dispos pen 1.5 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5570","description":"Insulin dispos pen 1.5 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOC1","description":"ICD-HDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCD1","description":"ICD-CBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMC0","description":"ICD-ADMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Angiotensin i enzyme test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82164","description":"Angiotensin i enzyme test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGC0","description":"ICD-KHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGD1","description":"ICD-CBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGF1","description":"ICD-NIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFC0","description":"ICD-KAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Supplies for maintenance of insulin infusion catheter_ per week","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4224","description":"Supplies for maintenance of insulin infusion catheter_ per week","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0905T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","description":"CPT-0905T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRC0","description":"ICD-OBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of larynx lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31578","description":"Removal of larynx lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18I","description":"Special Care Low _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUA1","description":"ICD-JGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDD1","description":"ICD-OIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hyperphenylalaninemia monitoring by patient-collected blood card sample_ quantitative measurement of phenylalanine and tyrosine_ liquid chromatography with tandem mass spectro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0382U","description":"Hyperphenylalaninemia monitoring by patient-collected blood card sample_ quantitative measurement of phenylalanine and tyrosine_ liquid chromatography with tandem mass spectro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vaginectomy w/nodes compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57112","description":"Vaginectomy w/nodes compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis g dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87527","description":"Hepatitis g dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRF1","description":"ICD-HHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEB0","description":"ICD-IHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGE1","description":"ICD-FAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJID1","description":"ICD-NJID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFE1","description":"ICD-BDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKF0","description":"ICD-BGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJC1","description":"ICD-FEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDA0","description":"ICD-IDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQE0","description":"ICD-CBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBF0","description":"ICD-MCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVF0","description":"ICD-NCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDE1","description":"ICD-BCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Two Medica re Diabetes Prevention Program (MDPP) core maintenance sessi on s (MS) were attended by an MDPP beneficiary in months (mo) 10-12 under the MDPP Expanded Model (EM).","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9879","description":"Two Medica re Diabetes Prevention Program (MDPP) core maintenance sessi on s (MS) were attended by an MDPP beneficiary in months (mo) 10-12 under the MDPP Expanded Model (EM).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCF0","description":"ICD-ICCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endoskel knee-shin mnl lock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5810","description":"Endoskel knee-shin mnl lock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJA1","description":"ICD-KGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARF0","description":"ICD-LARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHF0","description":"ICD-CBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITC0","description":"ICD-EITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with transluminal angioplasty with intravascular ultrasound (initial noncoro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7531","description":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with transluminal angioplasty with intravascular ultrasound (initial noncoro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXA0","description":"ICD-NAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQF0","description":"ICD-PKQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMB0","description":"ICD-JAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unsched dialysis esrd pt hos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0257","description":"Unsched dialysis esrd pt hos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAF1","description":"ICD-BAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQE0","description":"ICD-PJQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSB0","description":"ICD-LHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemophilia clot factor noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7199","description":"Hemophilia clot factor noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJD0","description":"ICD-OLJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ nusinersen_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2326","description":"Injection_ nusinersen_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Photochemotherapy uv-a or b","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96913","description":"Photochemotherapy uv-a or b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ace/arb thxpy not rxd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8475","description":"Ace/arb thxpy not rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBE1","description":"ICD-EFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Htlv-ii antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86688","description":"Htlv-ii antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ak 4 bar ling w/hydraul swig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5613","description":"Ak 4 bar ling w/hydraul swig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Val rsn hd ct ord reg indic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9595","description":"Val rsn hd ct ord reg indic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABC0","description":"ICD-BABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heavy duty control cable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6660","description":"Heavy duty control cable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQA1","description":"ICD-CCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSB1","description":"ICD-KHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pos macroalbuminuria rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3062F","description":"Pos macroalbuminuria rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWE0","description":"ICD-OEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXE1","description":"ICD-BGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wellness assessment by nonph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5190","description":"Wellness assessment by nonph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNB0","description":"ICD-CDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of rectal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46060","description":"Incision of rectal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPA0","description":"ICD-JDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUD1","description":"ICD-AEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release of skull seams","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61550","description":"Release of skull seams","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVE0","description":"ICD-CIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQD1","description":"ICD-CIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAA0","description":"ICD-GHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunoglobulin paraprotein (M-protein)_ qualitative_ immunoprecipitation and mass spectrometry_ blood or urine_ including isotype","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0077U","description":"Immunoglobulin paraprotein (M-protein)_ qualitative_ immunoprecipitation and mass spectrometry_ blood or urine_ including isotype","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc ref upper gi endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3132F","description":"Doc ref upper gi endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stenger test speech","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92577","description":"Stenger test speech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ vincristine sul lip 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9371","description":"Inj_ vincristine sul lip 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC0A","description":"Ultra High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBA0","description":"ICD-EIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA3C","description":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Main/clean max prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5993","description":"Main/clean max prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQA0","description":"ICD-OBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nebulizer administration set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7003","description":"Nebulizer administration set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNC0","description":"ICD-JFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDB1","description":"ICD-NLDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBB0","description":"ICD-GIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft hip bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27067","description":"Remove/graft hip bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ an","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL1C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise & treat bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51030","description":"Incise & treat bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial excision of lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40520","description":"Partial excision of lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLC0","description":"ICD-IFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cultr bacteria except blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87075","description":"Cultr bacteria except blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMB1","description":"ICD-JCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1CA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CA21","description":"ICD-1CA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX10","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1026T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1026T","description":"CPT-1026T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ imipenem 4mg_ cilastatin 4 mg and relebactam 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0742","description":"Injection_ imipenem 4mg_ cilastatin 4 mg and relebactam 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHA1","description":"ICD-FFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair nonunion carpal bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25431","description":"Repair nonunion carpal bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2AA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AA11","description":"ICD-2AA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMA1","description":"ICD-EFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRD1","description":"ICD-OKRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC22B","description":"Reduced Physical Function _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01380","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01380","description":"CPT-01380","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal cord puncture prenatal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59012","description":"Fetal cord puncture prenatal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXB0","description":"ICD-CAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"D & c after delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59160","description":"D & c after delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Seo mobile arm sup att to wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2626","description":"Seo mobile arm sup att to wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychological or neuropsychological test administration and scoring by technician_ two or more tests_ any method; first 30 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96138","description":"Psychological or neuropsychological test administration and scoring by technician_ two or more tests_ any method; first 30 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alkaloids nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80323","description":"Alkaloids nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair septal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33813","description":"Repair septal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYB1","description":"ICD-OBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDA0","description":"ICD-NFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE101","description":"Clinically Complex _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Frame typ socket bel elbow/w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6687","description":"Frame typ socket bel elbow/w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACC0","description":"ICD-NACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Cervical Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1082","description":"Radiation Therapy For Cervical Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAE0","description":"ICD-GBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOB1","description":"ICD-LDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSA0","description":"ICD-GGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implt/rpl crtd sns dev gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0268T","description":"Implt/rpl crtd sns dev gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients listed on the kidney-pancreas transplant waitlist or who received a living donor transplant within the first year following initiation of dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1259","description":"Patients listed on the kidney-pancreas transplant waitlist or who received a living donor transplant within the first year following initiation of dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOC1","description":"ICD-CCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJB0","description":"ICD-JGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAE0","description":"ICD-AFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJF0","description":"ICD-CHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXA0","description":"ICD-BIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suture large intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44604","description":"Suture large intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUD1","description":"ICD-KAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKE0","description":"ICD-FDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise/repl vagus n eltrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64569","description":"Revise/repl vagus n eltrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQB1","description":"ICD-PHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal Aneuploidy Short Tandem-Repeat Comparative Analysis_ Fetal Dna From Products Of Conception_ Reported As Normal (Euploidy)_ Monosomy_ Trisomy_ Or Partial Deletion/Duplica","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0252U","description":"Fetal Aneuploidy Short Tandem-Repeat Comparative Analysis_ Fetal Dna From Products Of Conception_ Reported As Normal (Euploidy)_ Monosomy_ Trisomy_ Or Partial Deletion/Duplica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95170","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit declotting kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5517","description":"Hit declotting kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHE0","description":"ICD-MFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXB0","description":"ICD-CIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC34","description":"Very High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rabies vaccine id","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90676","description":"Rabies vaccine id","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALE0","description":"ICD-JALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoe heel thomas with wedge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3465","description":"Shoe heel thomas with wedge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fondaparinux sodium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1652","description":"Fondaparinux sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFE0","description":"ICD-CEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replc sockt above elbow disa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6884","description":"Replc sockt above elbow disa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGC1","description":"ICD-GAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSE0","description":"ICD-GGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diag tst detect mucos abnorm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0431","description":"Diag tst detect mucos abnorm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBC0","description":"ICD-FFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGC0","description":"ICD-CBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDC1","description":"ICD-GGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWC0","description":"ICD-PBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDF1","description":"ICD-MBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-1 dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87534","description":"Hiv-1 dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hymenotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56442","description":"Hymenotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cetuximab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9055","description":"Cetuximab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFE0","description":"ICD-FCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair single ventricle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33617","description":"Repair single ventricle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPA0","description":"ICD-BBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTA1","description":"ICD-KDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHC0","description":"ICD-CGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB244","description":"Clinically Complex _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJA0","description":"ICD-JBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXD0","description":"ICD-JFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pos air press not prescribe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8853","description":"Pos air press not prescribe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWF1","description":"ICD-OBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18X","description":"Clinically Complex _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLB0","description":"ICD-GHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFA1","description":"ICD-OBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anal/urinary muscle study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51784","description":"Anal/urinary muscle study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAE0","description":"ICD-MLAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26746","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove lower leg bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27635","description":"Remove lower leg bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGC1","description":"ICD-BAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28D","description":"Clinically Complex _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decoronation or submergence of an erupted tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3921","description":"Decoronation or submergence of an erupted tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX54","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of arm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23930","description":"Drainage of arm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVB0","description":"ICD-CBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTF1","description":"ICD-ECTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVB1","description":"ICD-FAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJE1","description":"ICD-FBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LB11","description":"ICD-2LB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBF0","description":"ICD-JHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA154","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA25","description":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lung function test (mbc/mvv)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94200","description":"Lung function test (mbc/mvv)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ ziv-aflibercept_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9400","description":"Inj_ ziv-aflibercept_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMB0","description":"ICD-NKMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEC1","description":"ICD-KBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHF1","description":"ICD-KIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Design custom breast implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19396","description":"Design custom breast implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQA0","description":"ICD-LIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elder maltreatment screen not documented; documentation that patient is not eligible for the elder maltreatment screen at the time of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8535","description":"Elder maltreatment screen not documented; documentation that patient is not eligible for the elder maltreatment screen at the time of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21282","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIF1","description":"ICD-MBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18F","description":"Special Care High _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA10B","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHF0","description":"ICD-NGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC25A","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA117","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA43","description":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUA1","description":"ICD-OGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elbow socket ins use w/o lck","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6695","description":"Elbow socket ins use w/o lck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB01","description":"High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVD1","description":"ICD-KEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRA1","description":"ICD-GIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dx laryngoscopy newborn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31520","description":"Dx laryngoscopy newborn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLC1","description":"ICD-GBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Distal/proximal wedge proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4274","description":"Distal/proximal wedge proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise graft w/vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35884","description":"Revise graft w/vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWE0","description":"ICD-LDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB204","description":"Clinically Complex _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLA1","description":"ICD-MFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCC0","description":"ICD-OBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGF1","description":"ICD-KFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSA1","description":"ICD-HFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHB0","description":"ICD-OLHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of long leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29345","description":"Application of long leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMF0","description":"ICD-ADMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prenatal at risk education","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1003","description":"Prenatal at risk education","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial hip replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27125","description":"Partial hip replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home care supervis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99340","description":"Domicil/r-home care supervis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXA0","description":"ICD-JGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m tetrofosmin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9502","description":"Tc99m tetrofosmin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALC0","description":"ICD-NALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX11","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA220","description":"Reduced Physical Function _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUA1","description":"ICD-MAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFD0","description":"ICD-GBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJF1","description":"ICD-KIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dil retina exam interp rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2022F","description":"Dil retina exam interp rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0960T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","description":"CPT-0960T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX32","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC12","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFB0","description":"ICD-OAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA0A","description":"Ultra High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGND1","description":"ICD-FGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy lesion removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43216","description":"Esophagoscopy lesion removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt=d(rh)+ or sensitized","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3291F","description":"Pt=d(rh)+ or sensitized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiolipin antibody ea ig","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86147","description":"Cardiolipin antibody ea ig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJB0","description":"ICD-JBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXD0","description":"ICD-OJXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIA0","description":"ICD-OFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAED1","description":"ICD-KAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCA1","description":"ICD-NHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Habil prevoc waiver_ per d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2014","description":"Habil prevoc waiver_ per d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOD0","description":"ICD-HBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Full mouth debridement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4355","description":"Full mouth debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGB1","description":"ICD-OBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBB1","description":"ICD-FFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJED1","description":"ICD-MJED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAD1","description":"ICD-KEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Includes Recording_ Scanning Analysis With Report_ Revi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93241","description":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Includes Recording_ Scanning Analysis With Report_ Revi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove anal fist inter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46275","description":"Remove anal fist inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUD1","description":"ICD-NIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTD0","description":"ICD-EBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCD0","description":"ICD-JDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing id_ digit_ mon_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5254","description":"Hearing id_ digit_ mon_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug/substance nos 1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80375","description":"Drug/substance nos 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILB1","description":"ICD-OILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVE0","description":"ICD-BFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITB0","description":"ICD-EITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age And Had At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2123","description":"Patients 66-80 Years Of Age And Had At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCB0","description":"ICD-IBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear matrix protein 22","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86386","description":"Nuclear matrix protein 22","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDF1","description":"ICD-EEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADB1","description":"ICD-EADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIA1","description":"ICD-CIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHD1","description":"ICD-KCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28C","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACF0","description":"ICD-EACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Arch supp att to shoe long/m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3090","description":"Arch supp att to shoe long/m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation wi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7522","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUA1","description":"ICD-BIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oral prescrip drug non chemo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8499","description":"Oral prescrip drug non chemo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Metered dose inhaler drug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3535","description":"Metered dose inhaler drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tinnitus assessment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92625","description":"Tinnitus assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDD0","description":"ICD-BIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML36","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHB0","description":"ICD-FIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vein byp grft fem-popliteal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35583","description":"Vein byp grft fem-popliteal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDD0","description":"ICD-OGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92987","description":"Revision of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPB0","description":"ICD-OCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEF0","description":"ICD-JAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mirikizumab-mrkz_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9168","description":"Injection_ mirikizumab-mrkz_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEC1","description":"ICD-KIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; arterial anastomosis_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0670T","description":"Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; arterial anastomosis_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electro connect btw control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2310","description":"Electro connect btw control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAF0","description":"ICD-FEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home visit for hemodialysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99512","description":"Home visit for hemodialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVA1","description":"ICD-BIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcath mtral vlve repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0345T","description":"Transcath mtral vlve repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUE0","description":"ICD-FFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIA0","description":"ICD-OIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMC0","description":"ICD-CEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFD1","description":"ICD-OLFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18D","description":"Special Care High _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap enterolysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44180","description":"Lap enterolysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4IA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IA11","description":"ICD-4IA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBA1","description":"ICD-ADBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dm meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8494","description":"Dm meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01654","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01654","description":"CPT-01654","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEC1","description":"ICD-KGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alloskin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4123","description":"Alloskin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUC1","description":"ICD-MIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCC1","description":"ICD-NKCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIA1","description":"ICD-KBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTC1","description":"ICD-BHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pacemaker monitr audible/vis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0610","description":"Pacemaker monitr audible/vis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITF0","description":"ICD-OITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSB1","description":"ICD-PKSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trach-esoph voice pros md in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8509","description":"Trach-esoph voice pros md in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAB1","description":"ICD-OKAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVE0","description":"ICD-BCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNC1","description":"ICD-CBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat kneecap dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27566","description":"Treat kneecap dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB01","description":"Low Rehab_ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGC0","description":"ICD-NHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEE0","description":"ICD-NGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hyperthermia treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77600","description":"Hyperthermia treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRE1","description":"ICD-GIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRB0","description":"ICD-PDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFC1","description":"ICD-KAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBB0","description":"ICD-NDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOD1","description":"ICD-CBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heinz bodies direct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85441","description":"Heinz bodies direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWB1","description":"ICD-PCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQB1","description":"ICD-OJQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSB0","description":"ICD-GHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31360","description":"Removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOB1","description":"ICD-OHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAC0","description":"ICD-IHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal and reinsertion of sinus tarsi implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0511T","description":"Removal and reinsertion of sinus tarsi implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXC1","description":"ICD-CAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-66683","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","description":"CPT-66683","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQE0","description":"ICD-CFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRE0","description":"ICD-OBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28I","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBA0","description":"ICD-KFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Discography cerv/thor spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72285","description":"Discography cerv/thor spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4353","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","description":"HCPCS-Q4353","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQD0","description":"ICD-CIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD121","description":"Clinically Complex _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD111","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEF1","description":"ICD-IHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20665","description":"Removal of fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASC1","description":"ICD-DASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Memory current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9168","description":"Memory current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gauze > 48 sq in water/salne","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6230","description":"Gauze > 48 sq in water/salne","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Csit lowrisk surg pts preop","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8961","description":"Csit lowrisk surg pts preop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLC1","description":"ICD-AGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sugars single qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84376","description":"Sugars single qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tint photochromatic lens/es","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2744","description":"Tint photochromatic lens/es","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ avelumab_ 10mg (bavencio)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9491","description":"Injection_ avelumab_ 10mg (bavencio)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGA1","description":"ICD-OFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDE0","description":"ICD-GFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKED1","description":"ICD-MKED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWE1","description":"ICD-LFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCA1","description":"ICD-NFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87626","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","description":"CPT-87626","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopy of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50951","description":"Endoscopy of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFD1","description":"ICD-JIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDC0","description":"ICD-ICDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEA1","description":"ICD-KHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Initial or subsequent psychiatric collaborative care management_ first 30 minutes in a month of behavioral health care manager activities_ in consultation with a psychiatric c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2214","description":"Initial or subsequent psychiatric collaborative care management_ first 30 minutes in a month of behavioral health care manager activities_ in consultation with a psychiatric c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp subclav-subclavian","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35612","description":"Art byp subclav-subclavian","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEA1","description":"ICD-GIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUF0","description":"ICD-BEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAB0","description":"ICD-OIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Virtual reality technology to assist therapy (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0770T","description":"Virtual reality technology to assist therapy (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXD1","description":"ICD-GGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27446","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKC0","description":"ICD-OLKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHD1","description":"ICD-JBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fuse liver duct & intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47802","description":"Fuse liver duct & intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECB1","description":"ICD-AECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVC1","description":"ICD-GHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EC21","description":"ICD-2EC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N-et; stretcher van","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2005","description":"N-et; stretcher van","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKA1","description":"ICD-NJKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ef adult fluids and electro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4102","description":"Ef adult fluids and electro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Group adaptive behavior treatment with protocol modification_ administered by physician or other qualified health care professional_ face-to-face with multiple patients_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97158","description":"Group adaptive behavior treatment with protocol modification_ administered by physician or other qualified health care professional_ face-to-face with multiple patients_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTE0","description":"ICD-ACTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAB1","description":"ICD-KIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFF1","description":"ICD-BFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA115","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILB0","description":"ICD-OILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDA1","description":"ICD-MJDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9896","description":"Documentation of patient reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEED1","description":"ICD-IEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJB1","description":"ICD-OCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXB0","description":"ICD-JAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81538","description":"Oncology lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Round caliper and plate atta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2240","description":"Round caliper and plate atta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ translumin_ drug-coat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2623","description":"Cath_ translumin_ drug-coat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEF0","description":"ICD-KDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nephropathy doc tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3066F","description":"Nephropathy doc tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adult size pull-on xl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4528","description":"Adult size pull-on xl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD104","description":"Special Care High _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSD1","description":"ICD-LDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE255","description":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inject/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67505","description":"Inject/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXE1","description":"ICD-JEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOF1","description":"ICD-OIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo-vag hyst incl t/o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58552","description":"Laparo-vag hyst incl t/o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJD1","description":"ICD-BDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hla x-match noncytotoxc addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86826","description":"Hla x-match noncytotoxc addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup shrt leg fiberglass","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4038","description":"Cast sup shrt leg fiberglass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home Delivered Meals-Hot EntrĆ©e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1759","description":"Home Delivered Meals-Hot EntrĆ©e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDC0","description":"ICD-AGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISE0","description":"ICD-OISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trluml perip athrc renal art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0234T","description":"Trluml perip athrc renal art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transperineal periurethral balloon continence device; adjustment of balloon(s) fluid volume","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0551T","description":"Transperineal periurethral balloon continence device; adjustment of balloon(s) fluid volume","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWB0","description":"ICD-HAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHB1","description":"ICD-MCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEC1","description":"ICD-ECEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation shield","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5984","description":"Radiation shield","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNB0","description":"ICD-KDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUA1","description":"ICD-CCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCF1","description":"ICD-NLCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cranial bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21184","description":"Reconstruct cranial bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compatibility test electric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86923","description":"Compatibility test electric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC22","description":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTF1","description":"ICD-MLTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9805","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removable insert each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6691","description":"Removable insert each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLE1","description":"ICD-GFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPD0","description":"ICD-CFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC25D","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBA0","description":"ICD-BIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter Intracardiac Shunt (Tis) Creation By Stent Placement For Congenital Cardiac Anomalies To Establish Effective Intracardiac Flow_ Including All Imaging Guidance By","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33745","description":"Transcatheter Intracardiac Shunt (Tis) Creation By Stent Placement For Congenital Cardiac Anomalies To Establish Effective Intracardiac Flow_ Including All Imaging Guidance By","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBF1","description":"ICD-IHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Evacuate mole of uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59870","description":"Evacuate mole of uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLB0","description":"ICD-KGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB53","description":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPE1","description":"ICD-NFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sgd digitized pre-rec <=8min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2500","description":"Sgd digitized pre-rec <=8min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18G","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66030","description":"Injection treatment of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAD0","description":"ICD-JDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48155","description":"Removal of pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Depression screen annual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0444","description":"Depression screen annual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDD0","description":"ICD-AFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0666","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","description":"HCPCS-J0666","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBE0","description":"ICD-BEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE220","description":"Special Care High _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYA1","description":"ICD-HDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Zanamivir_inhalation pwd 10m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9018","description":"Zanamivir_inhalation pwd 10m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGB0","description":"ICD-FBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDE0","description":"ICD-FDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRE0","description":"ICD-HFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVB1","description":"ICD-CBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGD1","description":"ICD-BCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFB1","description":"ICD-JDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0983T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","description":"CPT-0983T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ chloroprocaine hydrochloride_ per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2401","description":"Injection_ chloroprocaine hydrochloride_ per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inflamation (eosinophilic esophagitis)_ ELISA analysis of eotaxin-3 (CCL26 [C-C motif chemokine ligand 26]) and major basic protein (PRG2 [proteoglycan 2_ pro eosinophil major","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0095U","description":"Inflamation (eosinophilic esophagitis)_ ELISA analysis of eotaxin-3 (CCL26 [C-C motif chemokine ligand 26]) and major basic protein (PRG2 [proteoglycan 2_ pro eosinophil major","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIB0","description":"ICD-IHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCD0","description":"ICD-FBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Motor speech goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9186","description":"Motor speech goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCD1","description":"ICD-MGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablate heart dysrhythm focus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33261","description":"Ablate heart dysrhythm focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1720","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1720","description":"CDT-D1720","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8I","description":"Very High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRE1","description":"ICD-OKRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABD0","description":"ICD-NABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAA1","description":"ICD-MDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPD0","description":"ICD-OCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKE0","description":"ICD-JIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transnasal; diagnostic_ including collection of specimen(s) by brushing or washing_ when performed (separate procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0652T","description":"Esophagogastroduodenoscopy_ flexible_ transnasal; diagnostic_ including collection of specimen(s) by brushing or washing_ when performed (separate procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Filtered nebulizer admin set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7006","description":"Filtered nebulizer admin set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXE1","description":"ICD-CCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43300","description":"Repair of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDA1","description":"ICD-GBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation medicine (allograft rejection_ renal)_ measurement of donor and third-party-induced CD154+T-cytotoxic memory cells_ utilizing whole peripheral blood_ algorithm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0018M","description":"Transplantation medicine (allograft rejection_ renal)_ measurement of donor and third-party-induced CD154+T-cytotoxic memory cells_ utilizing whole peripheral blood_ algorithm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDF1","description":"ICD-KDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFB1","description":"ICD-JIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDC0","description":"ICD-BIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSF1","description":"ICD-HCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of forearm bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25031","description":"Drainage of forearm bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-93146","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","description":"CPT-93146","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA21","description":"High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42835","description":"Removal of adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis - comprehensive series of radiographic images","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0372","description":"intraoral tomosynthesis - comprehensive series of radiographic images","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVA1","description":"ICD-KDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gauze <= 16 sq in w/border","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6219","description":"Gauze <= 16 sq in w/border","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSA1","description":"ICD-HGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment with protocol modification_ administered by physician or other qualified health care professional_ which may include simultaneous direction of tech","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97155","description":"Adaptive behavior treatment with protocol modification_ administered by physician or other qualified health care professional_ which may include simultaneous direction of tech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bridge base metal cast","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6211","description":"Bridge base metal cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of scleral staphyloma; without graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66220","description":"Repair of scleral staphyloma; without graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ bandage liner_ upper extremity_ any size or length_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6595","description":"Gradient compression bandaging supply_ bandage liner_ upper extremity_ any size or length_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXB1","description":"ICD-NJXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQB0","description":"ICD-CHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGE1","description":"ICD-NJGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neonatal emergency transport","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0225","description":"Neonatal emergency transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYC0","description":"ICD-CHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"NEURO INH ATAXIA DNA 51 GENE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0217U","description":"NEURO INH ATAXIA DNA 51 GENE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB115","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUB0","description":"ICD-GCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00922","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00922","description":"CPT-00922","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFA1","description":"ICD-JDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Deb subq tissue 20 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11042","description":"Deb subq tissue 20 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGND1","description":"ICD-GGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJD0","description":"ICD-JAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPD1","description":"ICD-JFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDC1","description":"ICD-CBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcath closure of asd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93580","description":"Transcath closure of asd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLA1","description":"ICD-GFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFE0","description":"ICD-NAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIC1","description":"ICD-NDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAF0","description":"ICD-FDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOC1","description":"ICD-KDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-33882","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","description":"CPT-33882","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Zneuroendoscopy w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62163","description":"Zneuroendoscopy w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQE0","description":"ICD-OJQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clsd reduct compd mandble fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7740","description":"Clsd reduct compd mandble fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mtms by pharm est 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99606","description":"Mtms by pharm est 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADF0","description":"ICD-JADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXF1","description":"ICD-KDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEME1","description":"ICD-KEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLC1","description":"ICD-OFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISA1","description":"ICD-PISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDD1","description":"ICD-CCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSB0","description":"ICD-CGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYF1","description":"ICD-PGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTF0","description":"ICD-ABTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mcp joint arthroscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29901","description":"Mcp joint arthroscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPE1","description":"ICD-NDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiof trsmtr implt scrl neu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8684","description":"Radiof trsmtr implt scrl neu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIID0","description":"ICD-BIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEA1","description":"ICD-CEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25405","description":"Repair/graft radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAB0","description":"ICD-OHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASC1","description":"ICD-GASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML1B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intend rpt dia retin msr grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9671","description":"Intend rpt dia retin msr grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41016","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transport port x-ray multipl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"R0075","description":"Transport port x-ray multipl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco use txmnt pharmacol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4001F","description":"Tobacco use txmnt pharmacol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic sigmoidoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45330","description":"Diagnostic sigmoidoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dermavest_ plurivest sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4153","description":"Dermavest_ plurivest sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glasses binaural hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5150","description":"Glasses binaural hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood glucose test strips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4772","description":"Blood glucose test strips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDA1","description":"ICD-IDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wound cleanser any type/size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6260","description":"Wound cleanser any type/size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWD0","description":"ICD-HAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBC0","description":"ICD-KGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of theophylline","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80198","description":"Assay of theophylline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHE1","description":"ICD-GGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTA0","description":"ICD-NFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urinary plastic pouch w/o fp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4381","description":"Urinary plastic pouch w/o fp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; characterization of alleles (eg_ expanded size or me","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81204","description":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; characterization of alleles (eg_ expanded size or me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo proc spermatic cord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55559","description":"Laparo proc spermatic cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transparent film <= 16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6257","description":"Transparent film <= 16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESE1","description":"ICD-LESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJC0","description":"ICD-BHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTA0","description":"ICD-OJTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTB1","description":"ICD-BFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXA0","description":"ICD-OKXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE104","description":"Reduced Physical Function _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr s/a/t/ext 2.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12031","description":"Intmd rpr s/a/t/ext 2.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEF0","description":"ICD-FCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA4C","description":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBC0","description":"ICD-GEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEA1","description":"ICD-FEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWA1","description":"ICD-CCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKB0","description":"ICD-CCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob prov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1255","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob prov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJA1","description":"ICD-CAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANC1","description":"ICD-CANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hippotherapy per session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8940","description":"Hippotherapy per session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Polysom <6 yrs 4/> paramtrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95782","description":"Polysom <6 yrs 4/> paramtrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVA0","description":"ICD-FGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m mebrofenin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9537","description":"Tc99m mebrofenin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of midface","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21188","description":"Reconstruction of midface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUF0","description":"ICD-ADUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prev visit est age 1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99392","description":"Prev visit est age 1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEE0","description":"ICD-NCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMA1","description":"ICD-FGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Construction of absent anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46735","description":"Construction of absent anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2107","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDC1","description":"ICD-NGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8I","description":"High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mgmt gene methylation anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81287","description":"Mgmt gene methylation anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4KC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KC11","description":"ICD-4KC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration sphenoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31050","description":"Exploration sphenoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Candida species panel (C. albicans_ C. glabrata_ C. parapsilosis_ C. kruseii_ C tropicalis_ and C. auris)_ amplified probe technique with qualitative report of the presence or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0068U","description":"Candida species panel (C. albicans_ C. glabrata_ C. parapsilosis_ C. kruseii_ C tropicalis_ and C. auris)_ amplified probe technique with qualitative report of the presence or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHF0","description":"ICD-AGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50010","description":"Exploration of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clin depression screen not d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8432","description":"Clin depression screen not d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Brain)_ Spheroid Cell Culture In A 3D Microenvironment_ 12 Drug Panel_ Tumor-Response Prediction For Each Drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0248U","description":"Oncology (Brain)_ Spheroid Cell Culture In A 3D Microenvironment_ 12 Drug Panel_ Tumor-Response Prediction For Each Drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYC1","description":"ICD-KHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJD0","description":"ICD-GDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of small bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74260","description":"X-ray exam of small bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLF1","description":"ICD-FGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPE1","description":"ICD-GGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hmatrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4134","description":"Hmatrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHD1","description":"ICD-CIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28B","description":"Clinically Complex _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFC0","description":"ICD-NCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC0D","description":"Medium Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGB0","description":"ICD-NGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBD0","description":"ICD-JEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI pelvis w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72195","description":"MRI pelvis w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDF0","description":"ICD-KCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDF0","description":"ICD-JBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMB1","description":"ICD-JFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHC1","description":"ICD-GFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUC0","description":"ICD-BIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Breast Ductal Carcinoma In Situ)_ Protein Expression Profiling By Immunohistochemistry Of 7 Proteins (Cox2_ Foxa1_ Her2_ Ki-67_ P16_ Pr_ Siah2)_ With 4 Clinicopathol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0295U","description":"Oncology (Breast Ductal Carcinoma In Situ)_ Protein Expression Profiling By Immunohistochemistry Of 7 Proteins (Cox2_ Foxa1_ Her2_ Ki-67_ P16_ Pr_ Siah2)_ With 4 Clinicopathol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj paravert f jnt l/s 3 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64495","description":"Inj paravert f jnt l/s 3 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMB0","description":"ICD-OLMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLD1","description":"ICD-EHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Osteopath manj 7-8 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98928","description":"Osteopath manj 7-8 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2FA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FA11","description":"ICD-2FA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFF1","description":"ICD-JIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc of neg or man pos tb scn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9359","description":"Doc of neg or man pos tb scn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYC0","description":"ICD-GAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote 30 day ecg rev/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93228","description":"Remote 30 day ecg rev/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAB0","description":"ICD-CGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVB0","description":"ICD-GEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHD1","description":"ICD-JDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient transfer to practice after initiation of chemotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9833","description":"Patient transfer to practice after initiation of chemotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBB1","description":"ICD-ACBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Scalp cooling_ mechanical; placement of device_ monitoring_ and removal of device (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0663T","description":"Scalp cooling_ mechanical; placement of device_ monitoring_ and removal of device (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt lft inpt fac w/in 60 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1110F","description":"Pt lft inpt fac w/in 60 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQC1","description":"ICD-HDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plmt ureteral stent prq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50695","description":"Plmt ureteral stent prq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWE1","description":"ICD-CEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-corrosive finish","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2780","description":"Non-corrosive finish","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIA1","description":"ICD-OEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Becaplermin gel 1%_ 0.5 gm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0157","description":"Becaplermin gel 1%_ 0.5 gm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aud rehab pre-ling hear loss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92630","description":"Aud rehab pre-ling hear loss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMC0","description":"ICD-FAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gonadotropin chorionic (hCG) immunoassay with direct optical observation blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0167U","description":"Gonadotropin chorionic (hCG) immunoassay with direct optical observation blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJD1","description":"ICD-JDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for immunofluorescence_ per specimen; each additional single antibody stain procedure (List separately in addition to code for primary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0846T","description":"Digitization of glass microscope slides for immunofluorescence_ per specimen; each additional single antibody stain procedure (List separately in addition to code for primary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB2A","description":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSA0","description":"ICD-CGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQB0","description":"ICD-ODQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDF1","description":"ICD-ABDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYA1","description":"ICD-DCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urinary reflex study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51792","description":"Urinary reflex study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES35C","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Monocyte distribution width_ whole blood (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0427U","description":"Monocyte distribution width_ whole blood (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31292","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML52","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction rectal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45190","description":"Destruction rectal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSA1","description":"ICD-DCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGD0","description":"ICD-CFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAC1","description":"ICD-GDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDID0","description":"ICD-FDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone marrow aspiration for bone grafting_ spine surgery only_ through separate skin or fascial incision (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20939","description":"Bone marrow aspiration for bone grafting_ spine surgery only_ through separate skin or fascial incision (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWA0","description":"ICD-HHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFED1","description":"ICD-MFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thera&Couns Svcs (Counseling Svcs)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0093","description":"Thera&Couns Svcs (Counseling Svcs)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLB1","description":"ICD-MLLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft aortbifemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35540","description":"Art byp grft aortbifemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDB0","description":"ICD-MLDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNA0","description":"ICD-KBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC231","description":"Special Care Low _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26180","description":"Removal of finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Peg interferon alfa-2b/10","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0148","description":"Peg interferon alfa-2b/10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shorten radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25392","description":"Shorten radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hla i typing 1 locus hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81380","description":"Hla i typing 1 locus hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHA0","description":"ICD-EHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKE1","description":"ICD-FDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Renal abscess open drain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50020","description":"Renal abscess open drain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBC1","description":"ICD-OHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy w/biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31535","description":"Laryngoscopy w/biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwr seat recline pwr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1005","description":"Pwr seat recline pwr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA4D","description":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOD1","description":"ICD-DIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICE1","description":"ICD-AICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELD0","description":"ICD-CELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9302","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9302","description":"HCPCS-C9302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQC1","description":"ICD-LIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFD0","description":"ICD-NKFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVB1","description":"ICD-GHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg_ Neisseria meningitidis_ Streptococcus pneumoniae_ Listeria_ Haemophilus influenza","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87483","description":"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg_ Neisseria meningitidis_ Streptococcus pneumoniae_ Listeria_ Haemophilus influenza","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Molecular pathology interpr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0452","description":"Molecular pathology interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODID0","description":"ICD-ODID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown porcelain high noble","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6750","description":"Crown porcelain high noble","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYE1","description":"ICD-OHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMB0","description":"ICD-EGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHF1","description":"ICD-FBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who are transferred from one institution to another with a known diagnosis of CVA for endovascular stroke treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9766","description":"Patients who are transferred from one institution to another with a known diagnosis of CVA for endovascular stroke treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYA1","description":"ICD-LAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) an","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML03","description":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC244","description":"Clinically Complex _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUF0","description":"ICD-AAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Screening pap smear by phys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P3001","description":"Screening pap smear by phys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0447T","description":"Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of adp & amp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82030","description":"Assay of adp & amp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACF0","description":"ICD-IACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81343","description":"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB2C","description":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documented history of renal failure or baseline serum creatinine = 4.0 mg/dl; renal transplant recipients are not considered to have preoperative renal failure_ unless_ since","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9722","description":"Documented history of renal failure or baseline serum creatinine = 4.0 mg/dl; renal transplant recipients are not considered to have preoperative renal failure_ unless_ since","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fragmenting of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50590","description":"Fragmenting of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDID1","description":"ICD-FDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHA1","description":"ICD-MIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJA0","description":"ICD-FEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQB0","description":"ICD-LDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1334","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALF0","description":"ICD-OALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSB1","description":"ICD-OGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EC11","description":"ICD-2EC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0203","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0203","description":"HCPCS-B0203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIC0","description":"ICD-JAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rem mntr pulm flu mntr setup","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0607T","description":"Rem mntr pulm flu mntr setup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQE1","description":"ICD-KDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Albumin (human)_5%_ 50ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9041","description":"Albumin (human)_5%_ 50ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath w/o bag 2-way silicone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4312","description":"Cath w/o bag 2-way silicone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder lock actuator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6647","description":"Shoulder lock actuator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dxa ordered for osteo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8861","description":"Dxa ordered for osteo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTD1","description":"ICD-KHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hematology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85999","description":"Hematology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient is not currently on a daily aspirin or other antiplatelet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9795","description":"Patient is not currently on a daily aspirin or other antiplatelet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35142","description":"Repair artery rupture thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of hypotony","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1326","description":"Patients with a diagnosis of hypotony","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1490","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","description":"HCPCS-M1490","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYA0","description":"ICD-OIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBB1","description":"ICD-EIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vagina gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56740","description":"Remove vagina gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDD1","description":"ICD-OEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXF0","description":"ICD-OGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAA0","description":"ICD-MDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leg pain was not measured by the Visual Analog Scale (VAS) within three months preoperatively and at one year (9 to 15 months)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1052","description":"Leg pain was not measured by the Visual Analog Scale (VAS) within three months preoperatively and at one year (9 to 15 months)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICF0","description":"ICD-MICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATD0","description":"ICD-AATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRE0","description":"ICD-OJRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of free testosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84402","description":"Assay of free testosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc prac mgmt dif pt comorb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9060","description":"Onc prac mgmt dif pt comorb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACD1","description":"ICD-AACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","description":"HCPCS-Q4402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIB1","description":"ICD-CCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mild osa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8848","description":"Mild osa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUF1","description":"ICD-OCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILB1","description":"ICD-NILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Technical Preparation And Transmission Of Data For Analysis To Be Performed Elsewhere","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77090","description":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Technical Preparation And Transmission Of Data For Analysis To Be Performed Elsewhere","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFD0","description":"ICD-JHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQA1","description":"ICD-HEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRA0","description":"ICD-DGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAA1","description":"ICD-MIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score hip not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8654","description":"Fun stat score hip not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compres burngarment chinstrp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6502","description":"Compres burngarment chinstrp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCE0","description":"ICD-ABCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRC0","description":"ICD-HDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEF0","description":"ICD-NCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel drsg gel filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6248","description":"Hydrogel drsg gel filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain ostomy pouch w/flange","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5063","description":"Drain ostomy pouch w/flange","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohols biomarkers 3/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80322","description":"Alcohols biomarkers 3/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVD0","description":"ICD-NEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSD0","description":"ICD-OHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis treatment performed exactly three times per week for > 90 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8714","description":"Hemodialysis treatment performed exactly three times per week for > 90 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA ADENOVIRUS ENTERIC TYP 40/41","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87301","description":"IAAD IA ADENOVIRUS ENTERIC TYP 40/41","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFB1","description":"ICD-OIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA5A","description":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst w/t/o & vag repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58263","description":"Vag hyst w/t/o & vag repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQE1","description":"ICD-OIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLC0","description":"ICD-NHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSC1","description":"ICD-OHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFID1","description":"ICD-CFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Microcapillary tube sealant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4652","description":"Microcapillary tube sealant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES104","description":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion_ subcutaneous cardiac rhythm monitor_ including programming","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33285","description":"Insertion_ subcutaneous cardiac rhythm monitor_ including programming","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI_ Rorschach_ WAIS)_ per hour of t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96101","description":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI_ Rorschach_ WAIS)_ per hour of t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elbow arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29836","description":"Elbow arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44403","description":"Colonoscopy w/resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMA0","description":"ICD-CIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUE1","description":"ICD-EBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Valvuloplasty_ aortic valve_ open_ with cardiopulmonary bypass; complex (eg_ leaflet extension_ leaflet resection_ leaflet reconstruction_ or annuloplasty)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33391","description":"Valvuloplasty_ aortic valve_ open_ with cardiopulmonary bypass; complex (eg_ leaflet extension_ leaflet resection_ leaflet reconstruction_ or annuloplasty)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKA0","description":"ICD-OFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQC0","description":"ICD-HIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ifosfamide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9208","description":"Ifosfamide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRE0","description":"ICD-PHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mirror coating","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2761","description":"Mirror coating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSF0","description":"ICD-GDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD11A","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repositioning of previously implanted aortic counterpulsation ventricular assist device; subcutaneous electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0460T","description":"Repositioning of previously implanted aortic counterpulsation ventricular assist device; subcutaneous electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brst prsths adhsv attchmnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4280","description":"Brst prsths adhsv attchmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28X","description":"Clinically Complex _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWB0","description":"ICD-OFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of percutaneous transhepatic catheter for biliary drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47510","description":"Introduction of percutaneous transhepatic catheter for biliary drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical pathology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88399","description":"Surgical pathology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBD1","description":"ICD-NFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUB1","description":"ICD-MJUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc s/n/h/f/g mal+mrg 2.1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11623","description":"Exc s/n/h/f/g mal+mrg 2.1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL33","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj foramen epidural l/s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64483","description":"Inj foramen epidural l/s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastric emptying imag study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78264","description":"Gastric emptying imag study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LC11","description":"ICD-4LC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDB1","description":"ICD-BHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reopen fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58345","description":"Reopen fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUF0","description":"ICD-BIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hib-mency vaccine 4 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90644","description":"Hib-mency vaccine 4 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAID1","description":"ICD-JAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMA0","description":"ICD-EDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB23","description":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wound char size etc docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2050F","description":"Wound char size etc docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablate atria w/bypass exten","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33256","description":"Ablate atria w/bypass exten","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWD0","description":"ICD-GFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (high-grade prostate cancer)_ biochemical assay of four proteins (Total PSA_ Free PSA_ Intact PSA_ and human kallikrein-2 [hK2])_ utilizing plasma or serum_ prognosti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81539","description":"Oncology (high-grade prostate cancer)_ biochemical assay of four proteins (Total PSA_ Free PSA_ Intact PSA_ and human kallikrein-2 [hK2])_ utilizing plasma or serum_ prognosti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJA0","description":"ICD-OIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Total cortisol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82533","description":"Total cortisol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSB0","description":"ICD-OBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ ITC/BTE","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5215","description":"Hearing aid_ contralateral routing system_ binaural_ ITC/BTE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bilobectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32482","description":"Bilobectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHC1","description":"ICD-AEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX2D","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVC0","description":"ICD-OFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRD1","description":"ICD-CFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX55","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Misoprostol_ oral_ 200 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0191","description":"Misoprostol_ oral_ 200 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq dev breast add us imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19286","description":"Perq dev breast add us imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTC0","description":"ICD-MFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESB1","description":"ICD-HESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGC0","description":"ICD-NDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vkorc1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81355","description":"Vkorc1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic exercises","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97110","description":"Therapeutic exercises","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENA0","description":"ICD-OENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aud rehab postling hear loss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92633","description":"Aud rehab postling hear loss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUF0","description":"ICD-AIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFF1","description":"ICD-FCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA23A","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1502","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1502","description":"CDT-D1502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Near ifr spectrsc of wounds","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0286T","description":"Near ifr spectrsc of wounds","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTC0","description":"ICD-OCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of percutaneous electrode array_ sacral_ with integrated neurostimulator_ including imaging guidance_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0786T","description":"Insertion or replacement of percutaneous electrode array_ sacral_ with integrated neurostimulator_ including imaging guidance_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXC1","description":"ICD-KIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDD1","description":"ICD-AIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc leg/ankle tum < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27618","description":"Exc leg/ankle tum < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ apadamtase alfa_ 10 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9167","description":"Injection_ apadamtase alfa_ 10 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFC1","description":"ICD-CCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg_ spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81184","description":"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg_ spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of glycated protein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82985","description":"Assay of glycated protein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0678","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0678","description":"HCPCS-G0678","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-76016","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","description":"CPT-76016","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hd shck absrber for hd powwc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1018","description":"Hd shck absrber for hd powwc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHA1","description":"ICD-FCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Total hip arthroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27130","description":"Total hip arthroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Centrifuge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1500","description":"Centrifuge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRC0","description":"ICD-LFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHD1","description":"ICD-GBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Collagen meniscus implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0428","description":"Collagen meniscus implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic caster tire each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2214","description":"Pneumatic caster tire each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBD1","description":"ICD-MLBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKA0","description":"ICD-OIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; adenovirus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87809","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; adenovirus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ bivalent spike protein_ preservative free_ 3 mcg/0.2 mL dosage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91317","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ bivalent spike protein_ preservative free_ 3 mcg/0.2 mL dosage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLF0","description":"ICD-FFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam breastbone 2/>vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71120","description":"X-ray exam breastbone 2/>vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc comp or mort w in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9267","description":"Doc comp or mort w in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBD1","description":"ICD-OLBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAC0","description":"ICD-EDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fistula repair transperine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57308","description":"Fistula repair transperine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy_ flexible; with therapeutic injection(s) (eg_ chemodenervation agent or corticosteroid_ injected percutaneous_ transoral_ or via endoscope channel)_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31573","description":"Laryngoscopy_ flexible; with therapeutic injection(s) (eg_ chemodenervation agent or corticosteroid_ injected percutaneous_ transoral_ or via endoscope channel)_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIID0","description":"ICD-GIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJB1","description":"ICD-KDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0625T","description":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Init pm e/m new pat 65+ yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99387","description":"Init pm e/m new pat 65+ yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVA0","description":"ICD-CHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWA0","description":"ICD-KBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc stroke after cea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9258","description":"Doc stroke after cea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEC0","description":"ICD-KEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJF0","description":"ICD-OKJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Right heart cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93451","description":"Right heart cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYE0","description":"ICD-KBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRE1","description":"ICD-GHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYB0","description":"ICD-CFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGE1","description":"ICD-CFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair diaphragm laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39501","description":"Repair diaphragm laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt ed re ft care inspct rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4305F","description":"Pt ed re ft care inspct rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFF1","description":"ICD-FHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infliximab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1745","description":"Infliximab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Hypoglossal Nerve Neurostimulator Array_ Pulse Generator_ And Distal Respiratory Sensor Electrode Or Electrode Array","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64584","description":"Removal Of Hypoglossal Nerve Neurostimulator Array_ Pulse Generator_ And Distal Respiratory Sensor Electrode Or Electrode Array","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC151","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB13B","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHC0","description":"ICD-CAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGA1","description":"ICD-BAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBID0","description":"ICD-MBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ect provided","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4066F","description":"Ect provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transplt allo hct/donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38240","description":"Transplt allo hct/donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQF0","description":"ICD-HIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEME1","description":"ICD-NEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVD1","description":"ICD-GBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB215","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGE0","description":"ICD-OKGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAC0","description":"ICD-IBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/fast/dir lab ldl-c >190","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9675","description":"Pt w/fast/dir lab ldl-c >190","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup gauntlet ped fbrgls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4016","description":"Cast sup gauntlet ped fbrgls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDA0","description":"ICD-CFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGID1","description":"ICD-BGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAA0","description":"ICD-JCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eval amniotic fluid protein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84112","description":"Eval amniotic fluid protein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWD0","description":"ICD-HEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVC0","description":"ICD-NFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKB0","description":"ICD-BFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth abdominal wall surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70051","description":"Anesth abdominal wall surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artery-vein autograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36825","description":"Artery-vein autograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cysto/uretero w/up stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52345","description":"Cysto/uretero w/up stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGF1","description":"ICD-OGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ carmustine (accord)_ not therapeutically equivalent to j9050_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9052","description":"Injection_ carmustine (accord)_ not therapeutically equivalent to j9050_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Graft repair of spine defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63710","description":"Graft repair of spine defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00326","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00326","description":"CPT-00326","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of big toe joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28760","description":"Fusion of big toe joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Afo tibial fracture soft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2112","description":"Afo tibial fracture soft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCC0","description":"ICD-BHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSB0","description":"ICD-HBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Supported employment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W6106","description":"Supported employment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18C","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACB1","description":"ICD-FACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUC1","description":"ICD-KDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBB1","description":"ICD-FBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD14C","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy tubal block","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58671","description":"Laparoscopy tubal block","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD216","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Md recertification hha pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0179","description":"Md recertification hha pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise spine & cord thoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63195","description":"Incise spine & cord thoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIE0","description":"ICD-AHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTF0","description":"ICD-MLTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOF1","description":"ICD-OBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEF1","description":"ICD-MKEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWD1","description":"ICD-GCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUB0","description":"ICD-CEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advanced I","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2133","description":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advanced I","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onlay porc/crmc 2 surfaces","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6608","description":"Onlay porc/crmc 2 surfaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of pyloric muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43520","description":"Incision of pyloric muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty (except dialysis circuit)_ open or percutaneous_ including all imaging and radiological supervision and interpretation necessary to perform th","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37248","description":"Transluminal balloon angioplasty (except dialysis circuit)_ open or percutaneous_ including all imaging and radiological supervision and interpretation necessary to perform th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBA1","description":"ICD-JGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVC0","description":"ICD-KHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEE0","description":"ICD-KCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intentional replantation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3470","description":"Intentional replantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBA0","description":"ICD-MEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVE0","description":"ICD-NIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCED1","description":"ICD-KCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAE1","description":"ICD-JFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVE1","description":"ICD-NCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVA0","description":"ICD-FEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apply intrcav radiat simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77761","description":"Apply intrcav radiat simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJB1","description":"ICD-FFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed)_ Single S","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78429","description":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed)_ Single S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ velmanase alfa-tycv_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0217","description":"Injection_ velmanase alfa-tycv_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUF1","description":"ICD-MJUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCF1","description":"ICD-AFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDE0","description":"ICD-NGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB145","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4427","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","description":"HCPCS-Q4427","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45499","description":"Laparoscope proc rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; not otherwise specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87899","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ercp w/specimen collection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43260","description":"Ercp w/specimen collection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastric bypass incl small i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43847","description":"Gastric bypass incl small i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL22","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rbc leukoreduced irradiated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9040","description":"Rbc leukoreduced irradiated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWB0","description":"ICD-PEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54700","description":"Drainage of scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4387","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","description":"HCPCS-Q4387","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDD0","description":"ICD-EEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA22C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTF1","description":"ICD-IHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1018T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","description":"CPT-1018T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Limited (30 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s hom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0082","description":"Limited (30 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s hom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFA0","description":"ICD-FHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIC0","description":"ICD-JEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFED1","description":"ICD-AFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heart infarct image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78466","description":"Heart infarct image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALF1","description":"ICD-OALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOA0","description":"ICD-GEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not performing a dilated macular examination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9892","description":"Documentation of patient reason(s) for not performing a dilated macular examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disp home glucose monitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9275","description":"Disp home glucose monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Musc tst done w/n tst nonext","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95887","description":"Musc tst done w/n tst nonext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hyperbaric o2 chamber disps","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4575","description":"Hyperbaric o2 chamber disps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tis trnfr trunk 10 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14000","description":"Tis trnfr trunk 10 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBF1","description":"ICD-FCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYB1","description":"ICD-CIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJA1","description":"ICD-GCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient had a bone mineral density test in the past two years or received osteoporosis medication or therapy in the past 12 months","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9769","description":"Patient had a bone mineral density test in the past two years or received osteoporosis medication or therapy in the past 12 months","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAF0","description":"ICD-MKAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Als defibrillation supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0392","description":"Als defibrillation supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4359","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","description":"HCPCS-Q4359","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDC0","description":"ICD-IIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRD0","description":"ICD-DHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Correct skin color 6.0 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11920","description":"Correct skin color 6.0 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUB1","description":"ICD-NIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELF1","description":"ICD-KELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKF0","description":"ICD-JAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Formoterol fumarate_ inh","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7606","description":"Formoterol fumarate_ inh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICB0","description":"ICD-OICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOC0","description":"ICD-LCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Device evaluation and interrogation of intraocular retinal electrode array (eg_ retinal prosthesis)_ in person_ including reprogramming and visual training_ when performed_ wi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0473T","description":"Device evaluation and interrogation of intraocular retinal electrode array (eg_ retinal prosthesis)_ in person_ including reprogramming and visual training_ when performed_ wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suture complicate wnd > 5 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7912","description":"Suture complicate wnd > 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJF1","description":"ICD-BDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation heart/lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33935","description":"Transplantation heart/lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYB0","description":"ICD-CDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adult companioncare per 15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5135","description":"Adult companioncare per 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES325","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening fentanyl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80354","description":"Drug screening fentanyl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWD1","description":"ICD-OHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen concentrator_ dual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1391","description":"Oxygen concentrator_ dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of nasal vestibular lateral wall stenosis with implant(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9749","description":"Repair of nasal vestibular lateral wall stenosis with implant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB135","description":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLF1","description":"ICD-MBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXD0","description":"ICD-NAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove cadaver donor kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50300","description":"Remove cadaver donor kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKB1","description":"ICD-FBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit antibiotic q12h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9501","description":"Hit antibiotic q12h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDND0","description":"ICD-BDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBC1","description":"ICD-OGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUA1","description":"ICD-BEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pne scrn done doc vac done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9279","description":"Pne scrn done doc vac done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg_ low-ejection fraction_ pulmonary hypertension_ hypertrophic cardiomyopathy); related","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0764T","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg_ low-ejection fraction_ pulmonary hypertension_ hypertrophic cardiomyopathy); related","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESE1","description":"ICD-HESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transection or ligation_ carotid artery in cavernous sinus_ with repair by anastomosis or graft (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61610","description":"Transection or ligation_ carotid artery in cavernous sinus_ with repair by anastomosis or graft (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous auricular neurostimulation_ set-up_ calibration_ and patient education on use of equipment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0783T","description":"Transcutaneous auricular neurostimulation_ set-up_ calibration_ and patient education on use of equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECD1","description":"ICD-MECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Minimally invasive direct co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2206","description":"Minimally invasive direct co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKB1","description":"ICD-GCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft hand/foot >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64891","description":"Nerve graft hand/foot >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mannitol for inhaler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7665","description":"Mannitol for inhaler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adapter_ single-use (i.e._ disposable)_ for attaching ultrasound system to upper gastrointestinal endoscope","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1606","description":"Adapter_ single-use (i.e._ disposable)_ for attaching ultrasound system to upper gastrointestinal endoscope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUE1","description":"ICD-AAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTF0","description":"ICD-AFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCF0","description":"ICD-JDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism Health Help_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1017","description":"Clinical decision support mechanism Health Help_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYF0","description":"ICD-DGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVA0","description":"ICD-FDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQC0","description":"ICD-CBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFID0","description":"ICD-BFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHD0","description":"ICD-JAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAF0","description":"ICD-JFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRC1","description":"ICD-KGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOE1","description":"ICD-KGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPE0","description":"ICD-OCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC224","description":"Special Care Low _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHME0","description":"ICD-GHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLA1","description":"ICD-NGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYF1","description":"ICD-PJYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFA0","description":"ICD-OCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMA1","description":"ICD-OAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneuma/vac walk boot pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4361","description":"Pneuma/vac walk boot pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAA1","description":"ICD-BEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNE0","description":"ICD-NGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor liver whole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47143","description":"Prep donor liver whole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percut ablate liver rf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47382","description":"Percut ablate liver rf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1194","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOF1","description":"ICD-DAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Breast)_ Mrna_ Next-Generation Sequencing Gene Expression Profiling Of 70 Content Genes And 31 Housekeeping Genes_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81523","description":"Oncology (Breast)_ Mrna_ Next-Generation Sequencing Gene Expression Profiling Of 70 Content Genes And 31 Housekeeping Genes_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVE1","description":"ICD-FIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amiodarone hcl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0282","description":"Amiodarone hcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIE1","description":"ICD-BDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA10A","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair lead pace-defib one","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33218","description":"Repair lead pace-defib one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA07","description":"High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0646U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0646U","description":"CPT-0646U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEB1","description":"ICD-FAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2004","description":"HCPCS-A2004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGB1","description":"ICD-CGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITC1","description":"ICD-FITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No vis inj at surg/1mos post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9630","description":"No vis inj at surg/1mos post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25680","description":"Treat wrist fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alloderm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4116","description":"Alloderm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVE1","description":"ICD-NHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Telemonitoring/home per mnth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9110","description":"Telemonitoring/home per mnth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLA0","description":"ICD-ECLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFD0","description":"ICD-BDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEC0","description":"ICD-BEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0604U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","description":"CPT-0604U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMF1","description":"ICD-CIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDE1","description":"ICD-OFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score shdl >=0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8663","description":"Fun stat score shdl >=0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of hand bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26230","description":"Partial removal of hand bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Camisole post-mast","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8460","description":"Camisole post-mast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUF0","description":"ICD-JGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJB1","description":"ICD-BHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBF0","description":"ICD-IIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDC1","description":"ICD-EBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove jaw joint cartilage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21060","description":"Remove jaw joint cartilage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWE0","description":"ICD-HBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0601","description":"HCPCS-C0601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFB1","description":"ICD-BCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILE0","description":"ICD-JILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prefab stnlss steel crwn pri","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2930","description":"Prefab stnlss steel crwn pri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDD1","description":"ICD-BGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26740","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBD1","description":"ICD-KEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD144","description":"Special Care Low _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQC0","description":"ICD-KCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAF1","description":"ICD-CAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC106","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKB1","description":"ICD-NBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQE1","description":"ICD-CBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"L hrt cath trnsptl puncture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93462","description":"L hrt cath trnsptl puncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Angiotensin Converting Enzyme (Ace) Inhibitor Or Angiotensin Receptor Blocker (Arb) Or Angiotensin Receptor-Neprilysin Inhibitor (Arni) Therapy Prescribed Or Currently Being T","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2092","description":"Angiotensin Converting Enzyme (Ace) Inhibitor Or Angiotensin Receptor Blocker (Arb) Or Angiotensin Receptor-Neprilysin Inhibitor (Arni) Therapy Prescribed Or Currently Being T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp2 hd mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0843","description":"Pwc gp2 hd mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL34","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of toe tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28232","description":"Incision of toe tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYE1","description":"ICD-GGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXE0","description":"ICD-OFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYE0","description":"ICD-HIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short sta","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX17","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFC1","description":"ICD-OLFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVB1","description":"ICD-OHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lt compres band >=5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6450","description":"Lt compres band >=5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVA1","description":"ICD-GFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMC0","description":"ICD-NDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJB0","description":"ICD-GCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGA0","description":"ICD-KEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD111","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADE1","description":"ICD-AADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of small bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44010","description":"Incision of small bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSE1","description":"ICD-GDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy w/markers","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31626","description":"Bronchoscopy w/markers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of heel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73650","description":"X-ray exam of heel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transection or ligation_ carotid artery in petrous canal; with repair by anastomosis or graft (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61612","description":"Transection or ligation_ carotid artery in petrous canal; with repair by anastomosis or graft (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECA1","description":"ICD-EECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB101","description":"Special Care High _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAE0","description":"ICD-ACAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEA0","description":"ICD-EIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ref to outpt card rehab prog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4500F","description":"Ref to outpt card rehab prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adjustable angle footplate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0040","description":"Adjustable angle footplate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQC1","description":"ICD-PHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electro hearng aid test one","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92594","description":"Electro hearng aid test one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Arthro_ loose body + chondro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0289","description":"Arthro_ loose body + chondro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Subtalar arthro w/fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29907","description":"Subtalar arthro w/fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iiv4 vacc no prsv 6-35 m im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90685","description":"Iiv4 vacc no prsv 6-35 m im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25443","description":"Reconstruct wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ortho shoe add full sole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3540","description":"Ortho shoe add full sole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental tmj arthrogram incl i","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0320","description":"Dental tmj arthrogram incl i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXB1","description":"ICD-KFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Weight record","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2001F","description":"Weight record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8G","description":"Medium Rehab _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGE0","description":"ICD-NLGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNB1","description":"ICD-NCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMF1","description":"ICD-JIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99424","description":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEE1","description":"ICD-FGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJE1","description":"ICD-NKJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALD0","description":"ICD-KALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1120","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg_ spinocerebellar ataxia) gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81185","description":"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg_ spinocerebellar ataxia) gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of pylorus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43800","description":"Reconstruction of pylorus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IB11","description":"ICD-1IB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33020","description":"Incision of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD201","description":"Special Care High _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUF1","description":"ICD-GHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXE0","description":"ICD-JAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLA1","description":"ICD-IBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Face bone graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21210","description":"Face bone graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8C","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscop mucosal resect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43211","description":"Esophagoscop mucosal resect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt has symp&signs neuropathy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3753F","description":"Pt has symp&signs neuropathy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAB0","description":"ICD-BBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPE1","description":"ICD-BCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ins cath ren art 2nd+ bilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36254","description":"Ins cath ren art 2nd+ bilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4437","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","description":"HCPCS-Q4437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPB1","description":"ICD-OEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal pacemaker electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33235","description":"Removal pacemaker electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDC1","description":"ICD-ACDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEA0","description":"ICD-IGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneumococcal Vaccine Was Not Administered On Or After Patient_S 60Th Birthday And Before The End Of The Measurement Period_ Reason Not Otherwise Specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9990","description":"Pneumococcal Vaccine Was Not Administered On Or After Patient_S 60Th Birthday And Before The End Of The Measurement Period_ Reason Not Otherwise Specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33422","description":"Revision of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIME1","description":"ICD-BIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL45","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVD0","description":"ICD-FCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCC1","description":"ICD-JBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOF0","description":"ICD-HFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCF1","description":"ICD-MKCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBD0","description":"ICD-FDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor xiii fibrin scrn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85291","description":"Clot factor xiii fibrin scrn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKD1","description":"ICD-JHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCED0","description":"ICD-GCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inject for lymphatic x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38790","description":"Inject for lymphatic x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Day habil waiver per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2020","description":"Day habil waiver per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ hip_ during operative procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73530","description":"Radiologic examination_ hip_ during operative procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECA1","description":"ICD-BECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAF1","description":"ICD-JAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraop oct breast cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0353T","description":"Intraop oct breast cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Satisfy with care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0916","description":"Satisfy with care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ DNA_ next-generation sequencing (NGS) of 60 genes and whole genome aneuploidy_ urine_ algorithms reported as minimal residual disease (MRD) status positive","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0467U","description":"Oncology (bladder)_ DNA_ next-generation sequencing (NGS) of 60 genes and whole genome aneuploidy_ urine_ algorithms reported as minimal residual disease (MRD) status positive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIC0","description":"ICD-OAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee cap medial or lateral p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2800","description":"Knee cap medial or lateral p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHME1","description":"ICD-EHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOC0","description":"ICD-GHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive estimate of coronary fractional flow reserve (FFR) derived from augmentative software analysis of the data set from a coronary computed tomography angiography_ wit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75580","description":"Noninvasive estimate of coronary fractional flow reserve (FFR) derived from augmentative software analysis of the data set from a coronary computed tomography angiography_ wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA16","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX44","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBB1","description":"ICD-GHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE140","description":"Clinically Complex _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC60","description":"Medium Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neutralizing antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)(Coronavirus disease[COVID-19]);titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86409","description":"Neutralizing antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)(Coronavirus disease[COVID-19]);titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXD0","description":"ICD-OAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C7571","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7571","description":"HCPCS-C7571","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAF0","description":"ICD-BHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABD0","description":"ICD-KABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Admin + supply_ tositumomab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G3001","description":"Admin + supply_ tositumomab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of arm artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34111","description":"Removal of arm artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYA0","description":"ICD-OCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBED0","description":"ICD-KBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGME1","description":"ICD-MGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elevated or hypertensive blood pressure reading documented_ indicated follow-up not documented_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1279","description":"Elevated or hypertensive blood pressure reading documented_ indicated follow-up not documented_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLD1","description":"ICD-FGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSC0","description":"ICD-GHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC10B","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNC1","description":"ICD-OBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1612","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","description":"HCPCS-J1612","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sewhfo airplane w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3976","description":"Sewhfo airplane w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCC1","description":"ICD-KFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFD1","description":"ICD-FFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADB1","description":"ICD-BADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUA1","description":"ICD-JAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMB0","description":"ICD-NHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection for myelogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62284","description":"Injection for myelogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IFNL3 (interferon_ lambda 3) (eg_ drug response)_ gene analysis_ rs12979860 variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81283","description":"IFNL3 (interferon_ lambda 3) (eg_ drug response)_ gene analysis_ rs12979860 variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFD1","description":"ICD-NCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJD0","description":"ICD-BAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphc trifo 7.25-12/4.25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2313","description":"Lens sphc trifo 7.25-12/4.25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB25D","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKF1","description":"ICD-CCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJF1","description":"ICD-CAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suspension of breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19316","description":"Suspension of breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGA0","description":"ICD-BEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18F","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEA0","description":"ICD-BFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJE0","description":"ICD-GIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Supply allowance for adjunctive continuous glucose monitor (CGM)_ includes all supplies and accessories_ 1 month supply = 1 unit of service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4238","description":"Supply allowance for adjunctive continuous glucose monitor (CGM)_ includes all supplies and accessories_ 1 month supply = 1 unit of service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXE1","description":"ICD-JHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4412","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","description":"HCPCS-Q4412","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98009","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","description":"CPT-98009","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC144","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Portable gas oxygen system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0738","description":"Portable gas oxygen system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastroenterology (Barrettā€™s esophagus)_ P16_ RUNX3_ HPP1_ and FBN1 methylation analysis_ prognostic and predictive algorithm reported as a risk score for progression to high-g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0386U","description":"Gastroenterology (Barrettā€™s esophagus)_ P16_ RUNX3_ HPP1_ and FBN1 methylation analysis_ prognostic and predictive algorithm reported as a risk score for progression to high-g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEF0","description":"ICD-AFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD136","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAD0","description":"ICD-OIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIA0","description":"ICD-CIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHD0","description":"ICD-GCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion during 3-dimensn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0241T","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion during 3-dimensn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDE0","description":"ICD-AEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTE0","description":"ICD-EFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVB0","description":"ICD-BAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRF1","description":"ICD-LIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMF1","description":"ICD-CBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCE1","description":"ICD-KBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive med svc 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2010","description":"Comprehensive med svc 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glucose tolerance test (gtt)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82951","description":"Glucose tolerance test (gtt)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIC0","description":"ICD-GEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Galactose transferase test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82776","description":"Galactose transferase test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth heart surg w/arrest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56351","description":"Anesth heart surg w/arrest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/bx med space","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32606","description":"Thoracoscopy w/bx med space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCF0","description":"ICD-JHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6060","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFD0","description":"ICD-BCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC03","description":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol/subs interv >30 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0397","description":"Alcohol/subs interv >30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCD1","description":"ICD-NFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJC1","description":"ICD-GHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1938","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","description":"HCPCS-J1938","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKB1","description":"ICD-KCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of primidone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80188","description":"Assay of primidone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Two Medica re Diabetes Prevention Program (MDPP) ongoing maintenance se ss ions (MS) were attended by an MDPP beneficiary in months (mo) 13-15 under the MDPP","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9882","description":"Two Medica re Diabetes Prevention Program (MDPP) ongoing maintenance se ss ions (MS) were attended by an MDPP beneficiary in months (mo) 13-15 under the MDPP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1404","description":"HCPCS-C1404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACF1","description":"ICD-IACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRE0","description":"ICD-PGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOF0","description":"ICD-KEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4363","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","description":"HCPCS-Q4363","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBND0","description":"ICD-NBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES23C","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIE0","description":"ICD-KDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALC0","description":"ICD-IALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert semi-rigid prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54400","description":"Insert semi-rigid prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQA1","description":"ICD-OIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWF1","description":"ICD-DGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pros sock multi ply upper lm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8435","description":"Pros sock multi ply upper lm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat foot bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28005","description":"Treat foot bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFD0","description":"ICD-BAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Airway inhalation treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94640","description":"Airway inhalation treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29886","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not have at least two HPV vaccines (with at least 146 days between the two) or three HPV vaccines on or between the patient_s 9th and 13th birthdays","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9763","description":"Patient did not have at least two HPV vaccines (with at least 146 days between the two) or three HPV vaccines on or between the patient_s 9th and 13th birthdays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC136","description":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam sacrum tailbone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72220","description":"X-ray exam sacrum tailbone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHA0","description":"ICD-NFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVC1","description":"ICD-ODVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAB1","description":"ICD-OEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Micro exam prep & report","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0473","description":"Micro exam prep & report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovas non-cardiac abl cath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1888","description":"Endovas non-cardiac abl cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vagina lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57130","description":"Remove vagina lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUD0","description":"ICD-JAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQB1","description":"ICD-OBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWF0","description":"ICD-OCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0979T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","description":"CPT-0979T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of skin_ subcutaneous tissue and/or mucous membrane (including simple closure)_ unless otherwise listed; single lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11100","description":"Biopsy of skin_ subcutaneous tissue and/or mucous membrane (including simple closure)_ unless otherwise listed; single lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01474","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01474","description":"CPT-01474","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy trifocal 4.0/.12-","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2303","description":"Lens sphcy trifocal 4.0/.12-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Norsn no foot exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9225","description":"Norsn no foot exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Presc opiates >6 wks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9561","description":"Presc opiates >6 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLC0","description":"ICD-JBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDA0","description":"ICD-AHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9024","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","description":"HCPCS-J9024","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELE0","description":"ICD-EELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSC1","description":"ICD-GBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVE1","description":"ICD-NBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chorionic gonadotropin assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84703","description":"Chorionic gonadotropin assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALE0","description":"ICD-CALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTB0","description":"ICD-CFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVD0","description":"ICD-GAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYA0","description":"ICD-GCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAB1","description":"ICD-KAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTE1","description":"ICD-ACTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1441","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","description":"HCPCS-M1441","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lvef assess planpost dschrge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3019F","description":"Lvef assess planpost dschrge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEC1","description":"ICD-MLEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orthodontic rem appliance tx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8210","description":"Orthodontic rem appliance tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22630","description":"Lumbar spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pvb thoracic single inj site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64461","description":"Pvb thoracic single inj site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Services performed by a occupational therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program_ each 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2169","description":"Services performed by a occupational therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program_ each 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYD1","description":"ICD-ODYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVC1","description":"ICD-OCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOA1","description":"ICD-KDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBD1","description":"ICD-OIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vertical shock reducing pylo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5988","description":"Vertical shock reducing pylo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cygnus Matrix_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4199","description":"Cygnus Matrix_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMF1","description":"ICD-OAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMF1","description":"ICD-MJMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHB0","description":"ICD-ODHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAA1","description":"ICD-OHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCE0","description":"ICD-CHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTC1","description":"ICD-KDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dist revas ligation hemo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36838","description":"Dist revas ligation hemo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQA0","description":"ICD-KHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anastrozole 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0170","description":"Anastrozole 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGC1","description":"ICD-GEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHB0","description":"ICD-FFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDE1","description":"ICD-BEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0629U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","description":"CPT-0629U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ initial artery_ open or pe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7532","description":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ initial artery_ open or pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIB0","description":"ICD-JDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSC1","description":"ICD-OCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHID1","description":"ICD-CHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insrt pulse gen w/mult leads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33231","description":"Insrt pulse gen w/mult leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28E","description":"Special Care High _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sig w/tndsc balloon dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45340","description":"Sig w/tndsc balloon dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLF1","description":"ICD-ICLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ stranded_ p-103","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2640","description":"Brachytx_ stranded_ p-103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Corneal trnspl endothelial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65756","description":"Corneal trnspl endothelial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQB0","description":"ICD-PEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRA1","description":"ICD-OCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHA1","description":"ICD-KDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient not screened for tobacco use_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9905","description":"Patient not screened for tobacco use_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCC1","description":"ICD-CBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gad-base mr contrast nos_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9579","description":"Gad-base mr contrast nos_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJE0","description":"ICD-KDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVD1","description":"ICD-KBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPB0","description":"ICD-CGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPA1","description":"ICD-JIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apomorphine hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0364","description":"Apomorphine hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRC1","description":"ICD-LDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spu Or Asc Patient Transferred To The Hospital Or Discharged From The Sp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0594","description":"Spu Or Asc Patient Transferred To The Hospital Or Discharged From The Sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB221","description":"Clinically Complex _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_ copy number variants_ microsatellite","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81459","description":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_ copy number variants_ microsatellite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Relieve pressure on nerve(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64722","description":"Relieve pressure on nerve(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68135","description":"Remove eyelid lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE11B","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEF0","description":"ICD-FIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Microbe susceptible mic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87186","description":"Microbe susceptible mic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE246","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQC1","description":"ICD-HAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACB1","description":"ICD-AACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq lamot/lam lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0275T","description":"Perq lamot/lam lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAB0","description":"ICD-FFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXB1","description":"ICD-GDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCC1","description":"ICD-EGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIF0","description":"ICD-OJIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; stable isotope dilution_ single analyte_ quantitative_ single st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82543","description":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; stable isotope dilution_ single analyte_ quantitative_ single st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGD1","description":"ICD-JFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUE0","description":"ICD-GAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC50","description":"High Rehab _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI joint upr extrem w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73222","description":"MRI joint upr extrem w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYA1","description":"ICD-DFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cryoprecipitatereducedplasma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9044","description":"Cryoprecipitatereducedplasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ casimersen_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1426","description":"Injection_ casimersen_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYF1","description":"ICD-LHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATF0","description":"ICD-NATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAF0","description":"ICD-CDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cntct lens hydrophil bifocl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2522","description":"Cntct lens hydrophil bifocl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1303","description":"Hospice services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Youth size pull-on","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4534","description":"Youth size pull-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDC0","description":"ICD-EEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lung perfusion differential","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78597","description":"Lung perfusion differential","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLA1","description":"ICD-NDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair ortho appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8691","description":"Repair ortho appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth vaginal hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94451","description":"Anesth vaginal hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAA0","description":"ICD-NGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEC0","description":"ICD-NCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1502","description":"HCPCS-B1502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ spine; scoliosis study_ including supine and erect studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72090","description":"Radiologic examination_ spine; scoliosis study_ including supine and erect studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLA0","description":"ICD-GFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUA0","description":"ICD-KAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBE0","description":"ICD-OBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA15D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBA0","description":"ICD-AEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC12","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGE1","description":"ICD-CBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFID1","description":"ICD-MFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPB1","description":"ICD-FHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVC1","description":"ICD-KAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esoph balloon distension tst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91040","description":"Esoph balloon distension tst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair mouth laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40831","description":"Repair mouth laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAC1","description":"ICD-OCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTB1","description":"ICD-OLTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSB1","description":"ICD-CGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Visual field assmnt rev/rprt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0378T","description":"Visual field assmnt rev/rprt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration Not Followed By Surgical Repair_ Artery; Upper Extremity (Eg_ Axillary_ Brachial_ Radial_ Ulnar)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35702","description":"Exploration Not Followed By Surgical Repair_ Artery; Upper Extremity (Eg_ Axillary_ Brachial_ Radial_ Ulnar)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ippb all types","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0500","description":"Ippb all types","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stress mgmt class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9454","description":"Stress mgmt class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim-jmdb_ biosimilar_ (Fulphila)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5108","description":"Injection_ pegfilgrastim-jmdb_ biosimilar_ (Fulphila)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKC1","description":"ICD-GDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOF1","description":"ICD-KFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBA1","description":"ICD-OHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEC1","description":"ICD-MGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEF0","description":"ICD-ABEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7518","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCE0","description":"ICD-MBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL52","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst w/urinary repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58267","description":"Vag hyst w/urinary repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic exenteration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45126","description":"Pelvic exenteration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALF0","description":"ICD-KALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no 7d f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9406","description":"Doc reas no 7d f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cabotegravir and rilpivirine_ 2mg/3mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9077","description":"Injection_ cabotegravir and rilpivirine_ 2mg/3mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc cln cncr stage 3 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3388F","description":"Ajcc cln cncr stage 3 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of eye thickness","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76514","description":"Echo exam of eye thickness","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCB0","description":"ICD-BBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLB1","description":"ICD-ICLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCD1","description":"ICD-OLCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ DNA (523 genes) and RNA (55 genes) by next-generation sequencing_ interrogation for sequence variants_ gene cop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0379U","description":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ DNA (523 genes) and RNA (55 genes) by next-generation sequencing_ interrogation for sequence variants_ gene cop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ptnot rcvng anti-rhm thxpyra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4196F","description":"Ptnot rcvng anti-rhm thxpyra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKF0","description":"ICD-JGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening propoxyphene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80367","description":"Drug screening propoxyphene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOA1","description":"ICD-CIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHD1","description":"ICD-FGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJA0","description":"ICD-GCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychosocial rehabilitation services_ per 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2017","description":"Psychosocial rehabilitation services_ per 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"vaccine administration-human papillomavirus - Dose 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1783","description":"vaccine administration-human papillomavirus - Dose 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87478","description":"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33405","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIB0","description":"ICD-MGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRD1","description":"ICD-PFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKF0","description":"ICD-FHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBA1","description":"ICD-JBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1803","description":"HCPCS-B1803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of knee ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27407","description":"Repair of knee ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B2004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2004","description":"HCPCS-B2004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD151","description":"Clinically Complex _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQE0","description":"ICD-OBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQE0","description":"ICD-KBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52300","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA15C","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDE1","description":"ICD-NIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAC0","description":"ICD-NAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDC1","description":"ICD-FGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Molded inner boot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2280","description":"Molded inner boot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair spinal fluid leakage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63709","description":"Repair spinal fluid leakage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open thrombect av fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36831","description":"Open thrombect av fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQB1","description":"ICD-KAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGD0","description":"ICD-OLGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Appl desensitizing resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9911","description":"Appl desensitizing resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth perineal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90476","description":"Anesth perineal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICE0","description":"ICD-AICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64864","description":"Repair of facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sterile saline or water","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4218","description":"Sterile saline or water","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECF0","description":"ICD-CECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVC0","description":"ICD-CHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNE1","description":"ICD-GFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDA1","description":"ICD-KFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAA1","description":"ICD-KAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ irinotecan liposome_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9205","description":"Injection_ irinotecan liposome_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pms2 gene dup/delet variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81319","description":"Pms2 gene dup/delet variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTD1","description":"ICD-NFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKA1","description":"ICD-KDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDC0","description":"ICD-NBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00148","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00148","description":"CPT-00148","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXC0","description":"ICD-BFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGF1","description":"ICD-NLGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Water seal drain container","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7041","description":"Water seal drain container","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJB1","description":"ICD-OEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDC0","description":"ICD-FHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foam drg <=16 sq in w/border","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6212","description":"Foam drg <=16 sq in w/border","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no lipid profile","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8726","description":"Doc reas no lipid profile","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iodine i-123 iobenguane","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9582","description":"Iodine i-123 iobenguane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFB1","description":"ICD-CAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Corticoster sparng thrpy rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4142F","description":"Corticoster sparng thrpy rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Womans shoe oxford brace","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3224","description":"Womans shoe oxford brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove thyroid duct lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60281","description":"Remove thyroid duct lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKE0","description":"ICD-JDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ clindamycin phosphate_ 300 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0736","description":"Injection_ clindamycin phosphate_ 300 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBF1","description":"ICD-IFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXA0","description":"ICD-KGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRB0","description":"ICD-HGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0803","description":"HCPCS-B0803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cst bse mtl inlay >= 3 surfa","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6605","description":"Cst bse mtl inlay >= 3 surfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1387","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","description":"HCPCS-M1387","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj metaraminol bitartrate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0380","description":"Inj metaraminol bitartrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam ribs uni 2 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71100","description":"X-ray exam ribs uni 2 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBA1","description":"ICD-NDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMC0","description":"ICD-IHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBE1","description":"ICD-JBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHD1","description":"ICD-KHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31235","description":"Nasal/sinus endoscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA25B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMC0","description":"ICD-FBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCB1","description":"ICD-BBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA45","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPC0","description":"ICD-GFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES105","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35190","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Seat lift for pt furn-electr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0628","description":"Seat lift for pt furn-electr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair sternum/nuss w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21743","description":"Repair sternum/nuss w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ prothrombin complex concentrate (human)_ balfaxar_ per i.u. of factor ix activity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9159","description":"Injection_ prothrombin complex concentrate (human)_ balfaxar_ per i.u. of factor ix activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLA1","description":"ICD-MLLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWC0","description":"ICD-LBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Harness chest/shlder saddle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6672","description":"Harness chest/shlder saddle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRF0","description":"ICD-KGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGB1","description":"ICD-FBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAF0","description":"ICD-MAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD13C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYA0","description":"ICD-DBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKE1","description":"ICD-BDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC4B","description":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0526T","description":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGC1","description":"ICD-KFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thyroid met imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78015","description":"Thyroid met imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCD1","description":"ICD-MDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUF0","description":"ICD-JAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXE1","description":"ICD-OCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEB1","description":"ICD-OAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTF0","description":"ICD-IGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUE0","description":"ICD-KIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXA1","description":"ICD-FDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFF1","description":"ICD-OCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFF1","description":"ICD-CFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Misc/exper non-prescript dru","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9150","description":"Misc/exper non-prescript dru","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Take-Home Supply Of Buprenorphine (Oral); Up To 7 Additional Day Supply (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Additio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2079","description":"Take-Home Supply Of Buprenorphine (Oral); Up To 7 Additional Day Supply (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Additio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo partial colectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44204","description":"Laparo partial colectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Drug-Delivery Device(S)_ Deep (Eg_ Subfascial) (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20701","description":"Removal Of Drug-Delivery Device(S)_ Deep (Eg_ Subfascial) (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHE1","description":"ICD-KDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45300","description":"Proctosigmoidoscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHB0","description":"ICD-MFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGID1","description":"ICD-GGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDF0","description":"ICD-MGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Arch supp att to shoe metata","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3080","description":"Arch supp att to shoe metata","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNC1","description":"ICD-NLNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDB0","description":"ICD-EIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of sutures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0630","description":"Removal of sutures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUD1","description":"ICD-CHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4335","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","description":"HCPCS-Q4335","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc breast risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0008M","description":"Onc breast risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fungi identification yeast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87106","description":"Fungi identification yeast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMB0","description":"ICD-GCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Supported housing_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0044","description":"Supported housing_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLC1","description":"ICD-JCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDE1","description":"ICD-ADDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Portable peak flow meter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8096","description":"Portable peak flow meter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of metanephrines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83835","description":"Assay of metanephrines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHB1","description":"ICD-FIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC17","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat slipped epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27175","description":"Treat slipped epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUD1","description":"ICD-KFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTB1","description":"ICD-ICTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Generator_ neurostimulator (implantable)_ includes closed feedback loop leads and all implantable components_ with rechargeable battery and charging system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1826","description":"Generator_ neurostimulator (implantable)_ includes closed feedback loop leads and all implantable components_ with rechargeable battery and charging system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDF0","description":"ICD-CCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dexrazoxane hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1190","description":"Dexrazoxane hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of colon/ileostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44151","description":"Removal of colon/ileostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMA0","description":"ICD-KBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Evicore_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1001","description":"Clinical Decision Support Mechanism Evicore_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical opening of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42955","description":"Surgical opening of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAA1","description":"ICD-NHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eyeglasses delux frames","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2025","description":"Eyeglasses delux frames","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nursing fac care subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99307","description":"Nursing fac care subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBA0","description":"ICD-NDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATE1","description":"ICD-OATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch clsd for bar w lk fl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4420","description":"Ost pch clsd for bar w lk fl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDC1","description":"ICD-EFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antidepressant not specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80338","description":"Antidepressant not specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFE0","description":"ICD-CFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEF1","description":"ICD-FAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKD0","description":"ICD-BEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic ring fx treat int fix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0414","description":"Pelvic ring fx treat int fix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1379","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","description":"HCPCS-M1379","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endo cholangiopancreatograph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43262","description":"Endo cholangiopancreatograph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0166","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","description":"HCPCS-J0166","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHD1","description":"ICD-CGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace socket above knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5701","description":"Replace socket above knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFA0","description":"ICD-JFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII_ antihemophilic factor (recombinant)_ (Esperoct)_ glycopegylated-exei_ per IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7204","description":"Injection_ Factor VIII_ antihemophilic factor (recombinant)_ (Esperoct)_ glycopegylated-exei_ per IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth head vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21651","description":"Anesth head vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5143","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","description":"HCPCS-Q5143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIC1","description":"ICD-JBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"(Zerbaxa) Injection_ Ceftolozane 50mg And Tazobactam 25 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9452","description":"(Zerbaxa) Injection_ Ceftolozane 50mg And Tazobactam 25 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE241","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0121A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFC0","description":"ICD-CAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ear cartilage graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21235","description":"Ear cartilage graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB204","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Temple bne implnt w/stimulat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69715","description":"Temple bne implnt w/stimulat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Test Appropriate_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1006","description":"Clinical Decision Support Mechanism Test Appropriate_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection(S)_ Anesthetic Agent(S) And/Or Steroid; Nerves Innervating The Sacroiliac Joint_ With Image Guidance (Ie_ Fluoroscopy Or Computed Tomography)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64451","description":"Injection(S)_ Anesthetic Agent(S) And/Or Steroid; Nerves Innervating The Sacroiliac Joint_ With Image Guidance (Ie_ Fluoroscopy Or Computed Tomography)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB15C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMF0","description":"ICD-MIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoe dennis browne splint bo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3640","description":"Shoe dennis browne splint bo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHND0","description":"ICD-NHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUF1","description":"ICD-FGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay acid phosphatase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84060","description":"Assay acid phosphatase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HEPATITIS B SURFACE AG NEUTRALIZATION","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87341","description":"IAAD IA HEPATITIS B SURFACE AG NEUTRALIZATION","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Bladder Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1074","description":"Radiation Therapy For Bladder Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inject sinus tract for x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20501","description":"Inject sinus tract for x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDE0","description":"ICD-KGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pulse gen sys tx endolymp fl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2120","description":"Pulse gen sys tx endolymp fl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRA1","description":"ICD-CIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVC0","description":"ICD-BBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair muscles of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26591","description":"Repair muscles of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUA0","description":"ICD-JCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESE1","description":"ICD-DESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hpv types 16 & 18 only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87625","description":"Hpv types 16 & 18 only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMB0","description":"ICD-KEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIED1","description":"ICD-CIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of neck vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37565","description":"Ligation of neck vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLD1","description":"ICD-BFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRF1","description":"ICD-KGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Afo doub solid stirrup calf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1990","description":"Afo doub solid stirrup calf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEF1","description":"ICD-OLEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQF1","description":"ICD-HHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ thigh length_ 30-40 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6557","description":"Gradient compression stocking_ thigh length_ 30-40 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biliary duct stone extraction_ percutaneous via t-tube tract_ basket_ o snare (eg_ burhenne technique)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47630","description":"Biliary duct stone extraction_ percutaneous via t-tube tract_ basket_ o snare (eg_ burhenne technique)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADE0","description":"ICD-BADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMB1","description":"ICD-MJMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Proposed Adopting Best Practices And Promoting Patient Safety Within Emergency Medicine Mips Value Pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0057","description":"Proposed Adopting Best Practices And Promoting Patient Safety Within Emergency Medicine Mips Value Pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rubeola antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86765","description":"Rubeola antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dispens fee immunosupressive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0510","description":"Dispens fee immunosupressive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEE0","description":"ICD-KAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Meg evoked single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95966","description":"Meg evoked single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45309","description":"Proctosigmoidoscopy removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAF0","description":"ICD-GAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVC0","description":"ICD-BAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thigh/wght bear lacer molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2540","description":"Thigh/wght bear lacer molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tiss ex molecul study add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88388","description":"Tiss ex molecul study add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDED1","description":"ICD-MDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not providing brief counseling if identified as an unhealthy alcohol user (e.g._ limited life expectancy_ other medical reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2203","description":"Documentation of medical reason(s) for not providing brief counseling if identified as an unhealthy alcohol user (e.g._ limited life expectancy_ other medical reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLE1","description":"ICD-CFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLB1","description":"ICD-EDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVE1","description":"ICD-OFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBF0","description":"ICD-OEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1703","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1703","description":"CDT-D1703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPB0","description":"ICD-OIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRC0","description":"ICD-HHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUB0","description":"ICD-EGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise knuckle with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26531","description":"Revise knuckle with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01772","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01772","description":"CPT-01772","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA56","description":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compre dental tx adult","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8090","description":"Compre dental tx adult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal duct glbldr calculi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47544","description":"Removal duct glbldr calculi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKE0","description":"ICD-JAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC20A","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ivf canc a stim case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4017","description":"Ivf canc a stim case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neg press wnd tx 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6023","description":"Collagen dressing >48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair dura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61618","description":"Repair dura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAA0","description":"ICD-KEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYF0","description":"ICD-OAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD155","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aprepitant_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9463","description":"Injection_ aprepitant_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73030","description":"X-ray exam of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAD1","description":"ICD-GFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJD0","description":"ICD-CBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE20C","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAC1","description":"ICD-NHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endometrial sampling or hysteroscopy with biopsy and results documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9823","description":"Endometrial sampling or hysteroscopy with biopsy and results documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIA0","description":"ICD-KBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDE0","description":"ICD-FGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Max MRI image capture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0385","description":"Max MRI image capture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVF1","description":"ICD-FCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDB1","description":"ICD-OIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA5B","description":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0647U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0647U","description":"CPT-0647U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv eccrine glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64653","description":"Chemodenerv eccrine glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87389","description":"IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDD0","description":"ICD-MKDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI joint upr extrem w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73221","description":"MRI joint upr extrem w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cromolyn sodium comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7632","description":"Cromolyn sodium comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERE0","description":"ICD-CERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESF1","description":"ICD-GESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of thyroglobulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84432","description":"Assay of thyroglobulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLB0","description":"ICD-KDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXD0","description":"ICD-GHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFA0","description":"ICD-BDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNB0","description":"ICD-BGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Refract not +/- 1.0 w/in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9520","description":"Refract not +/- 1.0 w/in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLB1","description":"ICD-NCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYA1","description":"ICD-KGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis training complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90989","description":"Dialysis training complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous vertebroplasties (bone biopsies included when performed)_ first lumbosacral and any additional cervicothoracic or lumbosacral vertebral bodies_ unilateral or bila","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7505","description":"Percutaneous vertebroplasties (bone biopsies included when performed)_ first lumbosacral and any additional cervicothoracic or lumbosacral vertebral bodies_ unilateral or bila","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSF0","description":"ICD-OFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFF0","description":"ICD-CIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWE0","description":"ICD-HIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIME0","description":"ICD-BIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove spinal cord lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63600","description":"Remove spinal cord lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBF1","description":"ICD-MLBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTF0","description":"ICD-ICTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC1A","description":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise parotid gland/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42425","description":"Excise parotid gland/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPA0","description":"ICD-OJPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDF1","description":"ICD-GBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Additional supplies_ materials_ and clinical staff time over and above those usually included in an office visit or other non-facility service(s)_ when performed during a PHE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99072","description":"Additional supplies_ materials_ and clinical staff time over and above those usually included in an office visit or other non-facility service(s)_ when performed during a PHE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospital observation per hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0378","description":"Hospital observation per hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRB1","description":"ICD-DBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBA0","description":"ICD-NEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLB1","description":"ICD-CCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYC1","description":"ICD-CAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPD1","description":"ICD-GDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBD1","description":"ICD-GHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Approp ace/arb tstng done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4188F","description":"Approp ace/arb tstng done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMF0","description":"ICD-FIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLA1","description":"ICD-ECLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABA1","description":"ICD-AABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAD1","description":"ICD-NFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-61715","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","description":"CPT-61715","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAC0","description":"ICD-CGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGE0","description":"ICD-JFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fmr1 gene detection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81243","description":"Fmr1 gene detection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIE0","description":"ICD-MIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPA0","description":"ICD-NIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cftr gene dup/delet variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81222","description":"Cftr gene dup/delet variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18X","description":"Clinically Complex _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-H0053","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","description":"HCPCS-H0053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54015","description":"Drain penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQF0","description":"ICD-HDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBB0","description":"ICD-IFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEC1","description":"ICD-MEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITA0","description":"ICD-FITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Histotripsy (Ie_ Non-Thermal Ablation Via Acoustic Energy Delivery) Of Malignant Hepatocellular Tissue_ Including Image Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0686T","description":"Histotripsy (Ie_ Non-Thermal Ablation Via Acoustic Energy Delivery) Of Malignant Hepatocellular Tissue_ Including Image Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDD1","description":"ICD-KEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWC1","description":"ICD-DGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUC1","description":"ICD-MKUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTE0","description":"ICD-NJTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31087","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLA0","description":"ICD-BBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQB0","description":"ICD-CBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHC1","description":"ICD-ABHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTD0","description":"ICD-EHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVD0","description":"ICD-CAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Visual evoked potential (VEP) checkerboard or flash testing_ central nervous system except glaucoma_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95930","description":"Visual evoked potential (VEP) checkerboard or flash testing_ central nervous system except glaucoma_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome banding study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88283","description":"Chromosome banding study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneumo imm status assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1022F","description":"Pneumo imm status assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOB0","description":"ICD-DGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93619","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC226","description":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCB1","description":"ICD-KFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Preop asses 4 cataract surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3325F","description":"Preop asses 4 cataract surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iiv no prsv increased ag im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90662","description":"Iiv no prsv increased ag im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orbit surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67599","description":"Orbit surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJA0","description":"ICD-BFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBC0","description":"ICD-OKBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAD0","description":"ICD-MIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLA0","description":"ICD-CFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8E","description":"Medium Rehab _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSB1","description":"ICD-CHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOF1","description":"ICD-ODOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tremelimumab-actl_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9347","description":"Injection_ tremelimumab-actl_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBE0","description":"ICD-NLBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAE1","description":"ICD-FHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAD1","description":"ICD-NGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDC0","description":"ICD-MHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAC1","description":"ICD-ICAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRE1","description":"ICD-OIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICF1","description":"ICD-BICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Screen c/v thin layer by md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0124","description":"Screen c/v thin layer by md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPF1","description":"ICD-KBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2040","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","description":"HCPCS-A2040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of skull/sutures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61559","description":"Excision of skull/sutures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBF0","description":"ICD-IEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epieffect_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4278","description":"Epieffect_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWE1","description":"ICD-ODWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHD0","description":"ICD-OGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (pemrydi rtu)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9324","description":"Injection_ pemetrexed (pemrydi rtu)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCB0","description":"ICD-BDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc death after cas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9256","description":"Doc death after cas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERD0","description":"ICD-OERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRE0","description":"ICD-DDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFC0","description":"ICD-GAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYD1","description":"ICD-PEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSA1","description":"ICD-CHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADC0","description":"ICD-KADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKB1","description":"ICD-KFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYC0","description":"ICD-DFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC14","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDB1","description":"ICD-NJDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALC1","description":"ICD-GALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUA1","description":"ICD-EGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlso flex trnk sj-ss pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0456","description":"Tlso flex trnk sj-ss pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENF0","description":"ICD-FENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKE0","description":"ICD-GAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAE1","description":"ICD-GBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inpatient consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99255","description":"Inpatient consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Collagen crosslinking cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0402T","description":"Collagen crosslinking cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology tx decision-mgmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9051","description":"Oncology tx decision-mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC40","description":"Ultra High Rehab _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01212","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01212","description":"CPT-01212","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERA1","description":"ICD-HERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKD1","description":"ICD-NFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic belt/harness/boot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0944","description":"Pelvic belt/harness/boot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00790","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00790","description":"CPT-00790","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75820","description":"Vein x-ray arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPA0","description":"ICD-BEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOC0","description":"ICD-HFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thera par drugs 2 or > admin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9612","description":"Thera par drugs 2 or > admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYC0","description":"ICD-OLYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No knee/ankle joints w/ ft b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5210","description":"No knee/ankle joints w/ ft b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ vancomycin hcl (xellia) not therapeutically equivalent to j3370_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3372","description":"Injection_ vancomycin hcl (xellia) not therapeutically equivalent to j3370_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Large disposable underpad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4541","description":"Large disposable underpad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise lip or cheek fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40819","description":"Excise lip or cheek fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXF1","description":"ICD-GCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAB0","description":"ICD-NKAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bladder defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51940","description":"Correction of bladder defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone cutting ramus closed","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7941","description":"Bone cutting ramus closed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIE1","description":"ICD-MKIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQE1","description":"ICD-LFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hhcp-svs of csw_ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0155","description":"Hhcp-svs of csw_ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablate atria x10sv add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33258","description":"Ablate atria x10sv add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLA1","description":"ICD-ACLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompressive craniotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61322","description":"Decompressive craniotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIB1","description":"ICD-NCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hiv tstng asked/docd/revwd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3292F","description":"Hiv tstng asked/docd/revwd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove wrist/forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25115","description":"Remove wrist/forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRA0","description":"ICD-DHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBD1","description":"ICD-NGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES355","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aneurysm press sensor add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34806","description":"Aneurysm press sensor add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted misc prosthetic ser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8499","description":"Unlisted misc prosthetic ser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICD0","description":"ICD-NICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKA0","description":"ICD-JIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plasma volume single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78110","description":"Plasma volume single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intranasal reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30620","description":"Intranasal reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBE1","description":"ICD-BGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOC1","description":"ICD-GFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 120 or more drugs and metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ includes specimen validity and a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0328U","description":"Drug assay_ definitive_ 120 or more drugs and metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ includes specimen validity and a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Analyze spine infus pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62367","description":"Analyze spine infus pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABB0","description":"ICD-FABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJB0","description":"ICD-FFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording and disconnection per patient encounter_ implantable aortic counte","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0463T","description":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording and disconnection per patient encounter_ implantable aortic counte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPE1","description":"ICD-CAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc med rsn no stat tx/presc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9667","description":"Doc med rsn no stat tx/presc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24925","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILD1","description":"ICD-KILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLF1","description":"ICD-KCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEF1","description":"ICD-JBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infiltration of sustained release therapeutic drug - single or multiple sites","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9613","description":"Infiltration of sustained release therapeutic drug - single or multiple sites","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytogen m array copy no&snp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81229","description":"Cytogen m array copy no&snp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLC0","description":"ICD-NFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mastoid surgery revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69604","description":"Mastoid surgery revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiesse injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2026","description":"Radiesse injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sho","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA06","description":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64567","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","description":"CPT-64567","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44384","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKE0","description":"ICD-OAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC0C","description":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICF1","description":"ICD-GICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Specimen site not prostate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8798","description":"Specimen site not prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor_ including system activation and patient training","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0446T","description":"Creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor_ including system activation and patient training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB134","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert subq exten to ip cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49435","description":"Insert subq exten to ip cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGD1","description":"ICD-CCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAE1","description":"ICD-EDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEME0","description":"ICD-OEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC20","description":"Ultra High Rehab _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAD0","description":"ICD-NIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHF1","description":"ICD-FDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBF1","description":"ICD-NCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fecal microbiota_ live - jslm_ 1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1440","description":"Fecal microbiota_ live - jslm_ 1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCF0","description":"ICD-GHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93592","description":"Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGC1","description":"ICD-JEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHD0","description":"ICD-CEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0015","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB23B","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRB1","description":"ICD-KHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAE0","description":"ICD-ICAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDC1","description":"ICD-OLDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQF1","description":"ICD-LCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIE1","description":"ICD-IBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of lymph channels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38308","description":"Incision of lymph channels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 11 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP11","description":"Auto.test pane pricing code_ 11 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHE1","description":"ICD-FHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITA1","description":"ICD-NITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Irinotecan injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9206","description":"Irinotecan injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMC0","description":"ICD-BIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No hist cd4+ cell count <350","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3493F","description":"No hist cd4+ cell count <350","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemotherapy intracavitary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96440","description":"Chemotherapy intracavitary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYA0","description":"ICD-HFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBE1","description":"ICD-BDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bmi is documented above normal parameters and a follow-up plan is documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1293","description":"Bmi is documented above normal parameters and a follow-up plan is documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUB0","description":"ICD-EHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIC1","description":"ICD-CBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth special head surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21851","description":"Anesth special head surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng arm splnt ped p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4019","description":"Cast sup lng arm splnt ped p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise spin&cord 2 stgs thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63199","description":"Incise spin&cord 2 stgs thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXB1","description":"ICD-KAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVC0","description":"ICD-KCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Calcitonin salmon injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0630","description":"Calcitonin salmon injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIE0","description":"ICD-GBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCE0","description":"ICD-CBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ amisulpride_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0184","description":"Injection_ amisulpride_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Access av dial grft for proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36148","description":"Access av dial grft for proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brief communication technology-based service_ e.g. virtual check-in_ by a qualified health care professional who cannot report evaluation and management services_ provided to","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2251","description":"Brief communication technology-based service_ e.g. virtual check-in_ by a qualified health care professional who cannot report evaluation and management services_ provided to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHA0","description":"ICD-KAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJF0","description":"ICD-GGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy with biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44389","description":"Colonoscopy with biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABE0","description":"ICD-BABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJE0","description":"ICD-NJJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUD1","description":"ICD-GIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace molded calf lacer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4050","description":"Replace molded calf lacer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy ureterolithotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50945","description":"Laparoscopy ureterolithotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJB0","description":"ICD-OGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC43","description":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA5C","description":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elective surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9643","description":"Elective surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD217","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHC1","description":"ICD-ICHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDD1","description":"ICD-MKDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plmt access bil tree sm bwl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47541","description":"Plmt access bil tree sm bwl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Simult panc kidn trans","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2065","description":"Simult panc kidn trans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gene test myo musclr dyst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3853","description":"Gene test myo musclr dyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Charger and base station for intraurethral activation device_ replacement only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1012","description":"Charger and base station for intraurethral activation device_ replacement only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Phys blood bank serv xmatch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86077","description":"Phys blood bank serv xmatch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay for infectious agent antibody(ies)_ qualitative or semi-quantitative_ single step method (eg. reagent strip); severe acute respiratory system coronavirus 2 (SARS C","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86328","description":"Immunoassay for infectious agent antibody(ies)_ qualitative or semi-quantitative_ single step method (eg. reagent strip); severe acute respiratory system coronavirus 2 (SARS C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Conformity evaluation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5020","description":"Conformity evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHB0","description":"ICD-KCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAD1","description":"ICD-GEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of vein clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34471","description":"Removal of vein clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEE1","description":"ICD-NKEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITF1","description":"ICD-KITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUC1","description":"ICD-KBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy treat blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31641","description":"Bronchoscopy treat blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQE0","description":"ICD-GFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIA0","description":"ICD-KDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAE0","description":"ICD-NJAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVC1","description":"ICD-OGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJC0","description":"ICD-CHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB125","description":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tmj reconstruction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7858","description":"Tmj reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBF1","description":"ICD-IGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9736","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBA1","description":"ICD-CHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC104","description":"Special Care High _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance for analysis of tissue composition (eg_ fat_ iron_ water content)_ including multiparametric data acquisition_ data preparation and transmissio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0648T","description":"Quantitative magnetic resonance for analysis of tissue composition (eg_ fat_ iron_ water content)_ including multiparametric data acquisition_ data preparation and transmissio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUA1","description":"ICD-MCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAF1","description":"ICD-EIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUD1","description":"ICD-CCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBD1","description":"ICD-BHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fev<60% pred & copd sym","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8924","description":"Fev<60% pred & copd sym","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMB1","description":"ICD-KGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA206","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0715","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0715","description":"HCPCS-E0715","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA120","description":"Clinically Complex _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy with biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31576","description":"Laryngoscopy with biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDD0","description":"ICD-EFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDD0","description":"ICD-KBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ an","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX1C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAB1","description":"ICD-MDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUA1","description":"ICD-IDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen_ qualitative; single drug class method (e.g._ immunoassay_ enzyme assay)_ each drug class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0431","description":"Drug screen_ qualitative; single drug class method (e.g._ immunoassay_ enzyme assay)_ each drug class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSB1","description":"ICD-CCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0428","description":"Bls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Motor-cognitive_ semi-immersive virtual reality-facilitated gait training_ each 15 minutes (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0791T","description":"Motor-cognitive_ semi-immersive virtual reality-facilitated gait training_ each 15 minutes (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Posterior vertebral joint replacement_ including bilateral facetectomy_ laminectomy_ and radical discectomy_ including imaging guidance_ lumbar spine_ single segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0719T","description":"Posterior vertebral joint replacement_ including bilateral facetectomy_ laminectomy_ and radical discectomy_ including imaging guidance_ lumbar spine_ single segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUC0","description":"ICD-EDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELB0","description":"ICD-NELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Automated reticulocyte count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85045","description":"Automated reticulocyte count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYF0","description":"ICD-OIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEC1","description":"ICD-FDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC21C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLD1","description":"ICD-FHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWB0","description":"ICD-CDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX16","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft of bronchus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31770","description":"Repair/graft of bronchus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFC1","description":"ICD-NGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chronic Care Management Services With The Following Required Elements: Multiple (Two Or More) Chronic Conditions Expected To Last At Least 12 Months_ Or Until The Death Of The","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99439","description":"Chronic Care Management Services With The Following Required Elements: Multiple (Two Or More) Chronic Conditions Expected To Last At Least 12 Months_ Or Until The Death Of The","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSD1","description":"ICD-CDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42665","description":"Ligation of salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC12","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of rectal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46040","description":"Incision of rectal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC10A","description":"Special Care High _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Emr pwr cbl combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0493","description":"Emr pwr cbl combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIC0","description":"ICD-NKIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFD0","description":"ICD-JCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALA1","description":"ICD-KALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt support & positioning sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0636","description":"Pt support & positioning sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEC0","description":"ICD-OFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mra_ w/o&w/dye_ upper extr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8936","description":"Mra_ w/o&w/dye_ upper extr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOD1","description":"ICD-PDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D8091","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D8091","description":"CDT-D8091","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQC0","description":"ICD-PHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Normal saline solution infus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7050","description":"Normal saline solution infus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVC0","description":"ICD-JAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Supra SDRM_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2011","description":"Supra SDRM_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0788","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0788","description":"HCPCS-E0788","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPA0","description":"ICD-BFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of central venous catheter through central venous occlusion via inferior and superior approaches (e.g._ inside-out technique)_ including imaging guidance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9780","description":"Insertion of central venous catheter through central venous occlusion via inferior and superior approaches (e.g._ inside-out technique)_ including imaging guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coagulation time lee & white","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85345","description":"Coagulation time lee & white","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening cocaine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80353","description":"Drug screening cocaine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHD0","description":"ICD-FIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of urethra lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53220","description":"Treatment of urethra lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stnd hemi (low seat) whlchr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0002","description":"Stnd hemi (low seat) whlchr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL0C","description":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB14C","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of fascia for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20922","description":"Removal of fascia for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC43","description":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1808","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","description":"HCPCS-E1808","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23532","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Md inr test revie inter mgmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0250","description":"Md inr test revie inter mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decalcify tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88311","description":"Decalcify tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls repos perph cnula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33963","description":"Ecmo/ecls repos perph cnula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWA1","description":"ICD-HGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42310","description":"Drainage of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31382","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-invasive vagus nerve stimulator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0735","description":"Non-invasive vagus nerve stimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise hip/thigh nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64766","description":"Incise hip/thigh nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Symptom mgmnt plan care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0555F","description":"Symptom mgmnt plan care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB225","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCE1","description":"ICD-BBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB113","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOB1","description":"ICD-DGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVA1","description":"ICD-FBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECE1","description":"ICD-AECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX30","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Measure venous pressure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93770","description":"Measure venous pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0462","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","description":"HCPCS-J0462","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB20C","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACF1","description":"ICD-JACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVA1","description":"ICD-NHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not performing a dilated macular examination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9976","description":"Documentation of patient reason(s) for not performing a dilated macular examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove impacted ear wax uni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69209","description":"Remove impacted ear wax uni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of galactose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82760","description":"Assay of galactose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0553","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","description":"HCPCS-G0553","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":">85y scope othr rsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9661","description":">85y scope othr rsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAA0","description":"ICD-ACAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAC0","description":"ICD-KBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIF0","description":"ICD-AAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit tpn 3 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9367","description":"Hit tpn 3 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCE1","description":"ICD-FDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLC1","description":"ICD-OHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ovine_ 1000 usp units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3472","description":"Ovine_ 1000 usp units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMF1","description":"ICD-BEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of hip joint/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27036","description":"Excision of hip joint/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYA0","description":"ICD-OFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implnt_bon void filler-strip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9362","description":"Implnt_bon void filler-strip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARA0","description":"ICD-HARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp4 vhd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0880","description":"Pwc gp4 vhd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Im admin 1st/only component","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90460","description":"Im admin 1st/only component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repositioning of teeth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7290","description":"Repositioning of teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKB0","description":"ICD-JDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25442","description":"Reconstruct wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA31","description":"Very High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVB0","description":"ICD-JEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/tumr remove","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45338","description":"Sigmoidoscopy w/tumr remove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRB1","description":"ICD-LHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rigid wheeled walker adj/fix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0141","description":"Rigid wheeled walker adj/fix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLF1","description":"ICD-OLLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLD0","description":"ICD-JFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art pressure waveform analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93050","description":"Art pressure waveform analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCC1","description":"ICD-FHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB24B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUA1","description":"ICD-AEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHF1","description":"ICD-CDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elb mold sock flex hinge pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6100","description":"Elb mold sock flex hinge pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES145","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pooling blood platelets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86965","description":"Pooling blood platelets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMA0","description":"ICD-NEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove groin lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38760","description":"Remove groin lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHID1","description":"ICD-MHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSC1","description":"ICD-ODSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0616","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","description":"HCPCS-J0616","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLD1","description":"ICD-CFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlh uterus over 250 g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58572","description":"Tlh uterus over 250 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKE1","description":"ICD-CBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dxa bone density study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77085","description":"Dxa bone density study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx gastric no recurrence","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9100","description":"Onc dx gastric no recurrence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGB1","description":"ICD-NLGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFC1","description":"ICD-GEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor IX_ albumin fusion protein (recombinant)_ Idelvion_ 1 i.u.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9139","description":"Injection_ Factor IX_ albumin fusion protein (recombinant)_ Idelvion_ 1 i.u.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group II_ all other (eg_ iron_ trichrome)_ except stain for microorganisms_ sta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0757T","description":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group II_ all other (eg_ iron_ trichrome)_ except stain for microorganisms_ sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise major vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33822","description":"Revise major vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBE1","description":"ICD-NDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMB0","description":"ICD-CBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHC0","description":"ICD-NGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coombs test indirect qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86885","description":"Coombs test indirect qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUD0","description":"ICD-GCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVA0","description":"ICD-JCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWB0","description":"ICD-LFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elisa hiv-1/hiv-2 screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0433","description":"Elisa hiv-1/hiv-2 screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA205","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBE1","description":"ICD-OHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDD1","description":"ICD-NKDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reciprocating peritoneal dia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1630","description":"Reciprocating peritoneal dia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB20D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEB1","description":"ICD-EEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAE0","description":"ICD-FAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYB1","description":"ICD-OGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHF1","description":"ICD-IFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB230","description":"Reduced Physical Function _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEF1","description":"ICD-AAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB114","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCC0","description":"ICD-IFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUE1","description":"ICD-IAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit high risk/escort","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9381","description":"Hit high risk/escort","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCED0","description":"ICD-BCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUB0","description":"ICD-BFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC206","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBB0","description":"ICD-CCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Touch quant sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0106T","description":"Touch quant sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25526","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove uterus after cesarean","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59525","description":"Remove uterus after cesarean","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chronic Care Management Services With The Following Required Elements: Multiple (Two Or More) Chronic Conditions Expected To Last At Least 12 Months_ Or Until The Death Of The","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99437","description":"Chronic Care Management Services With The Following Required Elements: Multiple (Two Or More) Chronic Conditions Expected To Last At Least 12 Months_ Or Until The Death Of The","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPC0","description":"ICD-OLPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVD1","description":"ICD-OBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lymph nodes neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38700","description":"Removal of lymph nodes neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAE1","description":"ICD-IEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bilirubin direct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82248","description":"Bilirubin direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX12","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVC0","description":"ICD-NHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18F","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise tear duct opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68705","description":"Revise tear duct opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRC1","description":"ICD-CHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYF0","description":"ICD-DHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRF1","description":"ICD-DBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGE0","description":"ICD-CCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Soft tissue graft firsttooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4277","description":"Soft tissue graft firsttooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Palliative care services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1309","description":"Palliative care services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adhesive bandage_ first-aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6413","description":"Adhesive bandage_ first-aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18X","description":"Clinically Complex _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTC1","description":"ICD-ODTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inhaled corticosteroids rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4140F","description":"Inhaled corticosteroids rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKD0","description":"ICD-CCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension_ percutaneous_ including imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32994","description":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension_ percutaneous_ including imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWA1","description":"ICD-OJWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of knee 3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73562","description":"X-ray exam of knee 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Multidisciplinary care plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0580F","description":"Multidisciplinary care plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXA1","description":"ICD-CFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBB0","description":"ICD-FIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOB0","description":"ICD-PHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELB0","description":"ICD-MELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late closure of wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13160","description":"Late closure of wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA5D","description":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFB0","description":"ICD-BIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAF0","description":"ICD-KFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRF1","description":"ICD-KHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLC0","description":"ICD-OLLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Polatuzumab Vedotin-Piiq_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9309","description":"Injection_ Polatuzumab Vedotin-Piiq_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC124","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLE1","description":"ICD-GCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDF0","description":"ICD-OCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB4C","description":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0666","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","description":"HCPCS-G0666","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB20B","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tongue base vol reduction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41530","description":"Tongue base vol reduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBE0","description":"ICD-AEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJD0","description":"ICD-KHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oxaliplatin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9263","description":"Oxaliplatin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bl push transfuse 2 yr/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36440","description":"Bl push transfuse 2 yr/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Multiple family group psytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90849","description":"Multiple family group psytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Res care_ nos waiver/month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2032","description":"Res care_ nos waiver/month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYC1","description":"ICD-OAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vinorelbine tartrate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9390","description":"Vinorelbine tartrate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mandibular flange prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5934","description":"Mandibular flange prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0798T","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXF1","description":"ICD-NHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"AmnioBind_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4225","description":"AmnioBind_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD131","description":"Clinically Complex _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDD1","description":"ICD-MJDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWF1","description":"ICD-CIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVE1","description":"ICD-OKVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAC0","description":"ICD-EHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKB0","description":"ICD-KFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAB0","description":"ICD-BIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acetylcysteine non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7608","description":"Acetylcysteine non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFD1","description":"ICD-JDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter closure of the left atrial appendage with endocardial implant_ including fluoroscopy_ transseptal puncture_ catheter placement(s)_ left atrial angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33340","description":"Percutaneous transcatheter closure of the left atrial appendage with endocardial implant_ including fluoroscopy_ transseptal puncture_ catheter placement(s)_ left atrial angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKA0","description":"ICD-GFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLB1","description":"ICD-MKLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00562","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00562","description":"CPT-00562","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHF0","description":"ICD-KEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVF0","description":"ICD-CIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMF0","description":"ICD-MGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEE1","description":"ICD-OLEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE11B","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ fluids_ washings_ or brushings_ except cervical or vaginal; smears with interpretation (List separately in addition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0827T","description":"Digitization of glass microscope slides for cytopathology_ fluids_ washings_ or brushings_ except cervical or vaginal; smears with interpretation (List separately in addition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1702","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1702","description":"HCPCS-B1702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aoe comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9466","description":"Aoe comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX5C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBE1","description":"ICD-FDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMA1","description":"ICD-CIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBF1","description":"ICD-MIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect ovarian malignancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58950","description":"Resect ovarian malignancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93799","description":"Cardiovascular procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTA0","description":"ICD-AHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMF1","description":"ICD-GBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINA0","description":"ICD-CINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61514","description":"Removal of brain abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic Surgery Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4035","description":"Thoracic Surgery Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTB0","description":"ICD-NCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTB0","description":"ICD-MHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB5D","description":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUB0","description":"ICD-NGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWB1","description":"ICD-OEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystouretero w/renal strict","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52346","description":"Cystouretero w/renal strict","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37277","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","description":"CPT-37277","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Testosterone pellet 75 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0189","description":"Testosterone pellet 75 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARE1","description":"ICD-HARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMA1","description":"ICD-JHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBB0","description":"ICD-OIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove thyroid lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60200","description":"Remove thyroid lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECE0","description":"ICD-BECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIB1","description":"ICD-JFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFC1","description":"ICD-GAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOD1","description":"ICD-PHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC246","description":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tprnl Plmt Biodegradable Matrl Periprostatic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0438T","description":"Tprnl Plmt Biodegradable Matrl Periprostatic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYD1","description":"ICD-HIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTD0","description":"ICD-ODTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cerebrospinal fluid scan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78647","description":"Cerebrospinal fluid scan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFID1","description":"ICD-AFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise external ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69300","description":"Revise external ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cancer stage docd metast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3301F","description":"Cancer stage docd metast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAD1","description":"ICD-GCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sys<140 and dia<90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9273","description":"Sys<140 and dia<90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including MR guidance; first lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10011","description":"Fine needle aspiration biopsy_ including MR guidance; first lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-47384","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","description":"CPT-47384","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient Had Prior Pneumococcal Vaccine Adverse Reaction Any Time During Or Before The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2158","description":"Patient Had Prior Pneumococcal Vaccine Adverse Reaction Any Time During Or Before The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3HA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HA31","description":"ICD-3HA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 60-days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0517","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 60-days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB121","description":"Special Care High _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin sub graft face/nk/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15275","description":"Skin sub graft face/nk/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26350","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMC0","description":"ICD-AFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1807","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","description":"HCPCS-E1807","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Azithromycin dihydrate_ oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0144","description":"Azithromycin dihydrate_ oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iv inj ra drug dx study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78808","description":"Iv inj ra drug dx study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPE0","description":"ICD-KDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAB0","description":"ICD-IEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXC1","description":"ICD-OGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine lamina 1 crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63045","description":"Remove spine lamina 1 crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBC1","description":"ICD-NIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4KC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KC31","description":"ICD-4KC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFD0","description":"ICD-KDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBD1","description":"ICD-MKBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67880","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEF1","description":"ICD-KDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1403","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1403","description":"CDT-D1403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUB1","description":"ICD-MAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUF0","description":"ICD-AEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBC0","description":"ICD-NLBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No impro med time pain med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9427","description":"No impro med time pain med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKE0","description":"ICD-CFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bath conductivity meter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1550","description":"Bath conductivity meter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Isch containmt/narrow m-l so","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5649","description":"Isch containmt/narrow m-l so","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBC0","description":"ICD-OIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEE1","description":"ICD-BBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEE0","description":"ICD-IBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSE0","description":"ICD-CBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB2C","description":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGE1","description":"ICD-NIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28645","description":"Repair toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1EB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EB21","description":"ICD-1EB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient admitted to a SPU or and ASC for a procedure which could not be certified as medically necessary for that place of service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0596","description":"Patient admitted to a SPU or and ASC for a procedure which could not be certified as medically necessary for that place of service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTF0","description":"ICD-OHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRD1","description":"ICD-LCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Embolization protect syst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1884","description":"Embolization protect syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown porcelain base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6751","description":"Crown porcelain base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Larynscop w/tumr exc + scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31541","description":"Larynscop w/tumr exc + scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDD0","description":"ICD-GBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Poliovirus vaccine_ (any type(s)) (opv)_ live_ for oral use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90712","description":"Poliovirus vaccine_ (any type(s)) (opv)_ live_ for oral use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flutemetamol F18_ diagnostic_ per study dose_ up to 5 millicuries","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9982","description":"Flutemetamol F18_ diagnostic_ per study dose_ up to 5 millicuries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRC1","description":"ICD-DHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB3C","description":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient Received At Least One Td Vaccine Or One Tdap Vaccine Between Nine Years Prior To The Start Of The Measurement Period And The End Of The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2154","description":"Patient Received At Least One Td Vaccine Or One Tdap Vaccine Between Nine Years Prior To The Start Of The Measurement Period And The End Of The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTF1","description":"ICD-CHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28I","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4361","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","description":"HCPCS-Q4361","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTD1","description":"ICD-IGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDA1","description":"ICD-FGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADD1","description":"ICD-CADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen non tlc devices","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80300","description":"Drug screen non tlc devices","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal vaccine inhalation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3530","description":"Nasal vaccine inhalation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/o cont_ abd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8901","description":"Mra w/o cont_ abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemotx Adm Iv Inf Tech; Ini Inf Office/Clin Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0498","description":"Chemotx Adm Iv Inf Tech; Ini Inf Office/Clin Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHC1","description":"ICD-MDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Solid organ transpl pkg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2152","description":"Solid organ transpl pkg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intro/sheath_ fixed_non-peel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1893","description":"Intro/sheath_ fixed_non-peel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVE0","description":"ICD-JIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNF1","description":"ICD-KDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA)_ genitourinary pathogens_ identification of 20 bacterial and fungal organisms_ including identification of 20 associated antib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0416U","description":"Infectious agent detection by nucleic acid (DNA)_ genitourinary pathogens_ identification of 20 bacterial and fungal organisms_ including identification of 20 associated antib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUC0","description":"ICD-CGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHC0","description":"ICD-IDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dem severity classified mod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1491F","description":"Dem severity classified mod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cerv semi-rig adj molded chn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0150","description":"Cerv semi-rig adj molded chn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTB1","description":"ICD-FCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00740","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00740","description":"CPT-00740","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBC1","description":"ICD-MGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC15B","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daptomycin (Xellia)_ unrefrigerated_ not therapeutically equivalent to J0878 or J0873_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0872","description":"Injection_ daptomycin (Xellia)_ unrefrigerated_ not therapeutically equivalent to J0878 or J0873_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFA0","description":"ICD-NEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18X","description":"Special Care Low _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXD0","description":"ICD-FAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit antibiotic q8h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9502","description":"Hit antibiotic q8h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUD1","description":"ICD-OFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNB0","description":"ICD-JHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bx breast 1st lesion strtctc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19081","description":"Bx breast 1st lesion strtctc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq device breast ea imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19282","description":"Perq device breast ea imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXE0","description":"ICD-BIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Powered air mattress overlay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0372","description":"Powered air mattress overlay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay dipstick","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83518","description":"Immunoassay dipstick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJA1","description":"ICD-KAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60252","description":"Removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTF1","description":"ICD-BDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTF0","description":"ICD-JDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUF0","description":"ICD-GBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGD0","description":"ICD-JAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVF1","description":"ICD-FBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"AmnioCyte Plus_ per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4242","description":"AmnioCyte Plus_ per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEF0","description":"ICD-GAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDME0","description":"ICD-CDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSF1","description":"ICD-GDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cbc/diffwbc w/o platelet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0306","description":"Cbc/diffwbc w/o platelet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSB0","description":"ICD-HHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENC1","description":"ICD-BENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHF1","description":"ICD-GBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC221","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amantadine hcl oral brand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9033","description":"Amantadine hcl oral brand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL2A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL21","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ edaravone_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1301","description":"Injection_ edaravone_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Realignment of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27712","description":"Realignment of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUC0","description":"ICD-NEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKD0","description":"ICD-GHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Joint device (implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1776","description":"Joint device (implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQD0","description":"ICD-KDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBA1","description":"ICD-GBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ofatumumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9302","description":"Ofatumumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMD1","description":"ICD-AIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vasc embolize/occlude bleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37244","description":"Vasc embolize/occlude bleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nicotine patch legend","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4990","description":"Nicotine patch legend","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUC0","description":"ICD-OKUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRF1","description":"ICD-HIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA256","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKB1","description":"ICD-BAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair fixed retainers","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8694","description":"Repair fixed retainers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNA1","description":"ICD-OFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE155","description":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPF1","description":"ICD-NIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Upper gi endo not barrtts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3141F","description":"Upper gi endo not barrtts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOE1","description":"ICD-DGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"O shoe add instep extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3570","description":"O shoe add instep extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Telehealth facility fee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q3014","description":"Telehealth facility fee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96131","description":"Psychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYD0","description":"ICD-PLYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERC0","description":"ICD-KERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOC1","description":"ICD-DHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert prost urethral stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53855","description":"Insert prost urethral stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERB0","description":"ICD-LERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLA1","description":"ICD-AHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWB1","description":"ICD-LCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair esophagus and fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43312","description":"Repair esophagus and fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ toe caps_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6572","description":"Gradient compression garment_ toe caps_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive anti-EGFR monoclonal antibody therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9844","description":"Patient did not receive anti-EGFR monoclonal antibody therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBE1","description":"ICD-KEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Debridement of a periimplant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6101","description":"Debridement of a periimplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3IA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IA11","description":"ICD-3IA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC116","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1016T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","description":"CPT-1016T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDE1","description":"ICD-GIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQD1","description":"ICD-HIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75891","description":"Vein x-ray liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOA1","description":"ICD-GEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLA0","description":"ICD-NKLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISF1","description":"ICD-KISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Methotrexate sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9260","description":"Methotrexate sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21084","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYE0","description":"ICD-PJYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4364","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","description":"HCPCS-Q4364","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB5C","description":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surfactant admin thru tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94610","description":"Surfactant admin thru tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISB1","description":"ICD-DISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIA0","description":"ICD-FIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTC0","description":"ICD-FBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61315","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSA0","description":"ICD-GFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radium/radioisotope therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77799","description":"Radium/radioisotope therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay bld/serum cholesterol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82465","description":"Assay bld/serum cholesterol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFA1","description":"ICD-OHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRE1","description":"ICD-CHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEB1","description":"ICD-NDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient pressure wrap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8429","description":"Gradient pressure wrap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFF0","description":"ICD-NBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQF1","description":"ICD-CFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antibody detection nos if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87299","description":"Antibody detection nos if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE112","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHC0","description":"ICD-OCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHA0","description":"ICD-BBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Impl/redo electrd antrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43881","description":"Impl/redo electrd antrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBED1","description":"ICD-BBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed var ht w/o rail w/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0293","description":"Hosp bed var ht w/o rail w/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trh stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80438","description":"Trh stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA32","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGID0","description":"ICD-MGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remov/replc penis pros comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54411","description":"Remov/replc penis pros comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB23C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKC0","description":"ICD-NIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHF1","description":"ICD-EGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Opioids & opiate analogs 3/4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80363","description":"Opioids & opiate analogs 3/4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp2 xhd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0840","description":"Pwc gp2 xhd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB35","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUD1","description":"ICD-IBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMA1","description":"ICD-JEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETA1","description":"ICD-JETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ftl cgen abnor four anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81511","description":"Ftl cgen abnor four anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJB1","description":"ICD-NFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWC1","description":"ICD-GCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX35","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWF1","description":"ICD-OAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17264","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0931T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","description":"CPT-0931T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHA0","description":"ICD-NJHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDD0","description":"ICD-OIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEB0","description":"ICD-FDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cl mult vsd w/rem pul band","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33677","description":"Cl mult vsd w/rem pul band","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1001","description":"HCPCS-A1001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCF0","description":"ICD-OKCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Current percep threshold tst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0255","description":"Current percep threshold tst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of hemosiderin qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83070","description":"Assay of hemosiderin qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D7252","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D7252","description":"CDT-D7252","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSB0","description":"ICD-PLSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0947T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","description":"CPT-0947T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr f/e/e/n/l/m 5.1-7.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12014","description":"Rpr f/e/e/n/l/m 5.1-7.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reason for not administering trastuzumab documented (e.g._ patient declined_ patient died_ patient transferred_ contraindication or other clinical exclusion_ neoadjuvant chemo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9836","description":"Reason for not administering trastuzumab documented (e.g._ patient declined_ patient died_ patient transferred_ contraindication or other clinical exclusion_ neoadjuvant chemo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETC0","description":"ICD-KETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Microbe susceptible mlc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87187","description":"Microbe susceptible mlc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWE0","description":"ICD-PIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMB0","description":"ICD-NDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRF1","description":"ICD-PLRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOB0","description":"ICD-OCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"B-amyloid (Abeta42) and phospho tau (181P) (pTau181)_ electrochemiluminescent immunoassay (ECLIA)_ cerebral spinal fluid_ ratio reported as positive or negative for amyloid pa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0445U","description":"B-amyloid (Abeta42) and phospho tau (181P) (pTau181)_ electrochemiluminescent immunoassay (ECLIA)_ cerebral spinal fluid_ ratio reported as positive or negative for amyloid pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIB0","description":"ICD-AIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Frame depth less than 22 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2203","description":"Frame depth less than 22 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBE1","description":"ICD-GDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPB1","description":"ICD-BIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Maxillary sinusotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7560","description":"Maxillary sinusotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKA1","description":"ICD-FBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient received at least one well-child visit with a PCP during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9964","description":"Patient received at least one well-child visit with a PCP during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0654U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0654U","description":"CPT-0654U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD20C","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00952","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00952","description":"CPT-00952","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mon cable elec/pneum vad rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0486","description":"Mon cable elec/pneum vad rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCA0","description":"ICD-EHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01382","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01382","description":"CPT-01382","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reusable underpad bed size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4537","description":"Reusable underpad bed size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKE1","description":"ICD-CIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDA0","description":"ICD-MIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0702","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0702","description":"HCPCS-B0702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACE1","description":"ICD-FACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABD0","description":"ICD-BABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYF0","description":"ICD-PHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYA1","description":"ICD-OEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLF1","description":"ICD-CCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0670U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0670U","description":"CPT-0670U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVF1","description":"ICD-FEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGD0","description":"ICD-CHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBC0","description":"ICD-JBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICC0","description":"ICD-MICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQC1","description":"ICD-OGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stereoscopic x-ray guidance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6002","description":"Stereoscopic x-ray guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens bifocal seg width over","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2219","description":"Lens bifocal seg width over","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHA0","description":"ICD-NKHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27825","description":"Treat lower leg fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMC1","description":"ICD-OBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00529","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00529","description":"CPT-00529","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIB0","description":"ICD-FFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IB31","description":"ICD-1IB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSE0","description":"ICD-LGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic us exam esoph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43237","description":"Endoscopic us exam esoph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Seat ht <17 or >=21 ltwt wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0056","description":"Seat ht <17 or >=21 ltwt wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXE1","description":"ICD-FHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure_ for example patient bilateral amputee; patient has condition tha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2178","description":"Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure_ for example patient bilateral amputee; patient has condition tha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0664U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0664U","description":"CPT-0664U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLC1","description":"ICD-GCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQC0","description":"ICD-LIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUA0","description":"ICD-IIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ ITC/ITC","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5214","description":"Hearing aid_ contralateral routing system_ binaural_ ITC/ITC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBF1","description":"ICD-CCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Absorpt drg >16 <=48 w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6252","description":"Absorpt drg >16 <=48 w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98008","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","description":"CPT-98008","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBA1","description":"ICD-NJBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHA1","description":"ICD-GDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWF1","description":"ICD-PCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVC1","description":"ICD-NJVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTF1","description":"ICD-IDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ argatroban_ 1 mg (for ESRD on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0884","description":"Injection_ argatroban_ 1 mg (for ESRD on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of serotonin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84260","description":"Assay of serotonin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTF0","description":"ICD-FBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJC1","description":"ICD-GEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-62331","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","description":"CPT-62331","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive (60 mins) home care plan oversight. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiaryā€™s home_ domiciliary_ rest ho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2015","description":"Comprehensive (60 mins) home care plan oversight. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiaryā€™s home_ domiciliary_ rest ho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ocular reconst transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65782","description":"Ocular reconst transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCD0","description":"ICD-CCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSA0","description":"ICD-LFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDC1","description":"ICD-FBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXB0","description":"ICD-NJXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adult size brief/diaper sm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4521","description":"Adult size brief/diaper sm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXA1","description":"ICD-CIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNE1","description":"ICD-NJNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES115","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac magnetic resonance imaging for morphology and function_ quantification of segmental dysfunction; with strain im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9762","description":"Cardiac magnetic resonance imaging for morphology and function_ quantification of segmental dysfunction; with strain im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ATXN8OS (ATXN8 opposite strand [non-protein coding]) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81182","description":"ATXN8OS (ATXN8 opposite strand [non-protein coding]) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVE0","description":"ICD-FFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical repair of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43501","description":"Surgical repair of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sitz type bath or equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0160","description":"Sitz type bath or equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52320","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of porphobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84110","description":"Assay of porphobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPD1","description":"ICD-BBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASC0","description":"ICD-DASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transurethral destruction of prostate tissue; by radiofrequency water vapor (steam) thermal therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9748","description":"Transurethral destruction of prostate tissue; by radiofrequency water vapor (steam) thermal therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDA1","description":"ICD-KIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"WoundEx_ BioSkin_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4163","description":"WoundEx_ BioSkin_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apply forearm splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29126","description":"Apply forearm splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urinary hvy plstc pch w/o fp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4382","description":"Urinary hvy plstc pch w/o fp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap esophagomyotomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2079","description":"Lap esophagomyotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise mandible lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21040","description":"Excise mandible lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunohisto antibody slide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88344","description":"Immunohisto antibody slide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA235","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDE0","description":"ICD-NHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJD1","description":"ICD-OKJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCC0","description":"ICD-ECCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of rectal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45020","description":"Drainage of rectal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES31B","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBB1","description":"ICD-MDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQA1","description":"ICD-LDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEA0","description":"ICD-NGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGF0","description":"ICD-NJGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB231","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE256","description":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0406","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0406","description":"CDT-D0406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ teplizumab-mzwv_ 5 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9381","description":"Injection_ teplizumab-mzwv_ 5 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing device_ monaural_ in the ear (ITE)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5171","description":"Hearing aid_ contralateral routing device_ monaural_ in the ear (ITE)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hallux rigidus correction with cheilectomy_ debridement and capsular release of the first metatarsophalangeal joint; with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28291","description":"Hallux rigidus correction with cheilectomy_ debridement and capsular release of the first metatarsophalangeal joint; with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC1A","description":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASD1","description":"ICD-CASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of knee cartilage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27333","description":"Removal of knee cartilage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Screening performed and positive and provision of recommendations","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9919","description":"Screening performed and positive and provision of recommendations","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ teprotumumab-trbw_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3241","description":"Injection_ teprotumumab-trbw_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8F","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ with definitive confirmation of positive results","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0111U","description":"Drug test(s)_ presumptive_ with definitive confirmation of positive results","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHA1","description":"ICD-FAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJF0","description":"ICD-NKJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEED1","description":"ICD-CEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88014","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQA0","description":"ICD-OAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIID0","description":"ICD-IIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYD0","description":"ICD-OGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBB0","description":"ICD-FHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glasses bone conduction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5080","description":"Glasses bone conduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lso sag r an/pos pnl pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0648","description":"Lso sag r an/pos pnl pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVD1","description":"ICD-KIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRB0","description":"ICD-GGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Strep b dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87653","description":"Strep b dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bezlotoxumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0565","description":"Injection_ bezlotoxumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig ref oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8566","description":"Pt inelig ref oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIE0","description":"ICD-IIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUC1","description":"ICD-GEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMA1","description":"ICD-KIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMF0","description":"ICD-BCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVD1","description":"ICD-JHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rheumatology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4032","description":"Rheumatology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCD1","description":"ICD-BBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA13C","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28E","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES226","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPE1","description":"ICD-GFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Obstetrics (pre-implantation genetic testing)_ evaluation of 300000 DNA single-nucleotide polymorphisms (SNPs) by microarray_ embryonic tissue_ algorithm reported as a probabi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0396U","description":"Obstetrics (pre-implantation genetic testing)_ evaluation of 300000 DNA single-nucleotide polymorphisms (SNPs) by microarray_ embryonic tissue_ algorithm reported as a probabi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQF1","description":"ICD-OGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE10A","description":"Clinically Complex _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Imaging of the head (CT or MRI) was obtained","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1027","description":"Imaging of the head (CT or MRI) was obtained","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBB0","description":"ICD-MGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFC1","description":"ICD-CIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transplant forearm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25310","description":"Transplant forearm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28F","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Erythro lactobionate /500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1364","description":"Erythro lactobionate /500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flebogamma injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1572","description":"Flebogamma injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0104","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0104","description":"CDT-D0104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic decompression of spinal cord_ nerve root(s)_ including laminotomy_ partial facetectomy_ foraminotomy_ discectomy and/or excision of herniated intervertebral disc_ 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62380","description":"Endoscopic decompression of spinal cord_ nerve root(s)_ including laminotomy_ partial facetectomy_ foraminotomy_ discectomy and/or excision of herniated intervertebral disc_ 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00632","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00632","description":"CPT-00632","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUA1","description":"ICD-MDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAA1","description":"ICD-MGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5940","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5940","description":"CDT-D5940","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pain Management_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 36 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0290U","description":"Pain Management_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 36 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDB1","description":"ICD-NIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGE0","description":"ICD-NIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 25 gene report_ with variant analysis and reported phenotypes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0348U","description":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 25 gene report_ with variant analysis and reported phenotypes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6038","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","description":"HCPCS-L6038","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB15","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive removal of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47122","description":"Extensive removal of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Above knee leather socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5642","description":"Above knee leather socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electric current therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97033","description":"Electric current therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hla class i semiquant panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86834","description":"Hla class i semiquant panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKF0","description":"ICD-OKKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flu imm no admin doc rea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8483","description":"Flu imm no admin doc rea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAD0","description":"ICD-CEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens aniseikonic trifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2318","description":"Lens aniseikonic trifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fixation of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23700","description":"Fixation of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystometrogram w/vp&up","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51729","description":"Cystometrogram w/vp&up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHB1","description":"ICD-GGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKC0","description":"ICD-GGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLB0","description":"ICD-ICLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise spinal cord ligaments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63182","description":"Revise spinal cord ligaments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHE1","description":"ICD-MAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMC1","description":"ICD-OGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Collagen dressing <=16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6021","description":"Collagen dressing <=16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOA1","description":"ICD-HFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDD0","description":"ICD-AGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"A finding of an incidental pulmonary nodule","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9754","description":"A finding of an incidental pulmonary nodule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcvng periton dialysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4055F","description":"Pt rcvng periton dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9715","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCE1","description":"ICD-OFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLE0","description":"ICD-AFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93620","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRD1","description":"ICD-PCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx cml remission","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9126","description":"Onc dx cml remission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUC1","description":"ICD-FCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair hand joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26540","description":"Repair hand joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALA1","description":"ICD-GALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTD1","description":"ICD-OGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial proctectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45113","description":"Partial proctectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of skin_ subcutaneous tissue and/or mucous membrane (including simple closure)_ unless otherwise listed; each separate/additional lesion (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11101","description":"Biopsy of skin_ subcutaneous tissue and/or mucous membrane (including simple closure)_ unless otherwise listed; each separate/additional lesion (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB124","description":"Special Care Low _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Icut allergy test drug/bug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95024","description":"Icut allergy test drug/bug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINB0","description":"ICD-KINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSD0","description":"ICD-PBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ gemcitabine hydrochloride (accord)_ not therapeutically equivalent to j9201_ 200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9196","description":"Injection_ gemcitabine hydrochloride (accord)_ not therapeutically equivalent to j9201_ 200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEF1","description":"ICD-AEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCB0","description":"ICD-OBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Statin med pres at disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8816","description":"Statin med pres at disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEF1","description":"ICD-EGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antiepileptics nos 1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80339","description":"Antiepileptics nos 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASC1","description":"ICD-HASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLE0","description":"ICD-JFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITE1","description":"ICD-MITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0644","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0644","description":"HCPCS-J0644","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bld inj at surg/1mos post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9625","description":"Bld inj at surg/1mos post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC217","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ monaural_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5242","description":"Hearing aid_ monaural_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28F","description":"Special Care High _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX03","description":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA221","description":"Clinically Complex _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Speech sound lang comprehen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92523","description":"Speech sound lang comprehen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psori tool doc/no bnchmk met","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9651","description":"Psori tool doc/no bnchmk met","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Image std nomenclature","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9318","description":"Image std nomenclature","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATC0","description":"ICD-CATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt not rcvng epo thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4095F","description":"Pt not rcvng epo thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX41","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINF0","description":"ICD-NINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB10C","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytomeg dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87497","description":"Cytomeg dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPF1","description":"ICD-JIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iliac bone graft microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20956","description":"Iliac bone graft microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2FB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FB11","description":"ICD-2FB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental occlusal guard","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9940","description":"Dental occlusal guard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0519U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","description":"CPT-0519U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leishmania antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86717","description":"Leishmania antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cltx thigh fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27267","description":"Cltx thigh fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision benign lesion>1.25c","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7411","description":"Excision benign lesion>1.25c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tone decay hearing test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92563","description":"Tone decay hearing test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAA1","description":"ICD-NJAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trluml perip athrc iliac art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0238T","description":"Trluml perip athrc iliac art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEA0","description":"ICD-BAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCE0","description":"ICD-KBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncoprotein dcp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83951","description":"Oncoprotein dcp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFF1","description":"ICD-BEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal hemoglobin assay qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83033","description":"Fetal hemoglobin assay qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDA1","description":"ICD-ACDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD236","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUE0","description":"ICD-CGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMA0","description":"ICD-AHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tubing with heating element","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4604","description":"Tubing with heating element","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFF0","description":"ICD-BCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRB0","description":"ICD-DCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA45","description":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61541","description":"Incision of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWE0","description":"ICD-DDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3HB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HB21","description":"ICD-3HB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJF0","description":"ICD-BEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1080T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1080T","description":"CPT-1080T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Add metal substructure to acrylic full denture (per arch)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5876","description":"Add metal substructure to acrylic full denture (per arch)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKF0","description":"ICD-GHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54430","description":"Revision of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct soft tissue neck w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70491","description":"Ct soft tissue neck w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJD1","description":"ICD-CAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPE1","description":"ICD-KIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTF1","description":"ICD-AHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hdr rdncl ntrstl/icav brchtx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77772","description":"Hdr rdncl ntrstl/icav brchtx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWA0","description":"ICD-OHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGB0","description":"ICD-NIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLE0","description":"ICD-MCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acetazolamid sodium injectio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1120","description":"Acetazolamid sodium injectio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNB0","description":"ICD-BCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ lower leg and foot_ padded_ for nighttime use_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6524","description":"Gradient compression garment_ lower leg and foot_ padded_ for nighttime use_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ heparin sodium (pfizer)_ not therapeutically equivalent to j1644_ per 1000 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1643","description":"Injection_ heparin sodium (pfizer)_ not therapeutically equivalent to j1644_ per 1000 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMC0","description":"ICD-CFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor fletcher fact","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85292","description":"Clot factor fletcher fact","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUF0","description":"ICD-KEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ stranded_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2698","description":"Brachytx_ stranded_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPF1","description":"ICD-OJPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHE1","description":"ICD-MHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1828","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","description":"HCPCS-E1828","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1107","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion radioulnar jnt/ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25830","description":"Fusion radioulnar jnt/ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lev 2 hosp type b ed visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0381","description":"Lev 2 hosp type b ed visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-rays at surgery add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74301","description":"X-rays at surgery add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSC1","description":"ICD-OGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noncovered ambulance mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0888","description":"Noncovered ambulance mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26205","description":"Remove/graft bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPF0","description":"ICD-GHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKD1","description":"ICD-CFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTE1","description":"ICD-JCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thorabd diaphr hern repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43337","description":"Thorabd diaphr hern repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAC1","description":"ICD-EBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTB0","description":"ICD-EDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic Small Intestine Follow-Through Study_ Including Multiple Serial Images (List Separately In Addition To Code For Primary Procedure For Upper Gi Radiologic Examinatio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74248","description":"Radiologic Small Intestine Follow-Through Study_ Including Multiple Serial Images (List Separately In Addition To Code For Primary Procedure For Upper Gi Radiologic Examinatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOE1","description":"ICD-GHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAE1","description":"ICD-EBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove pulmonary shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33924","description":"Remove pulmonary shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8F","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3FC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FC11","description":"ICD-3FC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chest compression gen system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0483","description":"Chest compression gen system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Whchr litwt det arm leg rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1240","description":"Whchr litwt det arm leg rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision lesion mouth roof","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42106","description":"Excision lesion mouth roof","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEE0","description":"ICD-NAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQD1","description":"ICD-GFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36904","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLD0","description":"ICD-MDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSF1","description":"ICD-PFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITD1","description":"ICD-MITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1004T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","description":"CPT-1004T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAE0","description":"ICD-JFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bleeding time test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85002","description":"Bleeding time test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIF1","description":"ICD-MKIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Loxapine for inhalation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2062","description":"Loxapine for inhalation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEC1","description":"ICD-MCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N blk inj sciatic cont inf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64446","description":"N blk inj sciatic cont inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUA1","description":"ICD-FDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of parastomal hernia_ any approach (ie_ open_ laparoscopic_ robotic)_ initial or recurrent_ including implantation of mesh or other prosthesis_ when performed; incarcer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49622","description":"Repair of parastomal hernia_ any approach (ie_ open_ laparoscopic_ robotic)_ initial or recurrent_ including implantation of mesh or other prosthesis_ when performed; incarcer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antiviral ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9245","description":"Antiviral ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRC0","description":"ICD-LGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Semen anal sperm detection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89321","description":"Semen anal sperm detection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOD1","description":"ICD-HHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Egd optical endomicroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43252","description":"Egd optical endomicroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIB0","description":"ICD-CGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSB1","description":"ICD-LCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vendaje ac_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4279","description":"Vendaje ac_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0602","description":"HCPCS-B0602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Factor viii fc fusion recomb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7205","description":"Factor viii fc fusion recomb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reloc skin pocket pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0416T","description":"Reloc skin pocket pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVB0","description":"ICD-FFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSB1","description":"ICD-OCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD236","description":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01400","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01400","description":"CPT-01400","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"History of preoperative posterior capsule rupture","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9759","description":"History of preoperative posterior capsule rupture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUB0","description":"ICD-OJUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"I&d absc intraoral soft tiss","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7510","description":"I&d absc intraoral soft tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYE0","description":"ICD-KAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA125","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Impltj Nonbiol/Synth Implt Fasc Rnfcmt Abdl Wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0437T","description":"Impltj Nonbiol/Synth Implt Fasc Rnfcmt Abdl Wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBE1","description":"ICD-MBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMF0","description":"ICD-IFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1AC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AC31","description":"ICD-1AC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGA1","description":"ICD-OHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHB1","description":"ICD-IHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short sta","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA13","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMB0","description":"ICD-OAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIA1","description":"ICD-IHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQE0","description":"ICD-PDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 anytime during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9910","description":"Patients age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 anytime during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIC1","description":"ICD-ACIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJE0","description":"ICD-BEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Xray control catheter change","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75984","description":"Xray control catheter change","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES236","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGC1","description":"ICD-CEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC121","description":"Clinically Complex _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB117","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Needle biopsy liver add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47001","description":"Needle biopsy liver add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endo ak/hip knee extens assi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5850","description":"Endo ak/hip knee extens assi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diast bp >/= 90 mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3080F","description":"Diast bp >/= 90 mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGA1","description":"ICD-NCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYC1","description":"ICD-CFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscp guide wire dilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43196","description":"Esophagoscp guide wire dilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES25C","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTA1","description":"ICD-GHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comp preop assess cat surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0014F","description":"Comp preop assess cat surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOD1","description":"ICD-KAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNC0","description":"ICD-CFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion Or Replacement Of Implantable Cardioverter-Defibrillator System With Substernal Electrode(S)_ Including All Imaging Guidance And Electrophysiological Evaluation (Inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0571T","description":"Insertion Or Replacement Of Implantable Cardioverter-Defibrillator System With Substernal Electrode(S)_ Including All Imaging Guidance And Electrophysiological Evaluation (Inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Social work visit_ in the ho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9127","description":"Social work visit_ in the ho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote real-time interactive video-conferenced critical care_ evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (List s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0189T","description":"Remote real-time interactive video-conferenced critical care_ evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (List s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7356","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","description":"HCPCS-J7356","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXD0","description":"ICD-KDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daptomycin (xellia) not therapeutically equivalent to j0878_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0873","description":"Injection_ daptomycin (xellia) not therapeutically equivalent to j0878_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADA1","description":"ICD-BADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Near ifr guide of vasc site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0287T","description":"Near ifr guide of vasc site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMB1","description":"ICD-MCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cyclosporine oral 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7515","description":"Cyclosporine oral 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic Insertion Of New Or Replacement Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0676T","description":"Laparoscopic Insertion Of New Or Replacement Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRB1","description":"ICD-LFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cell marker study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88182","description":"Cell marker study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect shoulder tumor 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23078","description":"Resect shoulder tumor 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVB0","description":"ICD-KIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBD1","description":"ICD-MFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KB31","description":"ICD-2KB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJC0","description":"ICD-GFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCA0","description":"ICD-JGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEA1","description":"ICD-FGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX53","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1024T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","description":"CPT-1024T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (non-small cell lung cancer)_ cell-free DNA from plasma_ targeted sequence analysis of at least 109 genes_ including sequence variants_ substitutions_ insertions_ del","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0397U","description":"Oncology (non-small cell lung cancer)_ cell-free DNA from plasma_ targeted sequence analysis of at least 109 genes_ including sequence variants_ substitutions_ insertions_ del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear localization/abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78807","description":"Nuclear localization/abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYC1","description":"ICD-KCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES255","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tissue in-situ hybridization","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0479","description":"Tissue in-situ hybridization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc count of ct in 12mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9321","description":"Doc count of ct in 12mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBE0","description":"ICD-AGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIA0","description":"ICD-JCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1386","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","description":"HCPCS-M1386","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAA1","description":"ICD-EHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tb intradermal test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86580","description":"Tb intradermal test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBA0","description":"ICD-CBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMC1","description":"ICD-GHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M0233","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","description":"HCPCS-M0233","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIB1","description":"ICD-KIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pentamidine iseth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0080","description":"Injection_ pentamidine iseth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA43","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise gastric port open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43886","description":"Revise gastric port open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQC1","description":"ICD-CBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYB1","description":"ICD-PIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0505","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0505","description":"CDT-D0505","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSA0","description":"ICD-DHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autonomic nrv adrenrg inervj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95922","description":"Autonomic nrv adrenrg inervj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thigh/wght bear lacer non-mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2530","description":"Thigh/wght bear lacer non-mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no statin med disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8817","description":"Doc reas no statin med disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis via av graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4053F","description":"Hemodialysis via av graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDD1","description":"ICD-NFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Musc tst done w/nerv tst lim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95885","description":"Musc tst done w/nerv tst lim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy w/biopsy(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31625","description":"Bronchoscopy w/biopsy(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXE1","description":"ICD-NLXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRA1","description":"ICD-PIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVB0","description":"ICD-KBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD12D","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alprostadil for injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0270","description":"Alprostadil for injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group III_ for enzyme constituents (List separately in addition to code for pri","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0759T","description":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group III_ for enzyme constituents (List separately in addition to code for pri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0106","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0106","description":"HCPCS-C0106","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNB0","description":"ICD-CHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0701","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0701","description":"HCPCS-A0701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEA0","description":"ICD-BHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMA0","description":"ICD-OFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vacsular emobolization or occlusion procedure with use of pressure-generation catheter (e.g._ one-way_ intermittentrly occluding)_ inclusive of all radiological supervision an","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9797","description":"Vacsular emobolization or occlusion procedure with use of pressure-generation catheter (e.g._ one-way_ intermittentrly occluding)_ inclusive of all radiological supervision an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lorazepam injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2060","description":"Lorazepam injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABED0","description":"ICD-ABED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDME1","description":"ICD-BDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCE1","description":"ICD-KCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQC1","description":"ICD-LFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treponema pallidum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86780","description":"Treponema pallidum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory bp recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93786","description":"Ambulatory bp recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylinder 4.00d/4.25-6d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2105","description":"Spherocylinder 4.00d/4.25-6d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWD1","description":"ICD-DFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKC1","description":"ICD-CBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1901","description":"HCPCS-B1901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWC0","description":"ICD-GBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Norsn no pros info op rpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9303","description":"Norsn no pros info op rpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of aqueous shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66184","description":"Revision of aqueous shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Direct immunofluorescence","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0482","description":"Direct immunofluorescence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDD1","description":"ICD-CHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB23C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB14C","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC104","description":"Clinically Complex _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEID1","description":"ICD-CEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIB1","description":"ICD-GEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMC0","description":"ICD-ICMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Function stat assessed rvwd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1175F","description":"Function stat assessed rvwd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJC1","description":"ICD-FGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIC1","description":"ICD-ODIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tumor imaging mult areas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78801","description":"Tumor imaging mult areas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYE1","description":"ICD-OIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWE1","description":"ICD-OHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPD1","description":"ICD-KAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAE0","description":"ICD-OHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICF1","description":"ICD-KICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise thigh tendon & fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27305","description":"Incise thigh tendon & fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore parathyroid glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60500","description":"Explore parathyroid glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0543U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","description":"CPT-0543U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surg on vag/urethral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94251","description":"Anesth surg on vag/urethral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQF1","description":"ICD-LEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETD1","description":"ICD-FETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of fibula epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27732","description":"Repair of fibula epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insulin (fiasp) for administration through dme (i.e._ insulin pump) per 50 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1811","description":"Insulin (fiasp) for administration through dme (i.e._ insulin pump) per 50 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1HA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HA11","description":"ICD-1HA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACME1","description":"ICD-ACME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHF1","description":"ICD-BDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB131","description":"Special Care High _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54308","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCE1","description":"ICD-OCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOC1","description":"ICD-GGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADC1","description":"ICD-CADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOB0","description":"ICD-DBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg 3.1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11424","description":"Exc h-f-nk-sp b9+marg 3.1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUB1","description":"ICD-IEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25560","description":"Treat fracture radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision Or Replacement Of Hypoglossal Nerve Neurostimulator Array And Distal Respiratory Sensor Electrode Or Electrode Array_ Including Connection To Existing Pulse Generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64583","description":"Revision Or Replacement Of Hypoglossal Nerve Neurostimulator Array And Distal Respiratory Sensor Electrode Or Electrode Array_ Including Connection To Existing Pulse Generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDA0","description":"ICD-FHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYE0","description":"ICD-HGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB241","description":"Clinically Complex _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ thrombectomy/embolect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1757","description":"Cath_ thrombectomy/embolect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQB0","description":"ICD-GFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICD1","description":"ICD-GICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tocilizumab-bavi (tofidence)_ biosimilar_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5133","description":"Injection_ tocilizumab-bavi (tofidence)_ biosimilar_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rep dev_ urinary_ w/sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1771","description":"Rep dev_ urinary_ w/sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXD0","description":"ICD-OGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTA0","description":"ICD-FBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0604","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0604","description":"HCPCS-C0604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJA0","description":"ICD-BCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRA1","description":"ICD-KDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSC0","description":"ICD-HCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFD0","description":"ICD-FHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ amivantamab-vmjw_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9083","description":"Injection_ amivantamab-vmjw_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKB1","description":"ICD-JGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDC1","description":"ICD-MEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQC0","description":"ICD-DFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDF1","description":"ICD-GFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0496U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","description":"CPT-0496U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy/needle bx addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31633","description":"Bronchoscopy/needle bx addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0943T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","description":"CPT-0943T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution_ 1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1097","description":"Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution_ 1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amino acid single qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82127","description":"Amino acid single qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBA1","description":"ICD-MDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDB0","description":"ICD-NGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mech hip extension assist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5855","description":"Mech hip extension assist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1388","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","description":"HCPCS-M1388","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt not rcvng glucoco thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4192F","description":"Pt not rcvng glucoco thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDD1","description":"ICD-BCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQF0","description":"ICD-OEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LA21","description":"ICD-4LA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTC1","description":"ICD-BFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMD0","description":"ICD-JAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI neck spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72141","description":"MRI neck spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nonprim loc anat bx site tum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3250F","description":"Nonprim loc anat bx site tum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIA0","description":"ICD-GHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAC1","description":"ICD-EGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JC11","description":"ICD-4JC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB251","description":"Special Care High _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXF0","description":"ICD-JHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Somatosensory testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95927","description":"Somatosensory testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95725","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B2101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2101","description":"HCPCS-B2101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES11A","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISF0","description":"ICD-GISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCF0","description":"ICD-FFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replantation hand complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20808","description":"Replantation hand complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25624","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLA0","description":"ICD-MLLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVE1","description":"ICD-CDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJA0","description":"ICD-FGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFF1","description":"ICD-NDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLF0","description":"ICD-BFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDA1","description":"ICD-ABDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exhaled air analysis o2/co2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94681","description":"Exhaled air analysis o2/co2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPE1","description":"ICD-CCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAD1","description":"ICD-MHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Phospholipid pltlt neutraliz","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85597","description":"Phospholipid pltlt neutraliz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAD1","description":"ICD-AAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADA1","description":"ICD-JADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQF0","description":"ICD-LAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilat macular exam done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2021F","description":"Dilat macular exam done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"GYPA GNOTYP NTRNS 1 5 EXON 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0189U","description":"GYPA GNOTYP NTRNS 1 5 EXON 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of spinal shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63746","description":"Removal of spinal shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBD1","description":"ICD-NJBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0697U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697U","description":"CPT-0697U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of colon/ileostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44156","description":"Removal of colon/ileostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCD0","description":"ICD-ABCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFE1","description":"ICD-GEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct orbit/ear/fossa w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70482","description":"Ct orbit/ear/fossa w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce radius and ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25492","description":"Reinforce radius and ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTD0","description":"ICD-EDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not achieve flat retinas six months post surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9379","description":"Patient did not achieve flat retinas six months post surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNF0","description":"ICD-NKNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXA0","description":"ICD-CGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUE0","description":"ICD-NGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETC0","description":"ICD-JETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Droperidol/fentanyl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1810","description":"Droperidol/fentanyl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXB0","description":"ICD-KEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDA0","description":"ICD-ABDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trabeculoplasty laser surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65855","description":"Trabeculoplasty laser surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHE0","description":"ICD-ADHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRD0","description":"ICD-LGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote monitoring of physiologic parameter(s) (eg_ weight_ blood pressure_ pulse oximetry_ respiratory flow rate)_ initial; device(s) supply with daily recording(s) or program","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99454","description":"Remote monitoring of physiologic parameter(s) (eg_ weight_ blood pressure_ pulse oximetry_ respiratory flow rate)_ initial; device(s) supply with daily recording(s) or program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco nonsmoker nor 2ndhnd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1033F","description":"Tobacco nonsmoker nor 2ndhnd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJB0","description":"ICD-BIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQF0","description":"ICD-PBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Docrsn for catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9239","description":"Docrsn for catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKA1","description":"ICD-BGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of hip socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27122","description":"Reconstruction of hip socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ decitabine (sun pharma) not therapeutically equivalent to j0894_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0893","description":"Injection_ decitabine (sun pharma) not therapeutically equivalent to j0894_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ paclitaxel protein-bound particles (teva) not therapeutically equivalent to j9264_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9258","description":"Injection_ paclitaxel protein-bound particles (teva) not therapeutically equivalent to j9264_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTE0","description":"ICD-FFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUB1","description":"ICD-FAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB211","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABF1","description":"ICD-FABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRA0","description":"ICD-HGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp mal+marg 0.5/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11620","description":"Exc h-f-nk-sp mal+marg 0.5/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJE0","description":"ICD-KEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPF1","description":"ICD-KEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWB1","description":"ICD-GEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBA0","description":"ICD-OLBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL11","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFC1","description":"ICD-ODFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Borrelia burgdorferi_ antibody detection of 5 recombinant protein groups_ by immunoblot_ IgM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0041U","description":"Borrelia burgdorferi_ antibody detection of 5 recombinant protein groups_ by immunoblot_ IgM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Calculus assay quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82360","description":"Calculus assay quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6010","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eo rigid w/o joints pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3762","description":"Eo rigid w/o joints pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt tk tams hcl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9503","description":"Pt tk tams hcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDD0","description":"ICD-KDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAD1","description":"ICD-NJAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBD0","description":"ICD-EIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIC0","description":"ICD-EGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKC0","description":"ICD-JEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray urethra/bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74455","description":"X-ray urethra/bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANE1","description":"ICD-NANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adult daycare services 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5100","description":"Adult daycare services 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant radiation dosimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4650","description":"Implant radiation dosimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUD1","description":"ICD-GGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRE1","description":"ICD-LIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0953T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","description":"CPT-0953T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFA1","description":"ICD-JCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leveen/shunt patency exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78291","description":"Leveen/shunt patency exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-H0052","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","description":"HCPCS-H0052","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEE1","description":"ICD-IIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiopulmonary exercise testing_ including measurements of minute ventilation_ CO2 production_ O2 uptake_ and electrocardiographic recordings","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94621","description":"Cardiopulmonary exercise testing_ including measurements of minute ventilation_ CO2 production_ O2 uptake_ and electrocardiographic recordings","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIA0","description":"ICD-CEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64790","description":"Removal of nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tendon lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27630","description":"Removal of tendon lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intens behave ther cardio dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0446","description":"Intens behave ther cardio dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87182","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","description":"CPT-87182","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQC1","description":"ICD-GDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXD1","description":"ICD-KCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sterile gauze <= 16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6402","description":"Sterile gauze <= 16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70390","description":"X-ray exam of salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES315","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0901T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","description":"CPT-0901T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATB0","description":"ICD-IATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYE0","description":"ICD-CCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUC1","description":"ICD-EGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTC0","description":"ICD-IDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELE1","description":"ICD-BELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLB1","description":"ICD-NJLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPA1","description":"ICD-NGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMF1","description":"ICD-IGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISD1","description":"ICD-PISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICD0","description":"ICD-MICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTD1","description":"ICD-MDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCE0","description":"ICD-GDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVB1","description":"ICD-KIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFC0","description":"ICD-OFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVB0","description":"ICD-CCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALC1","description":"ICD-FALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70250","description":"X-ray exam of skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIE0","description":"ICD-OLIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDB1","description":"ICD-CIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB10A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"BRCA1 (BRCA1_ DNA repair associated)_ BRCA2 (BRCA2_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81163","description":"BRCA1 (BRCA1_ DNA repair associated)_ BRCA2 (BRCA2_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1003","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1003","description":"CDT-D1003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFME1","description":"ICD-IFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Photorefractive keratectomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0810","description":"Photorefractive keratectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJE1","description":"ICD-OBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5165","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5165","description":"HCPCS-Q5165","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KC31","description":"ICD-2KC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAE1","description":"ICD-NDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup shoulder cast fbrgl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4004","description":"Cast sup shoulder cast fbrgl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wash harvest stem cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38209","description":"Wash harvest stem cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Expandable controller_ repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2376","description":"Expandable controller_ repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place device/marker_ non pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9728","description":"Place device/marker_ non pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXF0","description":"ICD-KHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES211","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of carnitine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82379","description":"Assay of carnitine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown full noble metal cast","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6792","description":"Crown full noble metal cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oxford w/ supinat/pronator c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3202","description":"Oxford w/ supinat/pronator c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQF1","description":"ICD-LGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBC0","description":"ICD-FCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onlay cst nbl mtl >=3 surfac","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6615","description":"Onlay cst nbl mtl >=3 surfac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ omadacycline_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9051","description":"Injection_ omadacycline_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sugars single quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84378","description":"Sugars single quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Talymed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4127","description":"Talymed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj fe-based mr contrast_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9953","description":"Inj fe-based mr contrast_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUF1","description":"ICD-BCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLF1","description":"ICD-NCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVB0","description":"ICD-CIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sgd prerec msg >8min <=20min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2502","description":"Sgd prerec msg >8min <=20min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63655","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIF0","description":"ICD-JHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVF0","description":"ICD-KEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANB1","description":"ICD-NANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBF0","description":"ICD-OIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLA0","description":"ICD-NJLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place po breast cath for rad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19296","description":"Place po breast cath for rad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYE1","description":"ICD-GHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEE1","description":"ICD-KFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy & revise urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52270","description":"Cystoscopy & revise urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Cervical (Cvemp)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92517","description":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Cervical (Cvemp)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUD1","description":"ICD-ECUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology_ RNA_ gene expression by whole transcriptome sequencing_ formalin-fixed paraffin embedded tissue or fresh frozen tissue_ predictive algorithm reported as potential ta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0019U","description":"Oncology_ RNA_ gene expression by whole transcriptome sequencing_ formalin-fixed paraffin embedded tissue or fresh frozen tissue_ predictive algorithm reported as potential ta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD256","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALB1","description":"ICD-OALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4DB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DB21","description":"ICD-4DB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17262","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL13","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWB0","description":"ICD-CIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic management program_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9140","description":"Diabetic management program_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYF0","description":"ICD-GIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Afo spiral prefabricated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1951","description":"Afo spiral prefabricated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC14A","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL17","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection of sclerosant; single incompetent vein (other than telangiectasia)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36470","description":"Injection of sclerosant; single incompetent vein (other than telangiectasia)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES204","description":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJE1","description":"ICD-OKJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOB1","description":"ICD-PKOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRF1","description":"ICD-OFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epstein-barr antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86663","description":"Epstein-barr antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLB0","description":"ICD-OFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cocaine or metabolite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6044","description":"Cocaine or metabolite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSA1","description":"ICD-PDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWE1","description":"ICD-CAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPB1","description":"ICD-BBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCA1","description":"ICD-JCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including fluoroscopic guidance; each additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10008","description":"Fine needle aspiration biopsy_ including fluoroscopic guidance; each additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Addition to lower extremity prosthesis_ endoskeletal_ kneedisarticulation_ above knee_ hip disarticulation_ positional rotation unit_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1022","description":"Addition to lower extremity prosthesis_ endoskeletal_ kneedisarticulation_ above knee_ hip disarticulation_ positional rotation unit_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GA11","description":"ICD-3GA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit anti-tnf per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9359","description":"Hit anti-tnf per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWC0","description":"ICD-GFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEC0","description":"ICD-CBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of lipase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83690","description":"Assay of lipase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Body jacket mold to patient","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1300","description":"Body jacket mold to patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Egd guide wire insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43248","description":"Egd guide wire insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cellular therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0075","description":"Cellular therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTC0","description":"ICD-MCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAB0","description":"ICD-NFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assessment by department of veterans affairs chaplain services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9001","description":"Assessment by department of veterans affairs chaplain services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"App topical fluoride varnish","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99188","description":"App topical fluoride varnish","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neck spinal fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22595","description":"Neck spinal fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETB0","description":"ICD-BETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBA0","description":"ICD-NJBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWF1","description":"ICD-GEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Virus inoculation shell via","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87254","description":"Virus inoculation shell via","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFB0","description":"ICD-OCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rigid plastic cust fab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0484","description":"Tlso rigid plastic cust fab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSB0","description":"ICD-OKSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAB0","description":"ICD-BFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A6515","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","description":"HCPCS-A6515","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAD0","description":"ICD-AIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOA0","description":"ICD-PAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSD0","description":"ICD-KDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOD1","description":"ICD-DHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHE0","description":"ICD-OHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDA0","description":"ICD-EFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAC0","description":"ICD-AFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair detached retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67101","description":"Repair detached retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB13D","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spec collection for sev acute resp synd coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ from an ind in a SNF or by a lab on behalf of an HH agcy any spec srce","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2024","description":"Spec collection for sev acute resp synd coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ from an ind in a SNF or by a lab on behalf of an HH agcy any spec srce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSD1","description":"ICD-HHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPB0","description":"ICD-JIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fungi identification mold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87107","description":"Fungi identification mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Death_ permanent nursing home resident or receiving hospice or palliative care any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9433","description":"Death_ permanent nursing home resident or receiving hospice or palliative care any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE156","description":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUA0","description":"ICD-GCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEF1","description":"ICD-MHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise flexor carpi radialis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25001","description":"Incise flexor carpi radialis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHC1","description":"ICD-GEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cyclophosphamide_ not otherwise specified_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9075","description":"Injection_ cyclophosphamide_ not otherwise specified_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC234","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prosthodont high noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6210","description":"Prosthodont high noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disposable Collection And Storage Bag For Breast Milk_ Any Size_ Any Type_ Each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1005","description":"Disposable Collection And Storage Bag For Breast Milk_ Any Size_ Any Type_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXA1","description":"ICD-GGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0579U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","description":"CPT-0579U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl nstim apnea stimj ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0430T","description":"Rmvl nstim apnea stimj ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCD1","description":"ICD-ABCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGD0","description":"ICD-CAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flu immunize order/admin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8482","description":"Flu immunize order/admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMB1","description":"ICD-OFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFD0","description":"ICD-FFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert xdrl body thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63301","description":"Remove vert xdrl body thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ascorbic acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82180","description":"Assay of ascorbic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXE0","description":"ICD-KBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kafo plastic pediatric size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2035","description":"Kafo plastic pediatric size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVF0","description":"ICD-GGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastroenterology (irritable bowel syndrome [IBS])_ immunoassay for anti-CdtB and anti-vinculin antibodies_ utilizing plasma_ algorithm for elevated or not elevated qualitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0164U","description":"Gastroenterology (irritable bowel syndrome [IBS])_ immunoassay for anti-CdtB and anti-vinculin antibodies_ utilizing plasma_ algorithm for elevated or not elevated qualitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9305","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9305","description":"HCPCS-C9305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQF0","description":"ICD-DAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUB1","description":"ICD-NJUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMF0","description":"ICD-FFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pho doc >1 cecal ldmk com ex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9612","description":"Pho doc >1 cecal ldmk com ex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBA1","description":"ICD-ECBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial Perfusion Echo Ischm/Viability Assmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0439T","description":"Myocardial Perfusion Echo Ischm/Viability Assmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYD0","description":"ICD-ODYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27610","description":"Explore/treat ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sales tax","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9999","description":"Sales tax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC251","description":"Special Care Low _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEC1","description":"ICD-AGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31530","description":"Laryngoscopy w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUF0","description":"ICD-ECUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUC0","description":"ICD-GHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mthfr gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81291","description":"Mthfr gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Metal frame recipro hip & ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2628","description":"Metal frame recipro hip & ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVC0","description":"ICD-GCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ferumoxytol_ non-esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0138","description":"Ferumoxytol_ non-esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28B","description":"Special Care Low _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJF1","description":"ICD-KDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKB1","description":"ICD-BBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB02","description":"Low Rehab_ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKD0","description":"ICD-NBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise hand/foot nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64704","description":"Revise hand/foot nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDME1","description":"ICD-MDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPD0","description":"ICD-JAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Employment - Employment Skills Development (1:2 to 1:3)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1729","description":"Employment - Employment Skills Development (1:2 to 1:3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLE1","description":"ICD-FGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHA0","description":"ICD-IHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHB0","description":"ICD-JEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOE0","description":"ICD-HEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQC0","description":"ICD-HHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHC0","description":"ICD-BFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEC1","description":"ICD-IBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFD1","description":"ICD-JBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lang comp current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9159","description":"Lang comp current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJF1","description":"ICD-OHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4AC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AC21","description":"ICD-4AC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUD0","description":"ICD-EEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA54","description":"High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4GC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GC21","description":"ICD-4GC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUC0","description":"ICD-JGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKA0","description":"ICD-CAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed fx ht w/o rails w/m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0290","description":"Hosp bed fx ht w/o rails w/m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAA0","description":"ICD-GAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUC0","description":"ICD-JFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB11","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVA1","description":"ICD-OFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD112","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB23B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-62330","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","description":"CPT-62330","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lvef>=40% doc normal or mild","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8395","description":"Lvef>=40% doc normal or mild","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC15","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTB1","description":"ICD-ADTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagectomy_ distal two-thirds_ with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy_ with laparoscopic pyloric drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43287","description":"Esophagectomy_ distal two-thirds_ with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy_ with laparoscopic pyloric drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0616U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","description":"CPT-0616U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTC0","description":"ICD-MGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBA1","description":"ICD-MJBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAA1","description":"ICD-BCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJC1","description":"ICD-NJJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEC0","description":"ICD-FAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKC1","description":"ICD-FFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWB1","description":"ICD-GCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBF1","description":"ICD-JHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70332","description":"X-ray exam of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJD1","description":"ICD-JEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure 60 minutes or longer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9362","description":"Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure 60 minutes or longer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJD1","description":"ICD-CCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGE0","description":"ICD-KBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Smear gram stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87205","description":"Smear gram stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8H","description":"Very High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain bladder by trocar/cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51101","description":"Drain bladder by trocar/cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device_ replacement only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0477","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device_ replacement only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41828","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBA0","description":"ICD-OIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art trnsposj vertbrl carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35691","description":"Art trnsposj vertbrl carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES150","description":"Extensive Services _ ADL Index 2-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCB1","description":"ICD-JDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVC0","description":"ICD-FIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRA1","description":"ICD-KBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWF1","description":"ICD-PIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEC0","description":"ICD-GDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESD0","description":"ICD-LESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parotid duct diversion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42507","description":"Parotid duct diversion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of rib and nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21616","description":"Removal of rib and nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIC1","description":"ICD-BIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place endorectal app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9725","description":"Place endorectal app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMD1","description":"ICD-NJMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Njx tfrml eprl w/us lumb/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0231T","description":"Njx tfrml eprl w/us lumb/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autoimmune diseases (systemic lupus erythematosus [SLE])_ analysis of 10 cytokine soluble mediator biomarkers by immunoassay_ plasma_ individual components reported with an al","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0446U","description":"Autoimmune diseases (systemic lupus erythematosus [SLE])_ analysis of 10 cytokine soluble mediator biomarkers by immunoassay_ plasma_ individual components reported with an al","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIME0","description":"ICD-GIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01952","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01952","description":"CPT-01952","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HC11","description":"ICD-4HC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDF1","description":"ICD-KIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICC1","description":"ICD-BICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFC0","description":"ICD-OAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA141","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB160","description":"Clinically Complex _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATE1","description":"ICD-CATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRC0","description":"ICD-HCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spec rpt no doc class histo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9425","description":"Spec rpt no doc class histo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIB0","description":"ICD-OFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0108","description":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing loss dup/del analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81431","description":"Hearing loss dup/del analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Carboplatin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9045","description":"Carboplatin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE113","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIB0","description":"ICD-OEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not currently being a statin therapy user or receive an order (prescription) for statin therapy (e.g._ patient with adverse effect_ alle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9781","description":"Documentation of medical reason(s) for not currently being a statin therapy user or receive an order (prescription) for statin therapy (e.g._ patient with adverse effect_ alle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Meperidine/promethazine inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2180","description":"Meperidine/promethazine inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAB0","description":"ICD-GFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHME0","description":"ICD-AHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLC1","description":"ICD-IHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Voriconazole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80285","description":"Voriconazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPB1","description":"ICD-OGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo proc endocrine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60659","description":"Laparo proc endocrine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High compres band w>=3in<5inyd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6452","description":"High compres band w>=3in<5inyd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thromboplastin time partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85730","description":"Thromboplastin time partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL35","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Muscle_ myocutaneous_ or fasciocutaneous flap; head and neck with named vascular pedicle (ie_ buccinators_ genioglossus_ temporalis_ masseter_ sternocleidomastoid_ levator sca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15733","description":"Muscle_ myocutaneous_ or fasciocutaneous flap; head and neck with named vascular pedicle (ie_ buccinators_ genioglossus_ temporalis_ masseter_ sternocleidomastoid_ levator sca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of toe tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28011","description":"Incision of toe tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGF0","description":"ICD-NCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIC1","description":"ICD-OLIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1381","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","description":"HCPCS-M1381","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSB1","description":"ICD-DFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMA0","description":"ICD-IHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXC1","description":"ICD-JEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Posterior gait trainer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E8000","description":"Posterior gait trainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWE0","description":"ICD-GGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAC1","description":"ICD-NCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHE1","description":"ICD-AFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANB0","description":"ICD-KANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heart first pass single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78481","description":"Heart first pass single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAD1","description":"ICD-GAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lymph vessel x-ray trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75805","description":"Lymph vessel x-ray trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4419","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","description":"HCPCS-Q4419","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIC1","description":"ICD-IGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autoimmune diseases (eg_ systemic lupus erythematosus [SLE])_ analysis of 8 IgG autoantibodies and 2 cell-bound complement activation products using enzyme-linked immunosorben","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0312U","description":"Autoimmune diseases (eg_ systemic lupus erythematosus [SLE])_ analysis of 8 IgG autoantibodies and 2 cell-bound complement activation products using enzyme-linked immunosorben","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIA1","description":"ICD-OLIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHED0","description":"ICD-OHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aac non-electronic board","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1902","description":"Aac non-electronic board","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Intermittent Monitoring And Maintenance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95712","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Intermittent Monitoring And Maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coombs test direct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86880","description":"Coombs test direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB12D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implt cran bone flap to abdo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61316","description":"Implt cran bone flap to abdo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYF0","description":"ICD-HFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD245","description":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJA0","description":"ICD-OLJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc idrl imed lesn thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63286","description":"Bx/exc idrl imed lesn thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Not medically necessary svc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9986","description":"Not medically necessary svc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYB1","description":"ICD-PLYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shdr fair lead cable direct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6590","description":"Shdr fair lead cable direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLD1","description":"ICD-JGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTE0","description":"ICD-JFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDF0","description":"ICD-ADDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Male external catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4326","description":"Male external catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0525U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","description":"CPT-0525U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFD0","description":"ICD-BBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cataract measures group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8906","description":"Cataract measures group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQD1","description":"ICD-LBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHE0","description":"ICD-FFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSC1","description":"ICD-KBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFF0","description":"ICD-CGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHID1","description":"ICD-AHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No pneumococcal admin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8867","description":"No pneumococcal admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOD1","description":"ICD-LHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACD1","description":"ICD-BACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARC1","description":"ICD-HARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0109","description":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal_ subcutaneous cardiac rhythm monitor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33286","description":"Removal_ subcutaneous cardiac rhythm monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX22","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUD0","description":"ICD-AGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIF0","description":"ICD-FAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJA1","description":"ICD-FDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPA0","description":"ICD-BAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHC1","description":"ICD-MBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63266","description":"Excise intrspinl lesion thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandage roll_ elastic long stretch_ linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6597","description":"Gradient compression bandage roll_ elastic long stretch_ linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"C diff amplified probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87493","description":"C diff amplified probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0528U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","description":"CPT-0528U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUB0","description":"ICD-OBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ovary(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58940","description":"Removal of ovary(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60225","description":"Partial removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC21B","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cabg artery-vein three","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33519","description":"Cabg artery-vein three","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFD1","description":"ICD-OEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGD0","description":"ICD-BGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAE0","description":"ICD-OEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group I_ for microorganisms (eg_ acid fast_ methenamine silver) (List separatel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0756T","description":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group I_ for microorganisms (eg_ acid fast_ methenamine silver) (List separatel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBD1","description":"ICD-OCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAF0","description":"ICD-OGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADB1","description":"ICD-KADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRF0","description":"ICD-DFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSE0","description":"ICD-PJSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQD0","description":"ICD-OJQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37261","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","description":"CPT-37261","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ald fm/dm adapt/boot couplin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5289","description":"Ald fm/dm adapt/boot couplin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHC0","description":"ICD-OEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANB1","description":"ICD-OANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECE1","description":"ICD-KECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIB1","description":"ICD-JDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTE0","description":"ICD-CHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgicord_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4218","description":"Surgicord_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00537","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00537","description":"CPT-00537","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HER2-targeted therapies administered during the initial course of treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9828","description":"HER2-targeted therapies administered during the initial course of treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inject epidural patch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62273","description":"Inject epidural patch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0540","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","description":"HCPCS-G0540","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWC1","description":"ICD-KAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEE0","description":"ICD-BBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPB0","description":"ICD-ODPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHA0","description":"ICD-JEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ teplizumab-mzwv_ 5 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9149","description":"Injection_ teplizumab-mzwv_ 5 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEF0","description":"ICD-GBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGC0","description":"ICD-GIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove nasal foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30310","description":"Remove nasal foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophageal capsule endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91111","description":"Esophageal capsule endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLD1","description":"ICD-OKLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nocardia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86744","description":"Nocardia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTD0","description":"ICD-NFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPE0","description":"ICD-OJPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA10A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVB0","description":"ICD-FCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tis trnfr trunk 10.1-30sqcm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14001","description":"Tis trnfr trunk 10.1-30sqcm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVC0","description":"ICD-FDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTC0","description":"ICD-OBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Robotic surgical system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2900","description":"Robotic surgical system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg_ spinocerebellar ataxia) gene analysis; known familial variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81186","description":"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg_ spinocerebellar ataxia) gene analysis; known familial variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAD0","description":"ICD-ABAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAA0","description":"ICD-AGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft aortobi-iliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35538","description":"Art byp grft aortobi-iliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVB0","description":"ICD-KHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair middle ear structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69667","description":"Repair middle ear structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNA0","description":"ICD-NHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTB0","description":"ICD-ICTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient receives hcv antibody test with reactive result","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1232","description":"Patient receives hcv antibody test with reactive result","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA117","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Counterimmunoelectrophoresis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86185","description":"Counterimmunoelectrophoresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Multi den insert custom mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5513","description":"Multi den insert custom mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31237","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHE0","description":"ICD-JHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTB0","description":"ICD-NLTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB2D","description":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dipyridamole injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1245","description":"Dipyridamole injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFA0","description":"ICD-GCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEE1","description":"ICD-IEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL0B","description":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYF1","description":"ICD-OIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITB0","description":"ICD-MITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28F","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCND0","description":"ICD-OCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFF0","description":"ICD-NHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB20D","description":"Clinically Complex _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEC1","description":"ICD-OKEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWA0","description":"ICD-PBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95976","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESD1","description":"ICD-GESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Specimen not intraop image","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8873","description":"Specimen not intraop image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Limited (30 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ domicil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0086","description":"Limited (30 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ domicil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Close chest after drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32810","description":"Close chest after drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARA1","description":"ICD-PARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 3 vhd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0853","description":"Pwc gp 3 vhd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECF1","description":"ICD-CECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18H","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNE0","description":"ICD-JHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWC0","description":"ICD-KGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCED1","description":"ICD-FCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kafo sing fre stirr thi/calf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2000","description":"Kafo sing fre stirr thi/calf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAE0","description":"ICD-CGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytogen test marrow b/4 tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3155F","description":"Cytogen test marrow b/4 tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGD1","description":"ICD-JGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKA1","description":"ICD-KIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRC0","description":"ICD-PJRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr s/n/ax/gen/trnk >30.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12007","description":"Rpr s/n/ax/gen/trnk >30.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA215","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXA1","description":"ICD-FCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPF0","description":"ICD-OIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of existing tract_ percutaneous_ for an endourologic procedure including imaging guidance (eg_ ultrasound and/or fluoroscopy) and all associated radiological supervis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50436","description":"Dilation of existing tract_ percutaneous_ for an endourologic procedure including imaging guidance (eg_ ultrasound and/or fluoroscopy) and all associated radiological supervis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHND0","description":"ICD-KHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body adbomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49402","description":"Remove foreign body adbomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Haberman feeder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8265","description":"Haberman feeder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise ileoanal reservior","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45136","description":"Excise ileoanal reservior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIC1","description":"ICD-KAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML3A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNE1","description":"ICD-ODNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4349","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","description":"HCPCS-Q4349","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert epicard eltrd open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33202","description":"Insert epicard eltrd open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMC0","description":"ICD-FFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRD0","description":"ICD-CFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rsa spine exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0348T","description":"Rsa spine exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYD1","description":"ICD-PCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37295","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","description":"CPT-37295","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD206","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYF0","description":"ICD-ODYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; retrieval and trans","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0555T","description":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; retrieval and trans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWA1","description":"ICD-CGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLA1","description":"ICD-GHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Integra matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4108","description":"Integra matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision lesion mouth roof","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42104","description":"Excision lesion mouth roof","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUE1","description":"ICD-ECUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Space maintainer fxd unilat","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1510","description":"Space maintainer fxd unilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHME1","description":"ICD-KHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMF1","description":"ICD-OFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUF0","description":"ICD-BFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIB0","description":"ICD-GBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24430","description":"Repair of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epidural lysis mult sessions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62263","description":"Epidural lysis mult sessions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC16","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGB0","description":"ICD-OBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Male vacuum erection system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7900","description":"Male vacuum erection system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23552","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABD1","description":"ICD-JABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUE0","description":"ICD-JFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCD1","description":"ICD-BFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (plasma cell disorders and myeloma)_ circulating plasma cell immunologic selection_ identification_ morphological characterization_ and enumeration of plasma cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0337U","description":"Oncology (plasma cell disorders and myeloma)_ circulating plasma cell immunologic selection_ identification_ morphological characterization_ and enumeration of plasma cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28510","description":"Treatment of toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel drg <=16 in w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6242","description":"Hydrogel drg <=16 in w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBID0","description":"ICD-FBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace aortic valve open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33364","description":"Replace aortic valve open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECA0","description":"ICD-BECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0614U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","description":"CPT-0614U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYA1","description":"ICD-KCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2099","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray upper gi&small intest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74245","description":"X-ray upper gi&small intest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFD0","description":"ICD-BGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1069T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1069T","description":"CPT-1069T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDF1","description":"ICD-BHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE21A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4357","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","description":"HCPCS-Q4357","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01951","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01951","description":"CPT-01951","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX35","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cultr oocyte/embryo <4 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89250","description":"Cultr oocyte/embryo <4 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psych svcs provided","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4060F","description":"Psych svcs provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUC1","description":"ICD-OAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB12","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Budesonide non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7633","description":"Budesonide non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEE1","description":"ICD-IAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACA0","description":"ICD-NACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES146","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTC1","description":"ICD-CGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3IA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IA31","description":"ICD-3IA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX23","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2036","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","description":"HCPCS-A2036","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYD0","description":"ICD-LCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flexible keel foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5972","description":"Flexible keel foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amino acids single quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82131","description":"Amino acids single quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urine incon characterized","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1091F","description":"Urine incon characterized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBE1","description":"ICD-CCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES240","description":"Extensive Services _ ADL Index 2-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"I & d of vulva/perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56405","description":"I & d of vulva/perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFC0","description":"ICD-KIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD21C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ho frejka cov only pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1610","description":"Ho frejka cov only pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Cns Tumors Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1085","description":"Radiation Therapy For Cns Tumors Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Survey not complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0914","description":"Survey not complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41899","description":"Dental surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1464","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","description":"HCPCS-M1464","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVD1","description":"ICD-JBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-84393","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","description":"CPT-84393","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGID1","description":"ICD-NGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDE1","description":"ICD-NFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAA1","description":"ICD-JGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt in the home per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9131","description":"Pt in the home per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEA0","description":"ICD-MHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEB0","description":"ICD-MJEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPA0","description":"ICD-BGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eeg monitoring/computer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95953","description":"Eeg monitoring/computer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD146","description":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTA1","description":"ICD-NHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52450","description":"Incision of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYD1","description":"ICD-CBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open bone biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20250","description":"Open bone biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWE0","description":"ICD-CIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE104","description":"Special Care High _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIA1","description":"ICD-CEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BA11","description":"ICD-2BA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUC0","description":"ICD-EEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epoetin beta esrd use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0887","description":"Epoetin beta esrd use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-pneum walk boot pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4386","description":"Non-pneum walk boot pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCD0","description":"ICD-OJCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUA0","description":"ICD-CBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYA0","description":"ICD-DAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients on peritoneal dialysis for any portion of the reporting month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0052","description":"Patients on peritoneal dialysis for any portion of the reporting month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLF0","description":"ICD-KCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOA1","description":"ICD-PGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAA1","description":"ICD-IDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJF0","description":"ICD-OJJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup long arm adult plst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4005","description":"Cast sup long arm adult plst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUA0","description":"ICD-FCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEE0","description":"ICD-GIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc hand tum deep 1.5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26113","description":"Exc hand tum deep 1.5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIA0","description":"ICD-FGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"O2 saturation doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3028F","description":"O2 saturation doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perfluoroalkyl substances (PFAS) (eg_ perfluorooctanoic acid_ perfluorooctane sulfonic acid)_ 9 PFAS compounds by LC-MS/MS_ plasma or serum_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0457U","description":"Perfluoroalkyl substances (PFAS) (eg_ perfluorooctanoic acid_ perfluorooctane sulfonic acid)_ 9 PFAS compounds by LC-MS/MS_ plasma or serum_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAB0","description":"ICD-BGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pul art balloon repr percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92998","description":"Pul art balloon repr percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC13C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIE0","description":"ICD-EEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nerve stimulator for tx n&v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0765","description":"Nerve stimulator for tx n&v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWC0","description":"ICD-DAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) achieved within the 30 minutes immediately before or the 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9771","description":"At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) achieved within the 30 minutes immediately before or the 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXB1","description":"ICD-JDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Uvl md cabinet sys 6 ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0694","description":"Uvl md cabinet sys 6 ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHE1","description":"ICD-OBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal/revision of cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29710","description":"Removal/revision of cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAC1","description":"ICD-JGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITE1","description":"ICD-GITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"2d tte w or w/o fol w/con_co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8923","description":"2d tte w or w/o fol w/con_co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAC0","description":"ICD-MLAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation medicine (kidney allograft rejection)_ microarray gene expression profiling of 1494 genes_ utilizing transplant biopsy tissue_ algorithm reported as a probabil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0088U","description":"Transplantation medicine (kidney allograft rejection)_ microarray gene expression profiling of 1494 genes_ utilizing transplant biopsy tissue_ algorithm reported as a probabil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIE0","description":"ICD-FFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-15016","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","description":"CPT-15016","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_ risk adj_ level 4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9010","description":"Mccd_ risk adj_ level 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0982T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","description":"CPT-0982T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Speech threshold audiometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92555","description":"Speech threshold audiometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDB1","description":"ICD-IGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGA1","description":"ICD-GGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of clot in graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35876","description":"Removal of clot in graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shrinker upper limb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8465","description":"Shrinker upper limb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thrombolytic therapy stroke","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37195","description":"Thrombolytic therapy stroke","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pessary rubber_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4561","description":"Pessary rubber_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAB1","description":"ICD-IDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRD1","description":"ICD-DHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWF0","description":"ICD-PGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLD1","description":"ICD-IGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tube_ pneum wheel drive tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2382","description":"Tube_ pneum wheel drive tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUF1","description":"ICD-OEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKD0","description":"ICD-KBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of omentum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49255","description":"Removal of omentum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leg perthes orth toronto typ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1700","description":"Leg perthes orth toronto typ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIA1","description":"ICD-OHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC45","description":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Occlusal guard adjustment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9943","description":"Occlusal guard adjustment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1459","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","description":"HCPCS-M1459","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscop w/arytenoidectom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31560","description":"Laryngoscop w/arytenoidectom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23625","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIB0","description":"ICD-IDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlso full corset","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0974","description":"Tlso full corset","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cerv collar supp adj cerv ba","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0190","description":"Cerv collar supp adj cerv ba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAB0","description":"ICD-ABAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient screened for unhealthy alcohol use using a systematic screening method and not identified as an unhealthy alcohol user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2197","description":"Patient screened for unhealthy alcohol use using a systematic screening method and not identified as an unhealthy alcohol user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovaginal Cryogen-Cooled_ Monopolar Radiofrequency Remodeling Of The Tissues Surrounding The Female Bladder Neck And Proximal Urethra For Urinary Incontinence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0672T","description":"Endovaginal Cryogen-Cooled_ Monopolar Radiofrequency Remodeling Of The Tissues Surrounding The Female Bladder Neck And Proximal Urethra For Urinary Incontinence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTE1","description":"ICD-NJTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHF1","description":"ICD-AFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFD0","description":"ICD-OKFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQB0","description":"ICD-OBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWC1","description":"ICD-HCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDF1","description":"ICD-IBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJE0","description":"ICD-FAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EA31","description":"ICD-2EA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAB1","description":"ICD-FDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGD0","description":"ICD-FGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRC1","description":"ICD-KBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPE1","description":"ICD-KDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENA1","description":"ICD-KENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGA1","description":"ICD-JHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICB0","description":"ICD-BICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALC1","description":"ICD-NALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIF1","description":"ICD-GIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antiepileptics nos 4-6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80340","description":"Antiepileptics nos 4-6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Toilet rail","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0243","description":"Toilet rail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWA0","description":"ICD-HIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFD0","description":"ICD-NBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKB0","description":"ICD-GDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEC0","description":"ICD-KIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSE1","description":"ICD-PDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB15C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental other tmj films","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0321","description":"Dental other tmj films","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDE1","description":"ICD-EDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFE1","description":"ICD-NDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXF0","description":"ICD-JIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prescription drug_ generic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5000","description":"Prescription drug_ generic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEC0","description":"ICD-NGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIA1","description":"ICD-NBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKE0","description":"ICD-JCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Human ig iv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90283","description":"Human ig iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLB0","description":"ICD-NLLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insj/rplcmt defib w/lead(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33249","description":"Insj/rplcmt defib w/lead(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat trigeminal tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61791","description":"Treat trigeminal tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC220","description":"Special Care High _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Maint drug infus cath per wk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4221","description":"Maint drug infus cath per wk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dress/debrid p-thick burn l","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16030","description":"Dress/debrid p-thick burn l","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIC0","description":"ICD-BIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee disart expand wall sock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5653","description":"Knee disart expand wall sock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hla i typing 1 allele hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81381","description":"Hla i typing 1 allele hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWA0","description":"ICD-GIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQC0","description":"ICD-OCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sipuleucel-t auto cd54+","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2043","description":"Sipuleucel-t auto cd54+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA25","description":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67412","description":"Explore/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEC1","description":"ICD-AEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orth foot non-standard size/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3255","description":"Orth foot non-standard size/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace foot drop spint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4394","description":"Replace foot drop spint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMC0","description":"ICD-MJMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant spinal canal cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62350","description":"Implant spinal canal cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Powered pres-redu air mattrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0277","description":"Powered pres-redu air mattrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMC1","description":"ICD-FAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIA0","description":"ICD-OAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leg Pain Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Greater Than 3.0 And Leg Pain Measured By The Visual Analog Scale (Vas) Wit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2147","description":"Leg Pain Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Greater Than 3.0 And Leg Pain Measured By The Visual Analog Scale (Vas) Wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rad resect abd tumor 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22905","description":"Rad resect abd tumor 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUD0","description":"ICD-KAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGB0","description":"ICD-CDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIE1","description":"ICD-CCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCF0","description":"ICD-IGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVE1","description":"ICD-BDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pessary_ non rubber_any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4562","description":"Pessary_ non rubber_any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD23C","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAC1","description":"ICD-NBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIA1","description":"ICD-NIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDA0","description":"ICD-BGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBD0","description":"ICD-NKBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFB0","description":"ICD-NLFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ romidepsin_ non-lypohilized (e.g. liquid)_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9065","description":"Injection_ romidepsin_ non-lypohilized (e.g. liquid)_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHE1","description":"ICD-BEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemical peel nonfacial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15792","description":"Chemical peel nonfacial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHD0","description":"ICD-EGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colpopexy intraperitoneal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57283","description":"Colpopexy intraperitoneal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCC1","description":"ICD-BGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJB1","description":"ICD-JAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB17","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEC1","description":"ICD-BDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj paravert f jnt c/t 3 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64492","description":"Inj paravert f jnt c/t 3 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEE1","description":"ICD-ODEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC2B","description":"Medium Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JC21","description":"ICD-3JC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFC1","description":"ICD-BBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNF1","description":"ICD-OFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy w/fb & op scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31531","description":"Laryngoscopy w/fb & op scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNA0","description":"ICD-GDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMF0","description":"ICD-ODMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCB1","description":"ICD-GDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18H","description":"Clinically Complex _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inflammatory bowel dis mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8899","description":"Inflammatory bowel dis mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEA0","description":"ICD-CHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDA1","description":"ICD-KCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ligate/divide/excise vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37785","description":"Ligate/divide/excise vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64575","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunization admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90471","description":"Immunization admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYC0","description":"ICD-KCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.00d/ove","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2206","description":"Lens sphcy bifocal 4.00d/ove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pathogen Test For Platelets","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9987","description":"Pathogen Test For Platelets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thyroglobulin antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86800","description":"Thyroglobulin antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Occlusal orthotic appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7880","description":"Occlusal orthotic appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ risperidone (Perseris)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9037","description":"Injection_ risperidone (Perseris)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQF1","description":"ICD-HEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLD0","description":"ICD-CDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCC1","description":"ICD-EFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9484","description":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETD1","description":"ICD-JETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Humidifier supplemental w/ i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0560","description":"Humidifier supplemental w/ i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPF0","description":"ICD-KBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sympt show clin import drop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1451F","description":"Sympt show clin import drop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAF1","description":"ICD-NFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAB0","description":"ICD-GDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFE0","description":"ICD-BBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28238","description":"Revision of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Semen anal strict criteria","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89322","description":"Semen anal strict criteria","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism EvidenceCare imaging advisor_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1013","description":"Clinical decision support mechanism EvidenceCare imaging advisor_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Athletic training evaluation_ moderate complexity_ requiring these components: A medical history and physical activity profile with 1-2 comorbidities that affect physical acti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97170","description":"Athletic training evaluation_ moderate complexity_ requiring these components: A medical history and physical activity profile with 1-2 comorbidities that affect physical acti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace picvad cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36585","description":"Replace picvad cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0203","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0203","description":"CDT-D0203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHE1","description":"ICD-JEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRB0","description":"ICD-PBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDID0","description":"ICD-IDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXA1","description":"ICD-OEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Online service by hc pro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98969","description":"Online service by hc pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infusion supplies with pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4222","description":"Infusion supplies with pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27829","description":"Treat lower leg joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEB0","description":"ICD-EDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMD1","description":"ICD-CDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFC1","description":"ICD-GCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFB0","description":"ICD-BBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repl semi/precision attach","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6091","description":"Repl semi/precision attach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPC0","description":"ICD-GCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL43","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Igh gene rearrang dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81262","description":"Igh gene rearrang dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAC0","description":"ICD-FGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYB0","description":"ICD-PBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLB1","description":"ICD-CHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIND1","description":"ICD-KIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLD1","description":"ICD-MFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Habil ed waiver_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2012","description":"Habil ed waiver_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYA0","description":"ICD-DIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUA1","description":"ICD-FGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Specimen handling pt-lab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99001","description":"Specimen handling pt-lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSC1","description":"ICD-PLSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ acetaminophen (b braun) not therapeutically equivalent to j0131_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0136","description":"Injection_ acetaminophen (b braun) not therapeutically equivalent to j0131_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kyphectomy 1-2 segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22818","description":"Kyphectomy 1-2 segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXA0","description":"ICD-FDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ configuration of wave form_ battery status_ elect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95973","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ configuration of wave form_ battery status_ elect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-53865","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","description":"CPT-53865","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNB0","description":"ICD-OJNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYF1","description":"ICD-GAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown full high noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6790","description":"Crown full high noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"External beam to prost only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4200F","description":"External beam to prost only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of ruptured tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24342","description":"Repair of ruptured tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JC21","description":"ICD-4JC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQC0","description":"ICD-OHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNE0","description":"ICD-NKNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLE1","description":"ICD-EHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJD0","description":"ICD-NJJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Platelets Pathogen Reduced Ea Unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9988","description":"Platelets Pathogen Reduced Ea Unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSE0","description":"ICD-GBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB2D","description":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followin","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA1C","description":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inactivated je vacc im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90738","description":"Inactivated je vacc im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastroesophageal reflux test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91034","description":"Gastroesophageal reflux test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHF1","description":"ICD-KBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81401","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUA0","description":"ICD-FEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIE0","description":"ICD-BGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQE1","description":"ICD-DBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJA0","description":"ICD-OJJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair fixed arms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1160","description":"Wheelchair fixed arms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYD0","description":"ICD-DBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEF0","description":"ICD-FEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUF1","description":"ICD-JBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Children who are taking antibiotics in the 30 days prior to the date of the encounter during which the diagnosis was established","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9701","description":"Children who are taking antibiotics in the 30 days prior to the date of the encounter during which the diagnosis was established","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopy swallow tst (fees)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92613","description":"Endoscopy swallow tst (fees)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Palb2 (Partner And Localizer Of Brca2) (Eg_ Breast And Pancreatic Cancer) Gene Analysis; Full Gene Sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81307","description":"Palb2 (Partner And Localizer Of Brca2) (Eg_ Breast And Pancreatic Cancer) Gene Analysis; Full Gene Sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNB0","description":"ICD-FFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMD0","description":"ICD-CFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEF1","description":"ICD-AFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fqhc visit_ ippe or awv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0468","description":"Fqhc visit_ ippe or awv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC11","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINE1","description":"ICD-CINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of System Reason(S) For An Interval Of Less Than 3 Years Since The Last Colonoscopy (E.G._ Unable To Locate Previous Colonoscopy Report_ Previous Colonoscopy Rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9999","description":"Documentation Of System Reason(S) For An Interval Of Less Than 3 Years Since The Last Colonoscopy (E.G._ Unable To Locate Previous Colonoscopy Report_ Previous Colonoscopy Rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Other manual wheelchair/base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0009","description":"Other manual wheelchair/base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","description":"HCPCS-Q4406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOC1","description":"ICD-PIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYA0","description":"ICD-LBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLA0","description":"ICD-OHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Collagenase_ clost hist inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0775","description":"Collagenase_ clost hist inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCE1","description":"ICD-EFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUC1","description":"ICD-MBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAA1","description":"ICD-KIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEC0","description":"ICD-NHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMD0","description":"ICD-CAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETB0","description":"ICD-GETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Close tear duct opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68761","description":"Close tear duct opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2312","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","description":"HCPCS-J2312","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLB0","description":"ICD-KBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch drain w bar & filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4424","description":"Ost pch drain w bar & filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAC0","description":"ICD-KCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bortezomib injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9041","description":"Bortezomib injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAD1","description":"ICD-OIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJB0","description":"ICD-OEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adm Tocilizu COVID-19 1st dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0249","description":"Adm Tocilizu COVID-19 1st dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRB1","description":"ICD-LCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABA0","description":"ICD-JABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJA0","description":"ICD-FIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJE1","description":"ICD-CCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBE0","description":"ICD-ECBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin seal protect moisturizr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6250","description":"Skin seal protect moisturizr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision gum each quadrant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41820","description":"Excision gum each quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYA0","description":"ICD-HIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIE0","description":"ICD-OGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28X","description":"Special Care Low _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Group adaptive behavior treatment by protocol_ administered by technician_ face-to-face with two or more patients; first 30 minutes of technician time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0366T","description":"Group adaptive behavior treatment by protocol_ administered by technician_ face-to-face with two or more patients; first 30 minutes of technician time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPB0","description":"ICD-NAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Finger splint_ static","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4049","description":"Finger splint_ static","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPC0","description":"ICD-CDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES217","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Manual reticulocyte count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85044","description":"Manual reticulocyte count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRD1","description":"ICD-PKRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJE1","description":"ICD-NLJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ht inj growth horm diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9558","description":"Ht inj growth horm diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incontinent rectal insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4337","description":"Incontinent rectal insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt not elig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9632","description":"Pt not elig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ metronidazole_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1836","description":"Injection_ metronidazole_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"INTRAORIFICE BARRIER","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3911","description":"INTRAORIFICE BARRIER","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Egd us fine needle bx/aspir","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43242","description":"Egd us fine needle bx/aspir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ dostarlimab-gxly_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9082","description":"Injection_ dostarlimab-gxly_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient encounter during the performance period with hospice and palliative care specialty code 17","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1365","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age Or Older And Had At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Dementia Medication","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2127","description":"Patients 66 Years Of Age Or Older And Had At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Dementia Medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHF0","description":"ICD-GFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUC1","description":"ICD-CDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28C","description":"Clinically Complex _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise sperm duct pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55605","description":"Incise sperm duct pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD256","description":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKB0","description":"ICD-GEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFED0","description":"ICD-MFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Hypotensive Patients Who Are At Immediate Risk Of Cardiogenic Shock_ Hospita","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2093","description":"Documentation Of Medical Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Hypotensive Patients Who Are At Immediate Risk Of Cardiogenic Shock_ Hospita","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder passive restor cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6320","description":"Shoulder passive restor cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDE1","description":"ICD-OHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL03","description":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIA0","description":"ICD-NBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Counseling for the control and prevention of adverse oral_ behavioral_ and systemic health effects associated with high-risk substance use","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1321","description":"Counseling for the control and prevention of adverse oral_ behavioral_ and systemic health effects associated with high-risk substance use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMF1","description":"ICD-MDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flutemetamol F18_ diagnostic_ per study dose_ up to 8.1 millicuries","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9983","description":"Flutemetamol F18_ diagnostic_ per study dose_ up to 8.1 millicuries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daratumumab_ 10 mg and hyaluronidase-fihj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9144","description":"Injection_ daratumumab_ 10 mg and hyaluronidase-fihj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove skin nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64774","description":"Remove skin nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFF0","description":"ICD-BDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHE0","description":"ICD-BBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gauze <= 16 sq in water/sal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6228","description":"Gauze <= 16 sq in water/sal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFA1","description":"ICD-KDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin fetal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85461","description":"Hemoglobin fetal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat dislocation/fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23680","description":"Treat dislocation/fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWC0","description":"ICD-PHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES110","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDC0","description":"ICD-EFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mental status assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2014F","description":"Mental status assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neox Cord 1K_ Neox Cord RT_ or Clarix Cord 1K_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4148","description":"Neox Cord 1K_ Neox Cord RT_ or Clarix Cord 1K_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRF0","description":"ICD-KCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFA0","description":"ICD-GEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABB0","description":"ICD-AABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD220","description":"Special Care Low _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brain image < 4 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78600","description":"Brain image < 4 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCF0","description":"ICD-BCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMD1","description":"ICD-NDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWB0","description":"ICD-CEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICE1","description":"ICD-NICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of fecal fat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82715","description":"Assay of fecal fat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6006","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC2B","description":"Ultra High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0583U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","description":"CPT-0583U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLB0","description":"ICD-CCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBC0","description":"ICD-IBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam thoracolmb 2/> vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72080","description":"X-ray exam thoracolmb 2/> vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOF1","description":"ICD-HDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ chest; 3 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71047","description":"Radiologic examination_ chest; 3 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDA0","description":"ICD-OEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTA1","description":"ICD-IBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Power wheelchair noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0898","description":"Power wheelchair noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYE0","description":"ICD-CDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOC1","description":"ICD-CFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAB0","description":"ICD-NJAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTA1","description":"ICD-ECTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHB1","description":"ICD-IBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBA1","description":"ICD-IGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESF1","description":"ICD-PESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61520","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54110","description":"Treatment of penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNC1","description":"ICD-KGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETE0","description":"ICD-CETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAB1","description":"ICD-JGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUA1","description":"ICD-NCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plastazote sandal each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3265","description":"Plastazote sandal each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove bladder stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52318","description":"Remove bladder stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB244","description":"Special Care Low _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESB1","description":"ICD-KESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit alpha-1-proteinas diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9346","description":"Hit alpha-1-proteinas diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ meropenem (b. braun) not therapeutically equivalent to j2185_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2184","description":"Injection_ meropenem (b. braun) not therapeutically equivalent to j2185_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental case management - patient education to improve oral health literacy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9994","description":"Dental case management - patient education to improve oral health literacy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES305","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Med reas pt_ pn_ not doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8722","description":"Med reas pt_ pn_ not doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eval for deep sed/gen anesth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9219","description":"Eval for deep sed/gen anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAE1","description":"ICD-GHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Matristem wound matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4119","description":"Matristem wound matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cmv antibody igm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86645","description":"Cmv antibody igm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLA0","description":"ICD-AHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOC1","description":"ICD-PCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUF0","description":"ICD-ICUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious Disease Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4010","description":"Infectious Disease Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBA1","description":"ICD-JHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skills training and development_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2038","description":"Skills training and development_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMC1","description":"ICD-KHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPA0","description":"ICD-JEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoe lift elev heel/sole cor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3320","description":"Shoe lift elev heel/sole cor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATB1","description":"ICD-CATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNB1","description":"ICD-OLNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj benztropine mesylate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0515","description":"Inj benztropine mesylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8B","description":"Low Rehab_ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOA0","description":"ICD-PCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBC1","description":"ICD-OJBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPB0","description":"ICD-GFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMA0","description":"ICD-GEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYB0","description":"ICD-HBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLA1","description":"ICD-BGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99426","description":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ak flex inner socket ext fra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5651","description":"Ak flex inner socket ext fra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29010","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALC0","description":"ICD-MALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSA1","description":"ICD-PGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEB1","description":"ICD-OJEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIE0","description":"ICD-ODIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFA0","description":"ICD-JAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography with right heart catheterization with endo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7521","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography with right heart catheterization with endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spectrophotometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84311","description":"Spectrophotometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKE0","description":"ICD-GDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESF0","description":"ICD-DESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elbow arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29835","description":"Elbow arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit longterm infusion diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9347","description":"Hit longterm infusion diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBD1","description":"ICD-EHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amp reqd w/in 48h ieler proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9641","description":"Amp reqd w/in 48h ieler proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQF1","description":"ICD-OFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUB0","description":"ICD-EFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA24","description":"High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Promazine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2950","description":"Promazine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETA1","description":"ICD-EETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARE0","description":"ICD-PARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Afo w/ankle joint_ prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1971","description":"Afo w/ankle joint_ prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGE0","description":"ICD-KHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBE1","description":"ICD-NCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert picc cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36568","description":"Insert picc cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUF1","description":"ICD-CIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB24B","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Palb2 (Partner And Localizer Of Brca2) (Eg_ Breast And Pancreatic Cancer) Gene Analysis; Known Familial Variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81308","description":"Palb2 (Partner And Localizer Of Brca2) (Eg_ Breast And Pancreatic Cancer) Gene Analysis; Known Familial Variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPD0","description":"ICD-OAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"In111 oxyquinoline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9547","description":"In111 oxyquinoline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXF1","description":"ICD-GGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIC0","description":"ICD-CCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA0B","description":"Default_ /SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTD0","description":"ICD-NKTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay duodenal fluid trypsin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84485","description":"Assay duodenal fluid trypsin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IC11","description":"ICD-1IC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFE1","description":"ICD-NEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mobile arm supports reclinin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2628","description":"Mobile arm supports reclinin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAE0","description":"ICD-IDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYD0","description":"ICD-OFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWB1","description":"ICD-PJWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQE1","description":"ICD-GIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection alemtuzumab 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9979","description":"Injection alemtuzumab 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score ls not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8662","description":"Fun stat score ls not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOB0","description":"ICD-DDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6074","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYE1","description":"ICD-DIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAE1","description":"ICD-MLAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGA1","description":"ICD-FHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAND0","description":"ICD-CAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOE0","description":"ICD-CFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ 50 mcg/0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91322","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ 50 mcg/0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00528","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00528","description":"CPT-00528","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAA1","description":"ICD-EIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"TB screening not performed or results not interpreted_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1005","description":"TB screening not performed or results not interpreted_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Speech Language Pathology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4034","description":"Speech Language Pathology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc system reas adv imaging","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9537","description":"Doc system reas adv imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ana crown exp 4 or> per quad","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4230","description":"Ana crown exp 4 or> per quad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral occlusal film","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0240","description":"Intraoral occlusal film","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive Care Management For A Single High-Risk Disease Services_ E.G. Principal Care Management_ At Least 30 Minutes Of Clinical Staff Time Directed By A Physician Or Ot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2065","description":"Comprehensive Care Management For A Single High-Risk Disease Services_ E.G. Principal Care Management_ At Least 30 Minutes Of Clinical Staff Time Directed By A Physician Or Ot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTE1","description":"ICD-FHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTB1","description":"ICD-KHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Benzodiazepines1-12","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80346","description":"Benzodiazepines1-12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTF1","description":"ICD-OFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIF1","description":"ICD-FHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Device Supply With Initial Set-Up And Patient Education On Use Of Equipment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0704T","description":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Device Supply With Initial Set-Up And Patient Education On Use Of Equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBE0","description":"ICD-CFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUE0","description":"ICD-EAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCF1","description":"ICD-FCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0630U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","description":"CPT-0630U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDED1","description":"ICD-FDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDF1","description":"ICD-BEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Above knee surgical stocking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4490","description":"Above knee surgical stocking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDF1","description":"ICD-BBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemostatic agent_ gastrointestinal_ topical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1052","description":"Hemostatic agent_ gastrointestinal_ topical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ cell-free DNA_ analysis of 311 or more genes_ interrogation for sequence variants_ including substitutions_ ins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0239U","description":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ cell-free DNA_ analysis of 311 or more genes_ interrogation for sequence variants_ including substitutions_ ins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIC1","description":"ICD-BCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory bp analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93788","description":"Ambulatory bp analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; clinical staff under the direction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0822T","description":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; clinical staff under the direction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDE0","description":"ICD-IGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0565","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0565","description":"HCPCS-G0565","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUA0","description":"ICD-CGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCA1","description":"ICD-JHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Postop dsg bk ea add cast ch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5410","description":"Postop dsg bk ea add cast ch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGE1","description":"ICD-OCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: abnormal neurologic exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2189","description":"Patients with clinical indications for imaging of the head: abnormal neurologic exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWD1","description":"ICD-KGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPE1","description":"ICD-NKPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m depreotide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9536","description":"Tc99m depreotide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKA0","description":"ICD-JEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBB1","description":"ICD-FDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAA0","description":"ICD-KGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAA1","description":"ICD-EAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCE0","description":"ICD-MDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBA0","description":"ICD-GIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair special seat dept","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1297","description":"Wheelchair special seat dept","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of knuckle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26850","description":"Fusion of knuckle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAF0","description":"ICD-MIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJA1","description":"ICD-ODJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leuprolide acetate /3.75 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1950","description":"Leuprolide acetate /3.75 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1JA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JA21","description":"ICD-1JA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHB1","description":"ICD-ECHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1504","description":"HCPCS-A1504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOF1","description":"ICD-DGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHD1","description":"ICD-EGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ga67 gallium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9556","description":"Ga67 gallium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUB1","description":"ICD-IAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIE0","description":"ICD-KCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFB0","description":"ICD-CCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"AmchoPlast_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4316","description":"AmchoPlast_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEA0","description":"ICD-KAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploratory shoulder surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23044","description":"Exploratory shoulder surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVF0","description":"ICD-GEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQE1","description":"ICD-PKQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA32","description":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL25","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"I125 serum albumin_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9532","description":"I125 serum albumin_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admini on the same date of service_ 5 to 15 minutes time Medicaid only.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0310","description":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admini on the same date of service_ 5 to 15 minutes time Medicaid only.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUF0","description":"ICD-NIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of finger abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26011","description":"Drainage of finger abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crutch underarm each no wood","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0116","description":"Crutch underarm each no wood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXC0","description":"ICD-GEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE21A","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEE1","description":"ICD-KCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Multiple_ including serial trended analysis and limited reprogramming of device parameter - AV and VV delays_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0225T","description":"Multiple_ including serial trended analysis and limited reprogramming of device parameter - AV and VV delays_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGF1","description":"ICD-KEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath w/drainage 3-way","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4316","description":"Cath w/drainage 3-way","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59857","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVC0","description":"ICD-OIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQD0","description":"ICD-PHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB2A","description":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No surg proc w/in 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8628","description":"No surg proc w/in 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18C","description":"Clinically Complex _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adult size pull-on lg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4527","description":"Adult size pull-on lg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ mon_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5255","description":"Hearing aid_ digit_ mon_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAB1","description":"ICD-GAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTE1","description":"ICD-CCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAB1","description":"ICD-KFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Saliva test_ hormone level;","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3652","description":"Saliva test_ hormone level;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFA1","description":"ICD-NDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mobilization of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44139","description":"Mobilization of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electric heat pad standard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0210","description":"Electric heat pad standard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHF1","description":"ICD-AHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBD0","description":"ICD-AFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27258","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSF1","description":"ICD-OKSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1503","description":"HCPCS-C1503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHC1","description":"ICD-GAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC12D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNF1","description":"ICD-OBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMD1","description":"ICD-CBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 xtra hd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0829","description":"Pwc gp 2 xtra hd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNE1","description":"ICD-FBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAID1","description":"ICD-AAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay resin 3 surface","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2663","description":"Dental onlay resin 3 surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chiropractic medicine mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0065","description":"Chiropractic medicine mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Realignment of knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27455","description":"Realignment of knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKD0","description":"ICD-OJKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIA0","description":"ICD-FCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vasc graft into carpal bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25430","description":"Vasc graft into carpal bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLD0","description":"ICD-CBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMA0","description":"ICD-EFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBE1","description":"ICD-NEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRD0","description":"ICD-LCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERC0","description":"ICD-LERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVF0","description":"ICD-JHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cryopreserve testicular tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89335","description":"Cryopreserve testicular tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAD0","description":"ICD-KGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54125","description":"Removal of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLC1","description":"ICD-MLLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPF0","description":"ICD-NKPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYB0","description":"ICD-HFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt dischg >2d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9254","description":"Doc pt dischg >2d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1135","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXD1","description":"ICD-OHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOF1","description":"ICD-CEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of vein clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34490","description":"Removal of vein clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAC0","description":"ICD-GFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOC1","description":"ICD-OBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj ctr cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33955","description":"Ecmo/ecls insj ctr cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"So cap design w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3671","description":"So cap design w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26357","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bamlanivimab and etesevimab_ 2100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0245","description":"Injection_ bamlanivimab and etesevimab_ 2100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA20B","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA21A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAE1","description":"ICD-KDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1401","description":"HCPCS-B1401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWE0","description":"ICD-PFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of reason(s) sentinel lymph node biopsy not performed (e.g._ reasons could include but not limited to; non-invasive cancer_ incidental discovery of breast cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8880","description":"Documentation of reason(s) sentinel lymph node biopsy not performed (e.g._ reasons could include but not limited to; non-invasive cancer_ incidental discovery of breast cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3KC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KC21","description":"ICD-3KC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUD0","description":"ICD-BBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEB0","description":"ICD-NEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainable rubber pch w fcplt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4376","description":"Drainable rubber pch w fcplt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUB0","description":"ICD-IAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRC0","description":"ICD-ODRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28153","description":"Partial removal of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj tendon sheath/ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20550","description":"Inj tendon sheath/ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFC1","description":"ICD-CDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPB0","description":"ICD-GBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUB1","description":"ICD-CCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Benesch boot pair infant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3212","description":"Benesch boot pair infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Intermittent Monitoring And Maintenance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95706","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Intermittent Monitoring And Maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/o us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20605","description":"Drain/inj joint/bursa w/o us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mis sup/ac imp vad nopay med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0509","description":"Mis sup/ac imp vad nopay med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD250","description":"Reduced Physical Function _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat odontoid fx w/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22319","description":"Treat odontoid fx w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prep renal graft/arterial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50328","description":"Prep renal graft/arterial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cranio/maxillofacial surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21299","description":"Cranio/maxillofacial surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAF1","description":"ICD-JHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEC1","description":"ICD-JCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onlay cst base mtl >=3 surfa","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6613","description":"Onlay cst base mtl >=3 surfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXA0","description":"ICD-BEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPC1","description":"ICD-KHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRD0","description":"ICD-OKRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHF1","description":"ICD-FEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFF0","description":"ICD-FCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Create tear duct drain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68750","description":"Create tear duct drain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGA0","description":"ICD-NEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assess hlth/behave subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96151","description":"Assess hlth/behave subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrogastrography w/test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91133","description":"Electrogastrography w/test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNE0","description":"ICD-OGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) that follow-up imaging is indicated (e.g._ patient has a known malignancy that can metastasize_ other medical reason(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9755","description":"Documentation of medical reason(s) that follow-up imaging is indicated (e.g._ patient has a known malignancy that can metastasize_ other medical reason(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant cochlear device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69930","description":"Implant cochlear device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEF1","description":"ICD-MIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDC0","description":"ICD-NEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNB1","description":"ICD-NJNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBC0","description":"ICD-CDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bioimpedance cv analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93701","description":"Bioimpedance cv analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPB0","description":"ICD-KGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Throat surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42999","description":"Throat surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFB0","description":"ICD-NDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACD1","description":"ICD-FACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIE1","description":"ICD-JHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44360","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heavy duty battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4611","description":"Heavy duty battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQE1","description":"ICD-PLQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE12C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immntx 4 sting insects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95133","description":"Immntx 4 sting insects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prp i/hern init block >5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49507","description":"Prp i/hern init block >5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXF0","description":"ICD-NEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Second level cer diskectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22858","description":"Second level cer diskectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64654","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","description":"CPT-64654","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIID0","description":"ICD-OIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA215","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excisional biopsy of minor salivary glands","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7284","description":"Excisional biopsy of minor salivary glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLF0","description":"ICD-OLLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABID1","description":"ICD-ABID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPB1","description":"ICD-OFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEF0","description":"ICD-CDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHE0","description":"ICD-JBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct injured chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32820","description":"Reconstruct injured chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWC0","description":"ICD-OFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBE0","description":"ICD-EBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAB1","description":"ICD-MBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARC1","description":"ICD-DARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of eyelid fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67715","description":"Incision of eyelid fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAC0","description":"ICD-OBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEC1","description":"ICD-AAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUE0","description":"ICD-IIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1735","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1735","description":"HCPCS-C1735","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXD0","description":"ICD-CBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOC0","description":"ICD-PLOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt recvd 2 rx anti-emet agt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4558F","description":"Pt recvd 2 rx anti-emet agt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAC1","description":"ICD-CFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical; with guided transhepatic cholangiography_ without biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47560","description":"Laparoscopy_ surgical; with guided transhepatic cholangiography_ without biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB160","description":"Special Care Low _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB235","description":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFA1","description":"ICD-GBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8I","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXA0","description":"ICD-KAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Needle localization by xray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77002","description":"Needle localization by xray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAC1","description":"ICD-FIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Services performed by a doula birth worker_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1033","description":"Services performed by a doula birth worker_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial Strain Imaging Using Speckle Tracking-Derived Assessment Of Myocardial Mechanics (List Separately In Addition To Codes For Echocardiography Imaging)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93356","description":"Myocardial Strain Imaging Using Speckle Tracking-Derived Assessment Of Myocardial Mechanics (List Separately In Addition To Codes For Echocardiography Imaging)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD110","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGE1","description":"ICD-BEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Strep a dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87650","description":"Strep a dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKD1","description":"ICD-CHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKD1","description":"ICD-FAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove infected skull bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61501","description":"Remove infected skull bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRD1","description":"ICD-OBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autologous blood process","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86890","description":"Autologous blood process","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHC1","description":"ICD-NFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Services outside us","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9989","description":"Services outside us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJE0","description":"ICD-NGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCA1","description":"ICD-MGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAB1","description":"ICD-KDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJF1","description":"ICD-CDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of foot at ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27888","description":"Amputation of foot at ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anticoagulant management for a patient taking warfarin_ must include review and interpretation of a new home_ office_ or lab international normalized ratio (INR) test result_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93793","description":"Anticoagulant management for a patient taking warfarin_ must include review and interpretation of a new home_ office_ or lab international normalized ratio (INR) test result_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Microbe suscept macrobroth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87188","description":"Microbe suscept macrobroth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81364","description":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI lower extremity w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73719","description":"MRI lower extremity w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAE0","description":"ICD-EHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKE0","description":"ICD-KIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAF1","description":"ICD-GFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28I","description":"Special Care High _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Occult bld feces 1-3 tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82272","description":"Occult bld feces 1-3 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Office emergency care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99058","description":"Office emergency care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE251","description":"Special Care Low _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1001","description":"HCPCS-B1001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Phototherap keratect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0812","description":"Phototherap keratect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tcran magn stim redetemine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90869","description":"Tcran magn stim redetemine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Back pain was not measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 - 20 weeks) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9943","description":"Back pain was not measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 - 20 weeks) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Financial mgt waiver/15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2040","description":"Financial mgt waiver/15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADA0","description":"ICD-AADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNF0","description":"ICD-KDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSC1","description":"ICD-CCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc medrsn no compl antibio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9300","description":"Doc medrsn no compl antibio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc med reas no follow imag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9555","description":"Doc med reas no follow imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0503","description":"HCPCS-C0503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXA0","description":"ICD-OLXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA201","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESC1","description":"ICD-KESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANF1","description":"ICD-OANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDA0","description":"ICD-CIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOF0","description":"ICD-GDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJF1","description":"ICD-GFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair retinal detach cplx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67113","description":"Repair retinal detach cplx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSF0","description":"ICD-DGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"W/c vent tray gimbaled","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1030","description":"W/c vent tray gimbaled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection into spinal artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62294","description":"Injection into spinal artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKA1","description":"ICD-ODKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQA1","description":"ICD-PIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBC1","description":"ICD-CCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27612","description":"Exploration of ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary ovarian cancer (eg_ hereditary ovarian cancer_ hereditary endometrial cancer)_ genomic sequence analysis panel utilizing a combination of NGS_ Sanger_ MLPA_ and arr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0103U","description":"Hereditary ovarian cancer (eg_ hereditary ovarian cancer_ hereditary endometrial cancer)_ genomic sequence analysis panel utilizing a combination of NGS_ Sanger_ MLPA_ and arr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBF1","description":"ICD-GIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"PermeaDerm glove_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2017","description":"PermeaDerm glove_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLE1","description":"ICD-AFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDD1","description":"ICD-BHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction anal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46924","description":"Destruction anal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA15B","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPE0","description":"ICD-OHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHC0","description":"ICD-MGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Whirlpool non-portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1310","description":"Whirlpool non-portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLE0","description":"ICD-KCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVD1","description":"ICD-FFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28F","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interim crown-further treatment or completion of diagnosis necessary prior to final impression","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2799","description":"Interim crown-further treatment or completion of diagnosis necessary prior to final impression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRE1","description":"ICD-PJRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUA1","description":"ICD-JHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hallux implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8642","description":"Hallux implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCD0","description":"ICD-OKCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDF0","description":"ICD-EBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ phenylephrine HCl (Immphentiv)_ 20 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2373","description":"Injection_ phenylephrine HCl (Immphentiv)_ 20 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOE1","description":"ICD-KBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITD0","description":"ICD-BITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antibody testing for a public health related pathogen_ including coronavirus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0605","description":"Antibody testing for a public health related pathogen_ including coronavirus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIA0","description":"ICD-MCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rocker bottom_ contact afo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2232","description":"Rocker bottom_ contact afo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECD1","description":"ICD-EECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory bp monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93784","description":"Ambulatory bp monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gadobutrol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9585","description":"Gadobutrol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17107","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTC0","description":"ICD-NBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01490","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01490","description":"CPT-01490","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILF0","description":"ICD-OILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOA1","description":"ICD-HEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hkafo unilat torsion cable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2080","description":"Hkafo unilat torsion cable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heinz bodies induced","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85445","description":"Heinz bodies induced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ald blu tooth fm/dm receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5286","description":"Ald blu tooth fm/dm receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ burosumab-twza_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0584","description":"Injection_ burosumab-twza_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28G","description":"Special Care High _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Custom glove for term device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6895","description":"Custom glove for term device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Closure of windpipe lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31820","description":"Closure of windpipe lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXA0","description":"ICD-KEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKD0","description":"ICD-NKKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENC0","description":"ICD-OENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAA1","description":"ICD-GIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01920","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01920","description":"CPT-01920","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPC1","description":"ICD-OCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAC1","description":"ICD-JAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1407","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","description":"HCPCS-M1407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artificial insemination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58321","description":"Artificial insemination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTC1","description":"ICD-EGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANC0","description":"ICD-OANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD206","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37258","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","description":"CPT-37258","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electronic spirometer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0487","description":"Electronic spirometer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Filter gone aft 3mos placmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9541","description":"Filter gone aft 3mos placmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLE1","description":"ICD-MDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEB0","description":"ICD-OFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTE0","description":"ICD-JBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHB0","description":"ICD-EBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation Device Evaluation(S) (Remote)_ Up To 90 Days_ Substernal Lead Implantable Cardioverter-Defibrillator System_ Remote Data Acquisition(S)_ Receipt Of Transmissions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0579T","description":"Interrogation Device Evaluation(S) (Remote)_ Up To 90 Days_ Substernal Lead Implantable Cardioverter-Defibrillator System_ Remote Data Acquisition(S)_ Receipt Of Transmissions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch clsd w barrier/filtr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4416","description":"Ost pch clsd w barrier/filtr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair paravag defect vag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57285","description":"Repair paravag defect vag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWA1","description":"ICD-OAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93622","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKE1","description":"ICD-JIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL2C","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNE0","description":"ICD-CDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of inner eye fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67036","description":"Removal of inner eye fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orion_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4276","description":"Orion_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXA0","description":"ICD-KHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYB0","description":"ICD-LBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo guide for artery repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76936","description":"Echo guide for artery repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLD0","description":"ICD-FFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Axillary crutch extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0978","description":"Axillary crutch extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNB0","description":"ICD-JCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBC1","description":"ICD-NDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insulin cartridge 300 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5566","description":"Insulin cartridge 300 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1122","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autoimmune (systemic lupus erythematosus)_ IgG and IgM analysis of 80 biomarkers_ utilizing serum_ algorithm reported with a risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0062U","description":"Autoimmune (systemic lupus erythematosus)_ IgG and IgM analysis of 80 biomarkers_ utilizing serum_ algorithm reported with a risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL2C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMA0","description":"ICD-NCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EA11","description":"ICD-2EA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kras gene variants exon 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81275","description":"Kras gene variants exon 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHA1","description":"ICD-OFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of epididymis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54861","description":"Removal of epididymis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Synthetic graft facial bones","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7995","description":"Synthetic graft facial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc surv no stroke after cas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9259","description":"Doc surv no stroke after cas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPE0","description":"ICD-GFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHA1","description":"ICD-GAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNF0","description":"ICD-NFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0678U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678U","description":"CPT-0678U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLD1","description":"ICD-NCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJF0","description":"ICD-NBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWC0","description":"ICD-HIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28C","description":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cvd risk assessment not performed or incomplete (e.g._ cvd risk assessment was not documented)_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1257","description":"Cvd risk assessment not performed or incomplete (e.g._ cvd risk assessment was not documented)_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXD1","description":"ICD-OCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHA1","description":"ICD-NGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYD0","description":"ICD-GEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUB1","description":"ICD-NLUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (pancreatic)_ DNA_ whole genome sequencing with 5-hydroxymethylcytosine enrichment_ whole blood or plasma_ algorithm reported as cancer detected or not detected","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0410U","description":"Oncology (pancreatic)_ DNA_ whole genome sequencing with 5-hydroxymethylcytosine enrichment_ whole blood or plasma_ algorithm reported as cancer detected or not detected","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release of nasal adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30560","description":"Release of nasal adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doppler echo exam heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93321","description":"Doppler echo exam heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPF0","description":"ICD-NAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18H","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pentamidine non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2545","description":"Pentamidine non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Brain Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1078","description":"Radiation Therapy For Brain Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFF0","description":"ICD-JDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXF0","description":"ICD-KCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPC1","description":"ICD-GAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endometrial sampling or hysteroscopy with biopsy and results not documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9824","description":"Endometrial sampling or hysteroscopy with biopsy and results not documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair major vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33321","description":"Repair major vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAA1","description":"ICD-OIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOA1","description":"ICD-OHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Emer rspns system purchase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5162","description":"Emer rspns system purchase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-81354","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","description":"CPT-81354","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICA0","description":"ICD-JICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert electrodes for eeg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95830","description":"Insert electrodes for eeg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Twist drill hole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61105","description":"Twist drill hole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL46","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray adrenal gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75840","description":"Vein x-ray adrenal gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Photodynmc tx 30 min add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96570","description":"Photodynmc tx 30 min add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQE0","description":"ICD-GEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMD0","description":"ICD-BEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6076","description":"Implant supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lengthen radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25393","description":"Lengthen radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNC1","description":"ICD-KHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00214","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00214","description":"CPT-00214","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Burr hole for puncture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61120","description":"Burr hole for puncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Scanning Analysis With Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93247","description":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Scanning Analysis With Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAA0","description":"ICD-ODAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFE1","description":"ICD-KGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASB0","description":"ICD-DASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWA1","description":"ICD-OIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj enoxaparin sodium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1650","description":"Inj enoxaparin sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL54","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAD1","description":"ICD-AEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBB0","description":"ICD-OBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal septal prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8047","description":"Nasal septal prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNE1","description":"ICD-FDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAED1","description":"ICD-OAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0592U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","description":"CPT-0592U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01942","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","description":"CPT-01942","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXB1","description":"ICD-FHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISB0","description":"ICD-CISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap vent/abd hern proc comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49653","description":"Lap vent/abd hern proc comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA06","description":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daptomycin (hospira)_ not therapeutically equivalent to j0878_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0877","description":"Injection_ daptomycin (hospira)_ not therapeutically equivalent to j0878_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIE1","description":"ICD-EAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOB1","description":"ICD-PLOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIC0","description":"ICD-FAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCA1","description":"ICD-OFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWC0","description":"ICD-CIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Above knee hydracadence","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5610","description":"Above knee hydracadence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt no doc hear loss","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8567","description":"Pt no doc hear loss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art or venous blood tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4750","description":"Art or venous blood tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (papillary thyroid cancer)_ gene-expression profiling via targeted hybrid captureā€“enrichment RNA sequencing of 82 content genes and 10 housekeeping genes_ formalin-fi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0362U","description":"Oncology (papillary thyroid cancer)_ gene-expression profiling via targeted hybrid captureā€“enrichment RNA sequencing of 82 content genes and 10 housekeeping genes_ formalin-fi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (List separately in addition to code for primary proce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0839T","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (List separately in addition to code for primary proce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Determine refractive state","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92015","description":"Determine refractive state","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNA1","description":"ICD-JDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVA1","description":"ICD-FCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAF0","description":"ICD-KDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCB1","description":"ICD-GGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair bladder & vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57289","description":"Repair bladder & vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE151","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ak/ft power asst incl motors","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5969","description":"Ak/ft power asst incl motors","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKE1","description":"ICD-GBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flortaucipir F 18 injection_ diagnostic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9601","description":"Flortaucipir F 18 injection_ diagnostic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKD1","description":"ICD-BDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No ret for surg w in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9307","description":"No ret for surg w in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brain aneurysm repr complx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61698","description":"Brain aneurysm repr complx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Analyze neurostim no prog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95970","description":"Analyze neurostim no prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anticoag clinic per session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9401","description":"Anticoag clinic per session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCID0","description":"ICD-KCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA33","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC25A","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17263","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWC1","description":"ICD-DFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace picc cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36584","description":"Replace picc cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFA0","description":"ICD-KEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Team conf w/o pat by phys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99367","description":"Team conf w/o pat by phys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUD0","description":"ICD-FBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITF0","description":"ICD-NITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEA0","description":"ICD-KCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of hydrocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55500","description":"Removal of hydrocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADE1","description":"ICD-IADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFF1","description":"ICD-OIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQE0","description":"ICD-PEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRA0","description":"ICD-LIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFA0","description":"ICD-KFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECD0","description":"ICD-MECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glasses cros hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5190","description":"Glasses cros hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE25D","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA02","description":"Default_ /Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0584U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","description":"CPT-0584U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTD1","description":"ICD-JFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBA1","description":"ICD-IEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHF0","description":"ICD-KCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUC1","description":"ICD-KAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iodine i-123 ioflupane","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9584","description":"Iodine i-123 ioflupane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPF1","description":"ICD-OEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of thigh/knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27496","description":"Decompression of thigh/knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKB0","description":"ICD-JAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKB0","description":"ICD-FAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYF1","description":"ICD-OLYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNB0","description":"ICD-NFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65275","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLE0","description":"ICD-OLLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOB1","description":"ICD-LAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUF0","description":"ICD-FHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adult size brief/diaper med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4522","description":"Adult size brief/diaper med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fosnetupitant 235 mg and palonosetron 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1454","description":"Injection_ fosnetupitant 235 mg and palonosetron 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adult size pull-on med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4526","description":"Adult size pull-on med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYF0","description":"ICD-GDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGA1","description":"ICD-JEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8012","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8012","description":"HCPCS-C8012","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSE0","description":"ICD-KFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUD0","description":"ICD-CHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDB0","description":"ICD-CGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auditory osseointegrated device_ transducer/actuator_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8694","description":"Auditory osseointegrated device_ transducer/actuator_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIB0","description":"ICD-MHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL2A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4DA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DA31","description":"ICD-4DA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTE1","description":"ICD-MGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gasket or seal_ for use with prosthetic socket insert_ any type_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7700","description":"Gasket or seal_ for use with prosthetic socket insert_ any type_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pfizer-BioNTech Covid-19 vaccine administration - third dose (SARSCOV2 COVID-19 VAC mRNA 30mcg/0.3mL IM DOSE 3)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1708","description":"Pfizer-BioNTech Covid-19 vaccine administration - third dose (SARSCOV2 COVID-19 VAC mRNA 30mcg/0.3mL IM DOSE 3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDD0","description":"ICD-NIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAD0","description":"ICD-IHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAB0","description":"ICD-MAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl of subq defibrillator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33272","description":"Rmvl of subq defibrillator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc leg/ankle tum deep <5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27619","description":"Exc leg/ankle tum deep <5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAC1","description":"ICD-NJAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Robotic surgical system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2900","description":"Robotic surgical system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair rectum-vagina fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57300","description":"Repair rectum-vagina fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDF0","description":"ICD-ABDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"L colectomy/coloproctostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44207","description":"L colectomy/coloproctostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autoimmune rheumatoid arthr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81490","description":"Autoimmune rheumatoid arthr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove cerclage suture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59871","description":"Remove cerclage suture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chromatography_ qualitative; paper_ 2-dimensional_ analyte not elsewhere specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82488","description":"Chromatography_ qualitative; paper_ 2-dimensional_ analyte not elsewhere specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ ns_ non-hdrir-192","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1719","description":"Brachytx_ ns_ non-hdrir-192","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWE1","description":"ICD-GFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPC1","description":"ICD-FCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWE0","description":"ICD-PLWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breast prosthesis nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8039","description":"Breast prosthesis nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDA0","description":"ICD-OJDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJD1","description":"ICD-GEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Afo pos solid ank plastic mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1960","description":"Afo pos solid ank plastic mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRB1","description":"ICD-DIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNC0","description":"ICD-BHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enzyme cell activity ra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82658","description":"Enzyme cell activity ra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFB0","description":"ICD-OIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFE0","description":"ICD-CCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWA1","description":"ICD-OCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB250","description":"Clinically Complex _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUA1","description":"ICD-MEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUB1","description":"ICD-CEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cabg measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8544","description":"Cabg measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gen w/c cushion wdth >=22 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2602","description":"Gen w/c cushion wdth >=22 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACF0","description":"ICD-JACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDA1","description":"ICD-OCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFA1","description":"ICD-BDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc brstcncr stage 2 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3376F","description":"Ajcc brstcncr stage 2 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJC1","description":"ICD-KBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAA0","description":"ICD-GGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLD0","description":"ICD-NKLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIID1","description":"ICD-AIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCF1","description":"ICD-EBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adjust ankle ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1815","description":"Adjust ankle ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC12C","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXC0","description":"ICD-JGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-63032","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","description":"CPT-63032","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay growth hormone (hgh)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83003","description":"Assay growth hormone (hgh)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ischm stroke symp ge3 hrsb/4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1066F","description":"Ischm stroke symp ge3 hrsb/4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage board postural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0606","description":"Drainage board postural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immune globulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90399","description":"Immune globulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28294","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB106","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGD0","description":"ICD-GIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMF1","description":"ICD-CEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ortho sidebar disconnect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2768","description":"Ortho sidebar disconnect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEC1","description":"ICD-FHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis machine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1590","description":"Hemodialysis machine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0407","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0407","description":"HCPCS-C0407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin fungi culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87101","description":"Skin fungi culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00174","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00174","description":"CPT-00174","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBC0","description":"ICD-OJBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01462","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01462","description":"CPT-01462","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extraction of lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66930","description":"Extraction of lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1250","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urology surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53899","description":"Urology surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFF1","description":"ICD-NIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair lower leg tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27675","description":"Repair lower leg tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of major peripheral nerve neuroma_ except sciatic_ with implantation of nerve end into bone or muscle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7551","description":"Excision of major peripheral nerve neuroma_ except sciatic_ with implantation of nerve end into bone or muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCB0","description":"ICD-KFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLB1","description":"ICD-EGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSE1","description":"ICD-DFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIB0","description":"ICD-MIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMC1","description":"ICD-FEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYE1","description":"ICD-LAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove part lumbar vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22114","description":"Remove part lumbar vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHE0","description":"ICD-AFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pm generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33233","description":"Removal of pm generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADD0","description":"ICD-IADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mucopolysaccharides","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83864","description":"Mucopolysaccharides","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJA0","description":"ICD-CCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQE1","description":"ICD-OBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18D","description":"Clinically Complex _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRE0","description":"ICD-OCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCF0","description":"ICD-EGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIB0","description":"ICD-MLIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQC1","description":"ICD-LDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orthopedic shoe add rub insl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3510","description":"Orthopedic shoe add rub insl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise penis/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54336","description":"Revise penis/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVF0","description":"ICD-OHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of chest artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37616","description":"Ligation of chest artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE236","description":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Harvest Of Upper Extremity Artery_ 1 Segment_ For Coronary Artery Bypass Procedure_ Endoscopic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33509","description":"Harvest Of Upper Extremity Artery_ 1 Segment_ For Coronary Artery Bypass Procedure_ Endoscopic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATB1","description":"ICD-MATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHA0","description":"ICD-EDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Physician Or Other Qualified Health Care Professional Services For Outpatient Pulmonary Rehabilitation; With Continuous Oximetry Monitoring (Per Session)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94626","description":"Physician Or Other Qualified Health Care Professional Services For Outpatient Pulmonary Rehabilitation; With Continuous Oximetry Monitoring (Per Session)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of thumb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26841","description":"Fusion of thumb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67516","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTD1","description":"ICD-GCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXD1","description":"ICD-KEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUD0","description":"ICD-NJUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUF0","description":"ICD-ODUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC11A","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJC0","description":"ICD-NGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L7406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","description":"HCPCS-L7406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (ovarian)_ spheroid cell culture_ poly (ADP-ribose) polymerase (PARP) inhibitors (niraparib_ olaparib_ rucaparib_ velparib)_ tumor response prediction for each drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0325U","description":"Oncology (ovarian)_ spheroid cell culture_ poly (ADP-ribose) polymerase (PARP) inhibitors (niraparib_ olaparib_ rucaparib_ velparib)_ tumor response prediction for each drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5273","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA205","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4AC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AC31","description":"ICD-4AC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHD0","description":"ICD-ACHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open coronary endarterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33572","description":"Open coronary endarterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUB1","description":"ICD-BCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFE1","description":"ICD-BHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXF0","description":"ICD-GHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGA1","description":"ICD-OIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDF0","description":"ICD-BCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown 3/4 cast hi noble met","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2780","description":"Crown 3/4 cast hi noble met","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELB1","description":"ICD-KELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18D","description":"Special Care High _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC1A","description":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic passive restor cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6370","description":"Thoracic passive restor cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heart pacing mapping","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93631","description":"Heart pacing mapping","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEC1","description":"ICD-NBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood viscosity examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85810","description":"Blood viscosity examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVA1","description":"ICD-KAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKB0","description":"ICD-NDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPC0","description":"ICD-BDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBC0","description":"ICD-BCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Slp stdy unattended","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95800","description":"Slp stdy unattended","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX60","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQA0","description":"ICD-DHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBB1","description":"ICD-OFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPE1","description":"ICD-NLPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTF1","description":"ICD-EFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAE1","description":"ICD-EEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Betadine/phisohex solution","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4246","description":"Betadine/phisohex solution","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gi wireless capsule measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91112","description":"Gi wireless capsule measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJB0","description":"ICD-NBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Closure of split wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12020","description":"Closure of split wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKD0","description":"ICD-NLKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28I","description":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair detached retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67108","description":"Repair detached retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXF1","description":"ICD-BDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPB0","description":"ICD-NCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPF1","description":"ICD-KCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMF0","description":"ICD-EEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKE0","description":"ICD-FEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGME1","description":"ICD-KGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEE0","description":"ICD-EGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMD1","description":"ICD-FFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dexamethasone comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7638","description":"Dexamethasone comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0501","description":"HCPCS-B0501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHF0","description":"ICD-MJHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients using hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9688","description":"Patients using hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDE1","description":"ICD-BBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1454","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","description":"HCPCS-M1454","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUF1","description":"ICD-CDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary breast cancer-related disorders (eg_ hereditary breast cancer_ hereditary ovarian cancer_ hereditary endometrial cancer); genomic sequence analysis panel_ must incl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81432","description":"Hereditary breast cancer-related disorders (eg_ hereditary breast cancer_ hereditary ovarian cancer_ hereditary endometrial cancer); genomic sequence analysis panel_ must incl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRC0","description":"ICD-PCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXD1","description":"ICD-GBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1429","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","description":"HCPCS-M1429","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMA1","description":"ICD-KDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol 74-100 gm pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4197","description":"Parenteral sol 74-100 gm pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99151","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQC1","description":"ICD-PCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immune complex assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86332","description":"Immune complex assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay phosphohexose enzymes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84087","description":"Assay phosphohexose enzymes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHB0","description":"ICD-GFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXD0","description":"ICD-NDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Puraply_ puraply antimic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9349","description":"Puraply_ puraply antimic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Speech audiometry complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92556","description":"Speech audiometry complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Community/work reintegration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97537","description":"Community/work reintegration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Community Transition Svcs (Set-Up Fees)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7335","description":"Community Transition Svcs (Set-Up Fees)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cemiplimab-rwlc_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9044","description":"Injection_ cemiplimab-rwlc_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQC0","description":"ICD-KDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUF0","description":"ICD-JFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rv1 vacc 2 dose live oral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90681","description":"Rv1 vacc 2 dose live oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVC1","description":"ICD-BHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX3B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4IB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IB31","description":"ICD-4IB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPF0","description":"ICD-KAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITF1","description":"ICD-AITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJA1","description":"ICD-BAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBE0","description":"ICD-FDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sip and puff interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2325","description":"Sip and puff interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esrd demo bundle-level ii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9014","description":"Esrd demo bundle-level ii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8B","description":"Medium Rehab _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX44","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAD0","description":"ICD-NCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWF0","description":"ICD-DHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTE1","description":"ICD-FCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of suture from anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46754","description":"Removal of suture from anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD121","description":"Special Care Low _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTC1","description":"ICD-MHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pierce skull & explore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61250","description":"Pierce skull & explore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Locm 300-399mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9967","description":"Locm 300-399mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plas shoe insert w ank joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2180","description":"Plas shoe insert w ank joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dolasetron mesylate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1260","description":"Dolasetron mesylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glycosylated acute phase proteins (GlycA)_ nuclear magnetic resonance spectroscopy_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0024U","description":"Glycosylated acute phase proteins (GlycA)_ nuclear magnetic resonance spectroscopy_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWB1","description":"ICD-OFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35022","description":"Repair artery rupture chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUB1","description":"ICD-EHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELE0","description":"ICD-CELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit enteral pump diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9342","description":"Hit enteral pump diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITA1","description":"ICD-OITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANF0","description":"ICD-NANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYC0","description":"ICD-HCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"DI GNOTYP SLC4A1 EXON 19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0183U","description":"DI GNOTYP SLC4A1 EXON 19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJE1","description":"ICD-NJJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGE0","description":"ICD-NGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid organ neoplasia)_ targeted genomic sequence analysis panel of 361 genes_ interrogation for gene fusions_ translocations_ or other rearrangements_ using DNA fro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0444U","description":"Oncology (solid organ neoplasia)_ targeted genomic sequence analysis panel of 361 genes_ interrogation for gene fusions_ translocations_ or other rearrangements_ using DNA fro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHD1","description":"ICD-GDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aspirin recvd w/in 24 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4084F","description":"Aspirin recvd w/in 24 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBF0","description":"ICD-MHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0994T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","description":"CPT-0994T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGD0","description":"ICD-CGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urtr inj at surg/1mos post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9631","description":"Urtr inj at surg/1mos post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj filgrastim gcsf biosimil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5101","description":"Inj filgrastim gcsf biosimil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIE1","description":"ICD-FIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHF0","description":"ICD-IEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inlay titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6624","description":"Inlay titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXE1","description":"ICD-NDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Community Transition Svcs (Moving Expenses)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7333","description":"Community Transition Svcs (Moving Expenses)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWF1","description":"ICD-CEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTD1","description":"ICD-EBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown 3/4 resin-based compos","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2712","description":"Crown 3/4 resin-based compos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Calculus spectroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82365","description":"Calculus spectroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLD0","description":"ICD-MLLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA12D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93975","description":"Vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKE1","description":"ICD-GEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1602","description":"HCPCS-A1602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB0A","description":"Low Rehab_ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx prostate unknwn nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9083","description":"Onc dx prostate unknwn nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNC1","description":"ICD-CCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQF1","description":"ICD-PDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0521U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","description":"CPT-0521U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home visit est patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99347","description":"Home visit est patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acth stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80400","description":"Acth stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert non-tunnel cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36555","description":"Insert non-tunnel cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBE1","description":"ICD-KFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLF0","description":"ICD-NFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6077","description":"Implant supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Beta-2 glycoprotein antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86146","description":"Beta-2 glycoprotein antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUB1","description":"ICD-MHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWD0","description":"ICD-PLWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0984T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","description":"CPT-0984T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVD1","description":"ICD-OEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of palm tendon each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26170","description":"Removal of palm tendon each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0661","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","description":"HCPCS-G0661","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mitoxantrone hydrochl / 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9293","description":"Mitoxantrone hydrochl / 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; common deletions or variant (eg_ Southeast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81257","description":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; common deletions or variant (eg_ Southeast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECA1","description":"ICD-GECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYF1","description":"ICD-HAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILD0","description":"ICD-KILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQF0","description":"ICD-PIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endocrinology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4004","description":"Endocrinology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of prostate abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55720","description":"Drainage of prostate abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADD0","description":"ICD-KADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUC0","description":"ICD-IDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2FC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FC21","description":"ICD-2FC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLB0","description":"ICD-OKLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prgrmg dev eval impltbl sys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93260","description":"Prgrmg dev eval impltbl sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUE0","description":"ICD-NHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-99470","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","description":"CPT-99470","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-76015","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","description":"CPT-76015","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal and replacement of implanted vestibular device_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0727T","description":"Removal and replacement of implanted vestibular device_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Mycoplasma Genitalium_ Amplified Probe Technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87563","description":"Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Mycoplasma Genitalium_ Amplified Probe Technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNC0","description":"ICD-KGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAF1","description":"ICD-KDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES351","description":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATE1","description":"ICD-FATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOE1","description":"ICD-DAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention_ under skin or into muscle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0012","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention_ under skin or into muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAE0","description":"ICD-EFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stoma plug or seal_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5081","description":"Stoma plug or seal_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD10A","description":"Special Care Low _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth kidney/ureter surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86251","description":"Anesth kidney/ureter surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLA1","description":"ICD-EDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ins vag brachytx device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57156","description":"Ins vag brachytx device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRF1","description":"ICD-DDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYE1","description":"ICD-KEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endo knee-shin frct swg & st","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5812","description":"Endo knee-shin frct swg & st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFA1","description":"ICD-KCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGA0","description":"ICD-KAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB141","description":"Special Care High _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSA0","description":"ICD-PFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0600U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","description":"CPT-0600U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tx contour defects 1.1-5.0cc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11951","description":"Tx contour defects 1.1-5.0cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB60","description":"Ultra High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXA0","description":"ICD-NHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARC0","description":"ICD-DARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXA0","description":"ICD-NEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oligoclonal bands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83916","description":"Oligoclonal bands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAC1","description":"ICD-IBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA104","description":"Reduced Physical Function _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAD0","description":"ICD-AAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1447","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","description":"HCPCS-M1447","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUA1","description":"ICD-NAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJF0","description":"ICD-JGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPF1","description":"ICD-GHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUC1","description":"ICD-JEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49428","description":"Ligation of shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVB1","description":"ICD-FBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAE1","description":"ICD-JDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enterovirus antibody dfa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87267","description":"Enterovirus antibody dfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLF0","description":"ICD-KBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXC0","description":"ICD-CDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX60","description":"Medium Rehab plus Extensive_ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Azathioprine parenteral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7501","description":"Azathioprine parenteral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHA0","description":"ICD-CBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCA1","description":"ICD-NBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Anal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1073","description":"Radiation Therapy For Anal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Allergen specific IgE; quantitative or semiquantitative_ recombinant or purified component_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86008","description":"Allergen specific IgE; quantitative or semiquantitative_ recombinant or purified component_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMC0","description":"ICD-KHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Multipo locking shoulder jnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6646","description":"Multipo locking shoulder jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRB0","description":"ICD-KIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bp out of nrml limits","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9274","description":"Bp out of nrml limits","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEB0","description":"ICD-FBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMA1","description":"ICD-FIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Family Medicine Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4005","description":"Family Medicine Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHA1","description":"ICD-JFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tx contour defects 1 cc/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11950","description":"Tx contour defects 1 cc/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIB1","description":"ICD-CEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surgery of breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40651","description":"Anesth surgery of breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0593U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","description":"CPT-0593U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX15","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ins lt atrl mont pres lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0294T","description":"Ins lt atrl mont pres lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"SARSCOV2 VAC 3 MCG TRS-SUCR","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91308","description":"SARSCOV2 VAC 3 MCG TRS-SUCR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD140","description":"Clinically Complex _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX55","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diag bronchoscope/catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31643","description":"Diag bronchoscope/catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALB1","description":"ICD-NALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Admin influenza virus vac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0008","description":"Admin influenza virus vac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEC0","description":"ICD-CIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDE1","description":"ICD-GFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHC0","description":"ICD-ADHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fibrin degradation quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85379","description":"Fibrin degradation quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDE0","description":"ICD-FIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDB0","description":"ICD-EDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRE1","description":"ICD-GGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ho flex pavlik harns pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1620","description":"Ho flex pavlik harns pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA33","description":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0701","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0701","description":"HCPCS-B0701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSD1","description":"ICD-HFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electron beam computed tomog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8092","description":"Electron beam computed tomog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEB1","description":"ICD-MHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTE1","description":"ICD-KBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1474","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","description":"HCPCS-M1474","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLC1","description":"ICD-MCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA53","description":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEF1","description":"ICD-JFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVE1","description":"ICD-GGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOC0","description":"ICD-CHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Total hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58152","description":"Total hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemical peel face epiderm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15788","description":"Chemical peel face epiderm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pre-prxd rsk et al docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3018F","description":"Pre-prxd rsk et al docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTB0","description":"ICD-FDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFA1","description":"ICD-NIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEA1","description":"ICD-FDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8F","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC12B","description":"Special Care High _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Office consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99244","description":"Office consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFB1","description":"ICD-KIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat scor nek/ts not don","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8674","description":"Fun stat scor nek/ts not don","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followin","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA60","description":"High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHID1","description":"ICD-OHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC113","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Caloric vestibular test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92533","description":"Caloric vestibular test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Salmonella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86768","description":"Salmonella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPA0","description":"ICD-BDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insulin tolerance panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80434","description":"Insulin tolerance panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCB0","description":"ICD-CHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOB1","description":"ICD-LFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRB0","description":"ICD-LGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERE1","description":"ICD-GERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADD0","description":"ICD-CADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mapcp demo community","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9152","description":"Mapcp demo community","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDA0","description":"ICD-BDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of pelvic fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57020","description":"Drainage of pelvic fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIA1","description":"ICD-CGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFF1","description":"ICD-GGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMD0","description":"ICD-OIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELE1","description":"ICD-OELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTD1","description":"ICD-BHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1468","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","description":"HCPCS-M1468","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Group behave couns 2-10","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0473","description":"Group behave couns 2-10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWA1","description":"ICD-DAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8A","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plast socket jts/thgh lacer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5105","description":"Plast socket jts/thgh lacer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57500","description":"Biopsy of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD116","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAA1","description":"ICD-MEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQA1","description":"ICD-PJQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage lymph node lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38305","description":"Drainage lymph node lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHC0","description":"ICD-CEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHA1","description":"ICD-MHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology (coronary heart disease [CAD])_ 9 genes (12 variants)_ targeted variant genotyping_ blood_ saliva_ or buccal swab_ algorithm reported as a genetic risk score for a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0401U","description":"Cardiology (coronary heart disease [CAD])_ 9 genes (12 variants)_ targeted variant genotyping_ blood_ saliva_ or buccal swab_ algorithm reported as a genetic risk score for a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETB0","description":"ICD-KETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11426","description":"Exc h-f-nk-sp b9+marg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANA0","description":"ICD-OANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL06","description":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSE1","description":"ICD-OCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWD1","description":"ICD-PFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESC1","description":"ICD-DESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21600","description":"Partial removal of rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay rbc cholinesterase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82482","description":"Assay rbc cholinesterase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMC0","description":"ICD-MEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Postop dress & 1 cast chg bk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5400","description":"Postop dress & 1 cast chg bk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOB1","description":"ICD-HGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18I","description":"Special Care Low _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE23C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compres burn garment leotard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6510","description":"Compres burn garment leotard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGME0","description":"ICD-OGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLD0","description":"ICD-OLLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVD1","description":"ICD-CHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESD0","description":"ICD-HESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDE1","description":"ICD-MIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFC0","description":"ICD-KHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clsd ostomy pouch faceplate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5053","description":"Clsd ostomy pouch faceplate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Arm tendon lengthening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24305","description":"Arm tendon lengthening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJC0","description":"ICD-NKJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMA1","description":"ICD-NEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFB1","description":"ICD-JEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abltj Perc Cryoabltj Img Gdn Uxtr/Perph Nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0440T","description":"Abltj Perc Cryoabltj Img Gdn Uxtr/Perph Nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ftrst upper hanger bracket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0044","description":"Ftrst upper hanger bracket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD11C","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of residual cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57550","description":"Removal of residual cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYB1","description":"ICD-PEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMA1","description":"ICD-FDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKF0","description":"ICD-KCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMC1","description":"ICD-NDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEF1","description":"ICD-ADEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coccidioidomycosis skin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86490","description":"Coccidioidomycosis skin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIB1","description":"ICD-KEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRC0","description":"ICD-OFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doppler echo exam heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93320","description":"Doppler echo exam heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB141","description":"Special Care Low _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABED1","description":"ICD-ABED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPC0","description":"ICD-JGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAA0","description":"ICD-GIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of kidney lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50390","description":"Drainage of kidney lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC22D","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18A","description":"Clinically Complex _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert cath pleura w/ image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32557","description":"Insert cath pleura w/ image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBD1","description":"ICD-CFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWC0","description":"ICD-OHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECE0","description":"ICD-AECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOD1","description":"ICD-DFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trach/laryn tube stainless","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7522","description":"Trach/laryn tube stainless","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LC21","description":"ICD-2LC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELE1","description":"ICD-NELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDF0","description":"ICD-AIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMB0","description":"ICD-FGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood methemoglobin assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83050","description":"Blood methemoglobin assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHB0","description":"ICD-CHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACA1","description":"ICD-JACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull for brain wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61458","description":"Incise skull for brain wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPE0","description":"ICD-JBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert vad artery access","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33990","description":"Insert vad artery access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter Intracardiac Shunt (Tis) Creation By Stent Placement For Congenital Cardiac Anomalies To Establish Effective Intracardiac Flow_ Including All Imaging Guidance By","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33746","description":"Transcatheter Intracardiac Shunt (Tis) Creation By Stent Placement For Congenital Cardiac Anomalies To Establish Effective Intracardiac Flow_ Including All Imaging Guidance By","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDB0","description":"ICD-IFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTE1","description":"ICD-FFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPD1","description":"ICD-JHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orth dev repair/repl minor p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4210","description":"Orth dev repair/repl minor p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vertebral body tethering_ anterior; 8 or more vertebral segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0657T","description":"Vertebral body tethering_ anterior; 8 or more vertebral segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDF0","description":"ICD-BEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB236","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC225","description":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRA0","description":"ICD-PKRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemical peel nonfacial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15793","description":"Chemical peel nonfacial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy_ and transluminal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9765","description":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy_ and transluminal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKD1","description":"ICD-CBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA110","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMC1","description":"ICD-JBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUD0","description":"ICD-MEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63086","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB22","description":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXD1","description":"ICD-BIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Slings","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4565","description":"Slings","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGA1","description":"ICD-BCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement pressure alarm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1540","description":"Replacement pressure alarm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient And/Or Care Partner Decline Referral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0041","description":"Patient And/Or Care Partner Decline Referral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUE1","description":"ICD-AEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hip adj flex ext abduct cont","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2624","description":"Hip adj flex ext abduct cont","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMA0","description":"ICD-BAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acp discuss-no dscnmkr docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1124F","description":"Acp discuss-no dscnmkr docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES10D","description":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Supportive care for neurodegenerative conditions mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0004","description":"Supportive care for neurodegenerative conditions mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBB1","description":"ICD-JHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chest x-ray and fluoroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71023","description":"Chest x-ray and fluoroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPC0","description":"ICD-CHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAB0","description":"ICD-KDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNB1","description":"ICD-KCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neuragen nerve guide_ per cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9352","description":"Neuragen nerve guide_ per cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVE1","description":"ICD-NFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEB1","description":"ICD-ECEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neutralizing antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)(Coronavirus disease[COVID-19]);screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86408","description":"Neutralizing antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)(Coronavirus disease[COVID-19]);screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMF0","description":"ICD-OEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEB0","description":"ICD-EEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDE1","description":"ICD-EBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug screenin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0002","description":"Alcohol and/or drug screenin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECA0","description":"ICD-NECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJME0","description":"ICD-NJME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release of foot tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28222","description":"Release of foot tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduction of large breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19318","description":"Reduction of large breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rprt bone scint xref w xray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3570F","description":"Rprt bone scint xref w xray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOA1","description":"ICD-OLOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foot arch support remov prem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3030","description":"Foot arch support remov prem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDA1","description":"ICD-BCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHF0","description":"ICD-NIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLE0","description":"ICD-CHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMF1","description":"ICD-BFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMF0","description":"ICD-MCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTA0","description":"ICD-GBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL25","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glycopyrrolate comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7643","description":"Glycopyrrolate comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ONC SOLID TUMOR 30 PRTN TRGT","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0174U","description":"ONC SOLID TUMOR 30 PRTN TRGT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIB1","description":"ICD-BFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE214","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDE0","description":"ICD-MBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dxa bone density axial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77080","description":"Dxa bone density axial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSD1","description":"ICD-GFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMC1","description":"ICD-IEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTC0","description":"ICD-OHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise/replace knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27486","description":"Revise/replace knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCF0","description":"ICD-OFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Collect & prep saliva sample","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0417","description":"Collect & prep saliva sample","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBF0","description":"ICD-NEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHD1","description":"ICD-OLHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBD1","description":"ICD-KHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement nasal prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5926","description":"Replacement nasal prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC02","description":"High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove sympathetic nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64821","description":"Remove sympathetic nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prefab stnlss steel crown pe","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2931","description":"Prefab stnlss steel crown pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABF1","description":"ICD-NABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQF0","description":"ICD-HBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVA0","description":"ICD-JGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINA0","description":"ICD-GINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXB1","description":"ICD-CBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGC0","description":"ICD-NIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9220","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","description":"HCPCS-J9220","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma plan of care not documented_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1222","description":"Glaucoma plan of care not documented_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endo knee-shin frct swg & st","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5818","description":"Endo knee-shin frct swg & st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFED0","description":"ICD-BFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of arm bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23931","description":"Drainage of arm bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABC0","description":"ICD-EABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orthovisc inj per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7324","description":"Orthovisc inj per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEE0","description":"ICD-ICEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"R&l hrt art/ventricle angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93460","description":"R&l hrt art/ventricle angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXF0","description":"ICD-BIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tisotumab vedotin-tftv_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9273","description":"Injection_ tisotumab vedotin-tftv_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSA0","description":"ICD-OBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNB1","description":"ICD-KFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy and biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46606","description":"Anoscopy and biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXA0","description":"ICD-FIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVD0","description":"ICD-OHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Potent antivir thxpy rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4276F","description":"Potent antivir thxpy rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEF1","description":"ICD-EIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWF1","description":"ICD-OFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJD1","description":"ICD-KCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES156","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIE1","description":"ICD-FCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNC1","description":"ICD-NCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQA0","description":"ICD-GIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open/perq place stent same","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37238","description":"Open/perq place stent same","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental case management - motivational interviewing","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9993","description":"Dental case management - motivational interviewing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBC0","description":"ICD-ACBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCA1","description":"ICD-MKCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc app","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44979","description":"Laparoscope proc app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52224","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Methotrexate (Jylamvo)_ oral_ 2.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8611","description":"Methotrexate (Jylamvo)_ oral_ 2.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Icut allergy test-delayed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95028","description":"Icut allergy test-delayed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHC1","description":"ICD-MEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCE0","description":"ICD-GFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWF0","description":"ICD-CIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTE0","description":"ICD-KCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNE0","description":"ICD-NBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDE0","description":"ICD-BHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQF1","description":"ICD-HGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27816","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB120","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYB1","description":"ICD-OJYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not currently being a statin therapy user or receive an order(prescription)for statin therapy (e.g.patient with adverse effect_ allergy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9668","description":"Documentation of medical reason(s) for not currently being a statin therapy user or receive an order(prescription)for statin therapy (e.g.patient with adverse effect_ allergy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHC0","description":"ICD-NJHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBD1","description":"ICD-ODBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBD0","description":"ICD-CGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esrd serv 2-3 vsts p mo <2yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90952","description":"Esrd serv 2-3 vsts p mo <2yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBA1","description":"ICD-CCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVD1","description":"ICD-ODVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (pancreas)_ DNA and mRNA next-generation sequencing analysis of 74 genes and analysis of CEA (CEACAM5) gene expression_ pancreatic cyst fluid_ algorithm reported as a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0313U","description":"Oncology (pancreas)_ DNA and mRNA next-generation sequencing analysis of 74 genes and analysis of CEA (CEACAM5) gene expression_ pancreatic cyst fluid_ algorithm reported as a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Closure of valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33600","description":"Closure of valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYE0","description":"ICD-GFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE201","description":"Special Care Low _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Periph field stimul revise","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0284T","description":"Periph field stimul revise","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ solid organ or hematolymphoid neoplasm or disorder_ 51 or greater genes (eg_ ALK_ BRAF_ CDKN2A_ CEBPA_ DNMT3A_ EGFR_ ERBB2_ EZH2_ FLT","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81456","description":"Targeted genomic sequence analysis panel_ solid organ or hematolymphoid neoplasm or disorder_ 51 or greater genes (eg_ ALK_ BRAF_ CDKN2A_ CEBPA_ DNMT3A_ EGFR_ ERBB2_ EZH2_ FLT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prepare donor lung single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32855","description":"Prepare donor lung single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMD0","description":"ICD-OHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOF0","description":"ICD-CGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC42","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQC1","description":"ICD-KBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOD1","description":"ICD-CCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHB1","description":"ICD-CEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Typhoid vaccine oral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90690","description":"Typhoid vaccine oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Family homecare training 15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5110","description":"Family homecare training 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treprostinil injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3285","description":"Treprostinil injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUC0","description":"ICD-FGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPA0","description":"ICD-NAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of pyruvate kinase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84220","description":"Assay of pyruvate kinase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDED1","description":"ICD-CDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITD1","description":"ICD-IITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAB0","description":"ICD-JHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduction of forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21139","description":"Reduction of forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENF1","description":"ICD-NENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSB0","description":"ICD-DHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01210","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01210","description":"CPT-01210","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psych hlth fac svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2013","description":"Psych hlth fac svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACC1","description":"ICD-MACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00474","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00474","description":"CPT-00474","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGB1","description":"ICD-FAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Norsn no dicom format doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9329","description":"Norsn no dicom format doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth perineal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90451","description":"Anesth perineal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTF1","description":"ICD-OKTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBC0","description":"ICD-KDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADB1","description":"ICD-OADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOE0","description":"ICD-KAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not receive cervical cytology or an HPV test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9807","description":"Patients who did not receive cervical cytology or an HPV test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYB1","description":"ICD-GIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECC1","description":"ICD-JECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA14","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABF1","description":"ICD-AABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9062","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9062","description":"HCPCS-J9062","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLA0","description":"ICD-EHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDE1","description":"ICD-BHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hast w/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94452","description":"Hast w/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCD0","description":"ICD-KGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Md doc_ door to punc tm >2hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9581","description":"Md doc_ door to punc tm >2hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXC1","description":"ICD-GGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1404","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1404","description":"CDT-D1404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA16","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ewhfo rigid w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3765","description":"Ewhfo rigid w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILB0","description":"ICD-AILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTB1","description":"ICD-MLTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINB1","description":"ICD-JINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine/urea-n","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84540","description":"Assay of urine/urea-n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWC1","description":"ICD-HGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27437","description":"Revise kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood_ l/r_ irradiated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9056","description":"Blood_ l/r_ irradiated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Functional status was measured by the Oswestry Disability Index (ODI version 2.1a) patient reported outcome tool within three m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1044","description":"Functional status was measured by the Oswestry Disability Index (ODI version 2.1a) patient reported outcome tool within three m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADA1","description":"ICD-NADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4DC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DC21","description":"ICD-4DC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHA1","description":"ICD-CDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hfo nontorsion jnts pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3929","description":"Hfo nontorsion jnts pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Topical fluoride varnish","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1206","description":"Topical fluoride varnish","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; patient-provided equipment_ sensor placement_ hook-u","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95249","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; patient-provided equipment_ sensor placement_ hook-u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPA1","description":"ICD-CHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive (60 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s hom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0079","description":"Comprehensive (60 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s hom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGC0","description":"ICD-OCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLB1","description":"ICD-GCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0631U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0631U","description":"CPT-0631U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Imm counseling by a physician or other qualified health care prof when the vaccine(s) is not admin on the same date of service for ages under 21_ 16-30 min Medicaid only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0313","description":"Imm counseling by a physician or other qualified health care prof when the vaccine(s) is not admin on the same date of service for ages under 21_ 16-30 min Medicaid only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHME0","description":"ICD-EHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMB1","description":"ICD-IHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-43889","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","description":"CPT-43889","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; known familial sequence variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81337","description":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; known familial sequence variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair throat esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42953","description":"Repair throat esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIED1","description":"ICD-KIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJB1","description":"ICD-OIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant/replace hearing aid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69710","description":"Implant/replace hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA51","description":"Low Rehab_ ADL Index 0-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1071","description":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLE1","description":"ICD-NCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYC1","description":"ICD-PLYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGE1","description":"ICD-NAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACB0","description":"ICD-KACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNF1","description":"ICD-NDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstr lwr jaw w/advance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21199","description":"Reconstr lwr jaw w/advance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTA0","description":"ICD-KFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC111","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of paste boot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29580","description":"Application of paste boot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc stroke after cas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9257","description":"Doc stroke after cas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1105T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1105T","description":"CPT-1105T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISF1","description":"ICD-DISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct scan for needle biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77012","description":"Ct scan for needle biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTA0","description":"ICD-JGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSE0","description":"ICD-OCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4542","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYE0","description":"ICD-CHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXC0","description":"ICD-GDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0103","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0103","description":"HCPCS-B0103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJF1","description":"ICD-JDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Typhoid vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90691","description":"Typhoid vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVB1","description":"ICD-OLVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"BRCA1 (breast cancer 1) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants (ie_ exon 13 del 3.835kb_ exo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81214","description":"BRCA1 (breast cancer 1) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants (ie_ exon 13 del 3.835kb_ exo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Htlv/hiv confirmj antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86689","description":"Htlv/hiv confirmj antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPE1","description":"ICD-OIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES241","description":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPA1","description":"ICD-JHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Caster pin lock each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0073","description":"Caster pin lock each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (Alzheimer Disease)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 24 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0289U","description":"Neurology (Alzheimer Disease)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 24 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severeacute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA\u0002LNP_ spike","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0113A","description":"Immunization administration by intramuscular injection of severeacute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA\u0002LNP_ spike","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB5B","description":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62256","description":"Remove brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFE1","description":"ICD-NGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Evaluation by ocularist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9150","description":"Evaluation by ocularist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFB0","description":"ICD-CIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADME1","description":"ICD-ADME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL30","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXE0","description":"ICD-FDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJE1","description":"ICD-BDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBA0","description":"ICD-FEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXB1","description":"ICD-OBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACE0","description":"ICD-IACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Instr xrcz back pain 12 wks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4240F","description":"Instr xrcz back pain 12 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDC1","description":"ICD-IBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHD1","description":"ICD-GHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt not elig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9626","description":"Pt not elig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Optical coherence tomography (OCT) of middle ear_ with interpretation and report; bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0486T","description":"Optical coherence tomography (OCT) of middle ear_ with interpretation and report; bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28X","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJF1","description":"ICD-KHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCE0","description":"ICD-IGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0561","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","description":"HCPCS-G0561","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0517T","description":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cftr gene known fam variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81221","description":"Cftr gene known fam variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAF0","description":"ICD-MBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ak/knee disartic acrylic soc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5631","description":"Ak/knee disartic acrylic soc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTA1","description":"ICD-CGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGB0","description":"ICD-NBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETD1","description":"ICD-GETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLD0","description":"ICD-IHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ko double upright pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0902","description":"Ko double upright pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCA1","description":"ICD-EHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNB0","description":"ICD-NBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystourethroscopy_ with mechanical dilation and urethral therapeutic drug delivery for urethral stricture or stenosis_ including fluoroscopy_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0499T","description":"Cystourethroscopy_ with mechanical dilation and urethral therapeutic drug delivery for urethral stricture or stenosis_ including fluoroscopy_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUB0","description":"ICD-EIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB36","description":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYE0","description":"ICD-CFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBB0","description":"ICD-JBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODME0","description":"ICD-ODME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB5B","description":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ vitolarsen_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1427","description":"Injection_ vitolarsen_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ thigh length_ 18-30 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6556","description":"Gradient compression stocking_ thigh length_ 18-30 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3376","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","description":"HCPCS-J3376","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interrogate subq defib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93261","description":"Interrogate subq defib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTC0","description":"ICD-JGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKA1","description":"ICD-OAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay porcelin 2 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2642","description":"Dental onlay porcelin 2 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METF1","description":"ICD-METF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Penicillin g potassium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2540","description":"Penicillin g potassium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPB1","description":"ICD-JBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGD1","description":"ICD-FHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABC1","description":"ICD-IABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWD1","description":"ICD-HDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLF0","description":"ICD-NHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary stress testing (eg_ 6-minute walk test)_ including measurement of heart rate_ oximetry_ and oxygen titration_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94618","description":"Pulmonary stress testing (eg_ 6-minute walk test)_ including measurement of heart rate_ oximetry_ and oxygen titration_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOA1","description":"ICD-KEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elec osteogen stim not spine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0747","description":"Elec osteogen stim not spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL32","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Multiple sleep latency test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95805","description":"Multiple sleep latency test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75756","description":"Artery x-rays chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect back tum 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21936","description":"Resect back tum 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD121","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFE1","description":"ICD-BAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILB0","description":"ICD-GILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl&rplcmt ss impl dfb pg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0614T","description":"Rmvl&rplcmt ss impl dfb pg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9615","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","description":"HCPCS-A9615","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYD0","description":"ICD-CGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIB1","description":"ICD-MDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC01","description":"Very High Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSA1","description":"ICD-HBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64659","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","description":"CPT-64659","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJB0","description":"ICD-JFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fabrication athletic guard","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9941","description":"Fabrication athletic guard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD126","description":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGD0","description":"ICD-GDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUC0","description":"ICD-GBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTF1","description":"ICD-KFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLB0","description":"ICD-NJLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23550","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"RHD&RHCE GNTYP NEXT GNRJ SEQ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0222U","description":"RHD&RHCE GNTYP NEXT GNRJ SEQ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQA1","description":"ICD-LFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 hd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0825","description":"Pwc gp 2 hd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct angiograph pelv w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72191","description":"Ct angiograph pelv w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1486","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","description":"HCPCS-M1486","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPE0","description":"ICD-KFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bmi not calculated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8421","description":"Bmi not calculated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0639U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0639U","description":"CPT-0639U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDD1","description":"ICD-FFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eye glass case","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2756","description":"Eye glass case","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct upper extremity w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73200","description":"Ct upper extremity w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFE1","description":"ICD-FCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1GB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GB31","description":"ICD-1GB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Installation_ ciprofloxacin otic suspension_ 6mg (Otiprio)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9479","description":"Installation_ ciprofloxacin otic suspension_ 6mg (Otiprio)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Children who are taking antibiotics in the 30 days prior to the diagnosis of pharyngitis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9703","description":"Children who are taking antibiotics in the 30 days prior to the diagnosis of pharyngitis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIF0","description":"ICD-GGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD111","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBB1","description":"ICD-BIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ amiodarone hydrochloride (nexterone)_ 30 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0283","description":"Injection_ amiodarone hydrochloride (nexterone)_ 30 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRC0","description":"ICD-PGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD256","description":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYE1","description":"ICD-CAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8X","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diuretic thxpy for 6 mos/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4221F","description":"Diuretic thxpy for 6 mos/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Corrugated tubing_ non-disposable_ used with large volume nebulizer_ 10 feet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7011","description":"Corrugated tubing_ non-disposable_ used with large volume nebulizer_ 10 feet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMF1","description":"ICD-BIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFF0","description":"ICD-OKFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGB0","description":"ICD-CCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (urothelial)_ mRNA_ gene expression profiling by real-time quantit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0119U","description":"Oncology (urothelial)_ mRNA_ gene expression profiling by real-time quantit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pentastarch 10% solution","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2513","description":"Pentastarch 10% solution","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ht muscle image spect mult","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78452","description":"Ht muscle image spect mult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKA0","description":"ICD-FCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBF1","description":"ICD-BDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB15A","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHF0","description":"ICD-BEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYE0","description":"ICD-OHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCF1","description":"ICD-NDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUA0","description":"ICD-EHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQA0","description":"ICD-OFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOF1","description":"ICD-KHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1292","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21462","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEF1","description":"ICD-GFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incomplete endodontic tx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3332","description":"Incomplete endodontic tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES330","description":"Extensive Services _ ADL Index 2-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAB0","description":"ICD-MBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Complete aca_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4302","description":"Complete aca_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suspension sleeve lower ext","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2397","description":"Suspension sleeve lower ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAA0","description":"ICD-EBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBE1","description":"ICD-FGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLD0","description":"ICD-AGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA144","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJA1","description":"ICD-KDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHE0","description":"ICD-OJHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydrotherapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97036","description":"Hydrotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng leg splnt fbrgl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4042","description":"Cast sup lng leg splnt fbrgl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAF0","description":"ICD-JHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0804","description":"HCPCS-C0804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay malate dehydrogenase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83775","description":"Assay malate dehydrogenase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alanine amino (alt) (sgpt)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84460","description":"Alanine amino (alt) (sgpt)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFA1","description":"ICD-KIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablate bone tumor(s) perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20982","description":"Ablate bone tumor(s) perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC240","description":"Special Care Low _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"P2y inhib not presc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9440","description":"P2y inhib not presc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEC1","description":"ICD-GGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of burn scab initi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16035","description":"Incision of burn scab initi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFA0","description":"ICD-KDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRE1","description":"ICD-PIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1048T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1048T","description":"CPT-1048T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cftr gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81220","description":"Cftr gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMF1","description":"ICD-MCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQB0","description":"ICD-OGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUA1","description":"ICD-KIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBE1","description":"ICD-BHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFB1","description":"ICD-CFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKD1","description":"ICD-FGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYE0","description":"ICD-GDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1060T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1060T","description":"CPT-1060T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCC0","description":"ICD-JGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of tibia fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27756","description":"Treatment of tibia fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-ionizing diagnostic procedure capable of quantifying_ monitoring_ and recording changes in structure of enamel_ dentin_ and cementum","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0600","description":"Non-ionizing diagnostic procedure capable of quantifying_ monitoring_ and recording changes in structure of enamel_ dentin_ and cementum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITD1","description":"ICD-BITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ald telephone amplifier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5268","description":"Ald telephone amplifier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWD0","description":"ICD-PBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26358","description":"Repair/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCD1","description":"ICD-MKCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDB1","description":"ICD-IEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPB1","description":"ICD-JCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRB1","description":"ICD-LIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABE0","description":"ICD-FABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSA1","description":"ICD-PJSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRA0","description":"ICD-CDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1803","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1803","description":"CDT-D1803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHB1","description":"ICD-NGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVA1","description":"ICD-FGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYB0","description":"ICD-HEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVB1","description":"ICD-NEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEB1","description":"ICD-JAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDE0","description":"ICD-GDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDB0","description":"ICD-KEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB12D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVB1","description":"ICD-JEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup long arm ped fbrgls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4008","description":"Cast sup long arm ped fbrgls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEF1","description":"ICD-KAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNA1","description":"ICD-BDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUB1","description":"ICD-KGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAE1","description":"ICD-MIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemotaxis assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86155","description":"Chemotaxis assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBA0","description":"ICD-NLBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA11","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVC1","description":"ICD-CBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0102","description":"HCPCS-C0102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC0B","description":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHF0","description":"ICD-NBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES13D","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Liver elastography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91200","description":"Liver elastography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crutch underarm pair wood","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0112","description":"Crutch underarm pair wood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of vulva/perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56606","description":"Biopsy of vulva/perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy nail unit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11755","description":"Biopsy nail unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Interpretation And Report By Physician Or Other Qualified Health Care Professional_ Per Calendar Month","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0706T","description":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Interpretation And Report By Physician Or Other Qualified Health Care Professional_ Per Calendar Month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUF1","description":"ICD-CBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphere trifocal 7.12-20","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2302","description":"Lens sphere trifocal 7.12-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALE0","description":"ICD-FALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQE0","description":"ICD-HAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJA1","description":"ICD-GEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eculizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1300","description":"Eculizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LA21","description":"ICD-3LA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx nose/jaw fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21345","description":"Closed tx nose/jaw fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31600","description":"Incision of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autograft Suspension_ Including Cell Processing And Application_ And All System Components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1832","description":"Autograft Suspension_ Including Cell Processing And Application_ And All System Components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMC0","description":"ICD-EGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB22B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICC0","description":"ICD-AICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXD1","description":"ICD-JIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemi-wheelchair detachable a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1084","description":"Hemi-wheelchair detachable a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Body-worn hearing aid bone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5040","description":"Body-worn hearing aid bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXF0","description":"ICD-BFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICC0","description":"ICD-NICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOC0","description":"ICD-CDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDE0","description":"ICD-FBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYA0","description":"ICD-LAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSD1","description":"ICD-DCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHF1","description":"ICD-EBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWD0","description":"ICD-HBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy_ arrhythmia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0747T","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy_ arrhythmia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of bile duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47420","description":"Incision of bile duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Interpretation And Report On Fracture-Risk Only By Other Qualified Health Care Professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77092","description":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Interpretation And Report On Fracture-Risk Only By Other Qualified Health Care Professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMD1","description":"ICD-MAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILC0","description":"ICD-NILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stat lab home/nf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3601","description":"Stat lab home/nf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tbo-filgrastim_ 5 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1446","description":"Injection_ tbo-filgrastim_ 5 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMF0","description":"ICD-JIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCE0","description":"ICD-OLCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQD1","description":"ICD-KBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ophthalmic endoscope add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66990","description":"Ophthalmic endoscope add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNF0","description":"ICD-BCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8007","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8007","description":"HCPCS-C8007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC51","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pet image skull-thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78812","description":"Pet image skull-thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARB0","description":"ICD-PARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQD0","description":"ICD-GHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOF1","description":"ICD-DFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fixed adjust armrest pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0020","description":"Fixed adjust armrest pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medical foods for inborn err","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9435","description":"Medical foods for inborn err","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCB0","description":"ICD-JFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUE0","description":"ICD-OCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX1A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBC1","description":"ICD-FEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens lenticular trifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2315","description":"Lens lenticular trifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUB0","description":"ICD-FDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft ilioiliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35563","description":"Art byp grft ilioiliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCE1","description":"ICD-BHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHF0","description":"ICD-CAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had a completed suicide safety plan initiated_ reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical enc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1350","description":"Patients who had a completed suicide safety plan initiated_ reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical enc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct midface no graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7948","description":"Reconstruct midface no graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65125","description":"Revise ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDE1","description":"ICD-NLDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new implantable sensor_ including system ac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0448T","description":"Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new implantable sensor_ including system ac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVF0","description":"ICD-JBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21076","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Path consult introp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88329","description":"Path consult introp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36015","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ epirubicin hcl_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9178","description":"Inj_ epirubicin hcl_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip fracture(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27228","description":"Treat hip fracture(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trabectedin_ 0.1mg (Yondelis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9480","description":"Injection_ trabectedin_ 0.1mg (Yondelis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANB1","description":"ICD-JANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSD0","description":"ICD-KCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPB0","description":"ICD-JAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHE0","description":"ICD-IDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQC0","description":"ICD-CAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOB0","description":"ICD-OHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPC1","description":"ICD-BFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKD1","description":"ICD-OEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCE0","description":"ICD-CCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBA1","description":"ICD-OFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abscess imaging ltd area","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78805","description":"Abscess imaging ltd area","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQA1","description":"ICD-CDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of retinal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67208","description":"Treatment of retinal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBF0","description":"ICD-KHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35081","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDE0","description":"ICD-GIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0151A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N-et; commerc carrier pass","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2004","description":"N-et; commerc carrier pass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perc d-e cor stent ather br","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9603","description":"Perc d-e cor stent ather br","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLC1","description":"ICD-BDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Craniofacial approach skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61581","description":"Craniofacial approach skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Beta amyloid_ AB40 and AB42 by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ ratio_ plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0346U","description":"Beta amyloid_ AB40 and AB42 by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ ratio_ plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96936","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXF0","description":"ICD-OAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAD0","description":"ICD-FGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEF0","description":"ICD-ODEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE245","description":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28F","description":"Special Care Low _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDE1","description":"ICD-KEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"5% dextrose with potassium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5012","description":"5% dextrose with potassium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise esophagus & stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43325","description":"Revise esophagus & stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFD1","description":"ICD-KHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEE0","description":"ICD-FBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSF0","description":"ICD-PGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Truskin_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4167","description":"Truskin_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWD1","description":"ICD-OGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Misc dialysis supplies noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4913","description":"Misc dialysis supplies noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE20A","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEF0","description":"ICD-EHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative computed tomography (CT) tissue characterization_ including interpretation and report_ obtained without concurrent CT examination of any structure contained in pr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0721T","description":"Quantitative computed tomography (CT) tissue characterization_ including interpretation and report_ obtained without concurrent CT examination of any structure contained in pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBC1","description":"ICD-GCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fremanezumab-vfrm_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9040","description":"Injection_ fremanezumab-vfrm_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25260","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMA1","description":"ICD-JDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc shoulder tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23076","description":"Exc shoulder tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOC1","description":"ICD-LFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDB0","description":"ICD-JIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87494","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","description":"CPT-87494","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of tendons at wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25300","description":"Fusion of tendons at wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBE1","description":"ICD-AFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88000","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ped hospital bed_ manual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0328","description":"Ped hospital bed_ manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFB1","description":"ICD-NFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEF0","description":"ICD-BGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28H","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sinus endo w/balloon dil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31295","description":"Sinus endo w/balloon dil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVA1","description":"ICD-OJVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76497","description":"Ct procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAF0","description":"ICD-BIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYB1","description":"ICD-DCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVA1","description":"ICD-CCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Above knee wood socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5644","description":"Above knee wood socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD144","description":"Special Care High _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rbc serum pretx incubj/inhib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86977","description":"Rbc serum pretx incubj/inhib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medical conference_ 60 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0221","description":"Medical conference_ 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXF1","description":"ICD-CEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydroxyprogesterone caproate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1725","description":"Hydroxyprogesterone caproate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTC0","description":"ICD-NLTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMD0","description":"ICD-BDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tissue homogenization cultr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87176","description":"Tissue homogenization cultr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0463","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","description":"HCPCS-J0463","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement interface spsd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1821","description":"Replacement interface spsd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCD1","description":"ICD-OKCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILF1","description":"ICD-IILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ full length/chap style_ 40 mmhg or greater_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6561","description":"Gradient compression stocking_ full length/chap style_ 40 mmhg or greater_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transdermal gfr measurements","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0602T","description":"Transdermal gfr measurements","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAC1","description":"ICD-JCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMC0","description":"ICD-KAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHD0","description":"ICD-GEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45332","description":"Sigmoidoscopy w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUC1","description":"ICD-MJUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJC1","description":"ICD-FCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERC1","description":"ICD-CERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALD0","description":"ICD-FALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBE1","description":"ICD-NKBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMA0","description":"ICD-NFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEA1","description":"ICD-GAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTA0","description":"ICD-CBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice in ltch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5007","description":"Hospice in ltch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23460","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTB1","description":"ICD-EFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cellesta Flowable Amnion (25 mg per cc); per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4185","description":"Cellesta Flowable Amnion (25 mg per cc); per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAC0","description":"ICD-BIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEF0","description":"ICD-JGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEB0","description":"ICD-FHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Irrigation sphenoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31002","description":"Irrigation sphenoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iliac revasc add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37222","description":"Iliac revasc add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIC0","description":"ICD-FEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPB1","description":"ICD-CAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPA1","description":"ICD-NIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE135","description":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair paravag defect lap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57423","description":"Repair paravag defect lap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Als esophageal intub suppls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0396","description":"Als esophageal intub suppls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6064","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEE0","description":"ICD-MCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFF0","description":"ICD-FBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE120","description":"Clinically Complex _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9700","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXB1","description":"ICD-KGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVD1","description":"ICD-CDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAF1","description":"ICD-FEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE115","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Affinity1 square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4159","description":"Affinity1 square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Platelet antibodies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86022","description":"Platelet antibodies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not administering influenza vaccine (e.g._ prior anaphylaxis due to the influenza vaccine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1169","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g._ prior anaphylaxis due to the influenza vaccine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urinalysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81005","description":"Urinalysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVF0","description":"ICD-NBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneuma compresor non-segment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0650","description":"Pneuma compresor non-segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOD1","description":"ICD-PEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ins cath ren art 1st bilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36252","description":"Ins cath ren art 1st bilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHF1","description":"ICD-AAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOF0","description":"ICD-CBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEC0","description":"ICD-JAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTC0","description":"ICD-MBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLA0","description":"ICD-GCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1065T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1065T","description":"CPT-1065T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLC0","description":"ICD-JHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBE0","description":"ICD-MKBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDE0","description":"ICD-GGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABF0","description":"ICD-IABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKC1","description":"ICD-OHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4415","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","description":"HCPCS-Q4415","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iodine i-131 iodide cap_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9528","description":"Iodine i-131 iodide cap_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFME1","description":"ICD-OFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69646","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hysteroscopy remove fb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58562","description":"Hysteroscopy remove fb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27886","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD22D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMA1","description":"ICD-NJMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8E","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPB1","description":"ICD-OJPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rebuild eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69633","description":"Rebuild eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSB1","description":"ICD-LGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDA1","description":"ICD-OKDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFF1","description":"ICD-JDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYB1","description":"ICD-CFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHA1","description":"ICD-KHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0952T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","description":"CPT-0952T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin electrophoresis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83020","description":"Hemoglobin electrophoresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lung transplant with bypass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32852","description":"Lung transplant with bypass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB2A","description":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Res_ nos waiver per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2033","description":"Res_ nos waiver per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial facial prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8046","description":"Partial facial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECD1","description":"ICD-OECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOB0","description":"ICD-DAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5145","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","description":"HCPCS-Q5145","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18G","description":"Special Care Low _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0007","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLE1","description":"ICD-MBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00300","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00300","description":"CPT-00300","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDD0","description":"ICD-FIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended release (brixadi)_ greater than 7 days and up to 28 days of therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0578","description":"Injection_ buprenorphine extended release (brixadi)_ greater than 7 days and up to 28 days of therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQC0","description":"ICD-OLQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBE1","description":"ICD-EBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB20D","description":"Special Care Low _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2005","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2005","description":"HCPCS-A2005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilated fundus eval done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2020F","description":"Dilated fundus eval done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic endoscopic retrograde cholangiopancreatography (ercp)_ including collection of specimen(s) by brushing or washing_ when performed_ with endoscopic cannulation of pa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7541","description":"Diagnostic endoscopic retrograde cholangiopancreatography (ercp)_ including collection of specimen(s) by brushing or washing_ when performed_ with endoscopic cannulation of pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fluocinolone acetonide implt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7311","description":"Fluocinolone acetonide implt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESE1","description":"ICD-OESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUF0","description":"ICD-GHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLA0","description":"ICD-JFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gauze >16 <=48 sq in w/bordr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6220","description":"Gauze >16 <=48 sq in w/bordr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDB0","description":"ICD-MEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQE1","description":"ICD-OHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNF1","description":"ICD-KGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hook to hand cable adapter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6670","description":"Hook to hand cable adapter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEE0","description":"ICD-JHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB254","description":"Special Care Low _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3BA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BA31","description":"ICD-3BA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCA1","description":"ICD-AGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYE1","description":"ICD-OKYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBB1","description":"ICD-OGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEA1","description":"ICD-BIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunfix e-phorsis/urine/csf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86335","description":"Immunfix e-phorsis/urine/csf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQE0","description":"ICD-OGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; cranioplasty or elevation of depres","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0132U","description":"Anesthesia for intracranial procedures; cranioplasty or elevation of depres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILC0","description":"ICD-KILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lengthen metacarpal/finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26568","description":"Lengthen metacarpal/finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBC1","description":"ICD-AFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup shrt leg ped fbrgls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4040","description":"Cast sup shrt leg ped fbrgls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trans care mgmt 7 day disch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99496","description":"Trans care mgmt 7 day disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"M.avium-intra dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87562","description":"M.avium-intra dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25265","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mopath procedure level 8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81407","description":"Mopath procedure level 8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIF1","description":"ICD-IHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL56","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNF1","description":"ICD-NCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ganciclovir long act implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7310","description":"Ganciclovir long act implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQA1","description":"ICD-HCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCC0","description":"ICD-FBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"removal of implant body not requiring bone removal or flap elevation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6105","description":"removal of implant body not requiring bone removal or flap elevation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Closure of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57120","description":"Closure of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cad measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8489","description":"Cad measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rigid lined custom fab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0482","description":"Tlso rigid lined custom fab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tap block unil by injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64486","description":"Tap block unil by injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIB0","description":"ICD-NIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB156","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCA1","description":"ICD-IBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDA1","description":"ICD-NKDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYD1","description":"ICD-LEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDC0","description":"ICD-FCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYF1","description":"ICD-OAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Septal defect imp sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1817","description":"Septal defect imp sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compl zift case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4014","description":"Compl zift case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB3D","description":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0686U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686U","description":"CPT-0686U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOE1","description":"ICD-LHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVA0","description":"ICD-KDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUD0","description":"ICD-CFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGF0","description":"ICD-OEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKD0","description":"ICD-FEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDC1","description":"ICD-NBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDE1","description":"ICD-OIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC4D","description":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKC1","description":"ICD-CAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBB0","description":"ICD-MLBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXB0","description":"ICD-KIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMF1","description":"ICD-EEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ra meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8499","description":"Ra meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of leg tendon each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27664","description":"Repair of leg tendon each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFA1","description":"ICD-OCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fld ped wc adjstabl w/o seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1238","description":"Fld ped wc adjstabl w/o seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOD0","description":"ICD-HFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8H","description":"Low Rehab_ ADL Index 0-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSB1","description":"ICD-PLSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGE0","description":"ICD-OHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 12 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP12","description":"Auto.test pane pricing code_ 12 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore and drain kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50125","description":"Explore and drain kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Atten d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9167","description":"Atten d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTA1","description":"ICD-FHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vagina wall complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57110","description":"Remove vagina wall complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMD0","description":"ICD-FIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Management of established patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0525","description":"Management of established patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABF0","description":"ICD-GABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIC0","description":"ICD-IFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDB1","description":"ICD-EEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINA0","description":"ICD-BINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5140","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","description":"HCPCS-Q5140","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWA1","description":"ICD-KGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"reline custom sleep apnea appliance (indirect)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9953","description":"reline custom sleep apnea appliance (indirect)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Air polymer-type A intrauterine foam_ 0.1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9574","description":"Air polymer-type A intrauterine foam_ 0.1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITA0","description":"ICD-EITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMA1","description":"ICD-BCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Approp diuretic tstng done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4190F","description":"Approp diuretic tstng done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29877","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46761","description":"Repair of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking full lngth 40-50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6538","description":"Gc stocking full lngth 40-50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31368","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1012","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKF1","description":"ICD-FIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC14","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKC1","description":"ICD-GEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB144","description":"Special Care Low _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tissue localization-excision","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1819","description":"Tissue localization-excision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMF1","description":"ICD-NJMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEE1","description":"ICD-OBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHE0","description":"ICD-NHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant brain electrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61760","description":"Implant brain electrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIE1","description":"ICD-AAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHE0","description":"ICD-GEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elbow fair lead cable dir fo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6586","description":"Elbow fair lead cable dir fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDE0","description":"ICD-CIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISA1","description":"ICD-OISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOD1","description":"ICD-KEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOC0","description":"ICD-KDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQF0","description":"ICD-HEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clonidine hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0735","description":"Clonidine hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBE0","description":"ICD-EGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI brain stem w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70552","description":"MRI brain stem w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXC0","description":"ICD-GIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQC1","description":"ICD-DEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Io rad tx delivery by x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77424","description":"Io rad tx delivery by x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Larynscop remve cart + scop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31561","description":"Larynscop remve cart + scop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDF1","description":"ICD-NKDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITB1","description":"ICD-EITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67921","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psytx pt&/family 30 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90832","description":"Psytx pt&/family 30 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote dx retinal imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92227","description":"Remote dx retinal imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implantation_ osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside of the mastoid and resulting in removal of greater","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69729","description":"Implantation_ osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside of the mastoid and resulting in removal of greater","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLC0","description":"ICD-GDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWB1","description":"ICD-LDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVA0","description":"ICD-OBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner_ including a certified peer sp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0140","description":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner_ including a certified peer sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWB0","description":"ICD-GIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit cont antiemetic diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9351","description":"Hit cont antiemetic diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Md document visit by npp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0454","description":"Md document visit by npp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFD0","description":"ICD-KCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Static or dynami afo pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4396","description":"Static or dynami afo pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDED0","description":"ICD-MDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABF0","description":"ICD-CABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alt long-term cntrl med rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4144F","description":"Alt long-term cntrl med rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fluoroscopy (separate procedure)_ up to 1 hour physician or other qualified health care professional time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76000","description":"Fluoroscopy (separate procedure)_ up to 1 hour physician or other qualified health care professional time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0664","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","description":"HCPCS-G0664","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home injectable therapy_ immunotherapy_ including administrative services_ professional pharmacy services_ care coordination_ and all necessary supplies and equipment (drugs a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9563","description":"Home injectable therapy_ immunotherapy_ including administrative services_ professional pharmacy services_ care coordination_ and all necessary supplies and equipment (drugs a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB54","description":"Low Rehab_ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise graft w/vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35879","description":"Revise graft w/vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone-material quality testing by microindentation(s) of the tibia(s)_ with results reported as a score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0547T","description":"Bone-material quality testing by microindentation(s) of the tibia(s)_ with results reported as a score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pcv13 vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90670","description":"Pcv13 vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXE0","description":"ICD-KCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRF0","description":"ICD-LIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefepime hydrochloride (b braun)_ not therapeutically equivalent to maxipime_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0703","description":"Injection_ cefepime hydrochloride (b braun)_ not therapeutically equivalent to maxipime_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVD1","description":"ICD-CBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB42","description":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA02","description":"Low Rehab_ ADL Index 0-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8X","description":"Medium Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1483","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","description":"HCPCS-M1483","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0529U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","description":"CPT-0529U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29824","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spun microhematocrit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85013","description":"Spun microhematocrit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35151","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx head/neck m1 mets rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9111","description":"Onc dx head/neck m1 mets rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXA1","description":"ICD-JDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAD0","description":"ICD-CAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJD1","description":"ICD-KHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAD0","description":"ICD-EBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations_ based on selected intervals of interest from 12-lead elect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0897T","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations_ based on selected intervals of interest from 12-lead elect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX46","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64581","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB33","description":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDA1","description":"ICD-NHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEC1","description":"ICD-NFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aortic suspension","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33800","description":"Aortic suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic colonoscopy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9937","description":"Diagnostic colonoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1KB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KB11","description":"ICD-1KB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of urinary leakage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53085","description":"Drainage of urinary leakage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALD0","description":"ICD-JALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQF0","description":"ICD-LCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ romidepsin_ lyophilized_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9319","description":"Injection_ romidepsin_ lyophilized_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBA0","description":"ICD-EDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMD1","description":"ICD-OFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prior thyroid dise dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9553","description":"Prior thyroid dise dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES15D","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEE1","description":"ICD-OIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAC0","description":"ICD-AGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8D","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJD0","description":"ICD-JDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCND0","description":"ICD-KCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25695","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0503","description":"HCPCS-A0503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rho(d) immune globulin h_ sd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2792","description":"Rho(d) immune globulin h_ sd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKE0","description":"ICD-FFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Upper gi endoscopy performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3130F","description":"Upper gi endoscopy performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHC1","description":"ICD-NGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSC0","description":"ICD-KBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALE0","description":"ICD-IALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTA0","description":"ICD-KHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFF1","description":"ICD-KIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mech amb infusion pump <8hrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0780","description":"Mech amb infusion pump <8hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB07","description":"High Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHF0","description":"ICD-FIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4AA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AA21","description":"ICD-4AA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27600","description":"Decompression of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL01","description":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHB0","description":"ICD-FCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFF1","description":"ICD-NFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDME1","description":"ICD-NDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise prosth vag graft lap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57426","description":"Revise prosth vag graft lap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHE1","description":"ICD-KIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pierce skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61151","description":"Pierce skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Harvest cultured skin graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15040","description":"Harvest cultured skin graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0006","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hgb lvl >/= 13 g/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3279F","description":"Hgb lvl >/= 13 g/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0104","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0104","description":"HCPCS-B0104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTF0","description":"ICD-KBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYA1","description":"ICD-HFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUB1","description":"ICD-GBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRF1","description":"ICD-LGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD115","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVA1","description":"ICD-ODVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0871","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0871","description":"HCPCS-J0871","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Impltj ntrstrml crnl rng seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65785","description":"Impltj ntrstrml crnl rng seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADE1","description":"ICD-FADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28E","description":"Clinically Complex _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCF1","description":"ICD-JGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQF1","description":"ICD-PBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWA0","description":"ICD-OGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HB31","description":"ICD-4HB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8C","description":"Medium Rehab _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasopharyngoscopy_ Surgical_ With Dilation Of Eustachian Tube (Ie_ Balloon Dilation); Bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69706","description":"Nasopharyngoscopy_ Surgical_ With Dilation Of Eustachian Tube (Ie_ Balloon Dilation); Bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACME0","description":"ICD-ACME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Advnc care plan tlk docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1158F","description":"Advnc care plan tlk docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29880","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBF1","description":"ICD-KEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not prescribing warfarin or another FDA-approved oral anticoagulant that is FDA approved for the prevention of thromboembolism (e.g._ pa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8969","description":"Documentation of patient reason(s) for not prescribing warfarin or another FDA-approved oral anticoagulant that is FDA approved for the prevention of thromboembolism (e.g._ pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration/repair of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45562","description":"Exploration/repair of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lso flex w/rigid stays cust","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0629","description":"Lso flex w/rigid stays cust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFF0","description":"ICD-OJFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECB1","description":"ICD-OECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect inferior turbinate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30140","description":"Resect inferior turbinate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD25A","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEB1","description":"ICD-EGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise inner eye adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65875","description":"Incise inner eye adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esrd serv 1 visit p mo <2yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90953","description":"Esrd serv 1 visit p mo <2yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIF0","description":"ICD-NDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC146","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transport portable x-ray","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"R0070","description":"Transport portable x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1132","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC30","description":"Medium Rehab _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Add ue prost a/e acrylic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7404","description":"Add ue prost a/e acrylic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUC0","description":"ICD-BCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPC0","description":"ICD-FBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKE0","description":"ICD-ODKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX55","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCD0","description":"ICD-KDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKC1","description":"ICD-OGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pseudoaneurysm injection trt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36002","description":"Pseudoaneurysm injection trt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQB1","description":"ICD-OFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTE0","description":"ICD-EBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE221","description":"Special Care Low _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHE1","description":"ICD-NIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69725","description":"Release facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"History of or active diagnosis of familial or pure hypercholesterolemia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9782","description":"History of or active diagnosis of familial or pure hypercholesterolemia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEA0","description":"ICD-BDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin full graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15241","description":"Skin full graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cmprsburngrmnt glove-axilla","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6506","description":"Cmprsburngrmnt glove-axilla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAF1","description":"ICD-OBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJC1","description":"ICD-NDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHC1","description":"ICD-JGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/endoscopic fnb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45392","description":"Colonoscopy w/endoscopic fnb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIB1","description":"ICD-FHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATE1","description":"ICD-NATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLA1","description":"ICD-NHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urine reagent strips/tablets","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4250","description":"Urine reagent strips/tablets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX3B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEE1","description":"ICD-EBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIE0","description":"ICD-ABIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQE1","description":"ICD-CGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGD0","description":"ICD-NIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter placement of iliac arteriovenous anastomosis implant_ inclusive of all radiological supervision and interpretation_ intraprocedural roadmapping_ and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0553T","description":"Percutaneous transcatheter placement of iliac arteriovenous anastomosis implant_ inclusive of all radiological supervision and interpretation_ intraprocedural roadmapping_ and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYC0","description":"ICD-DDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMB0","description":"ICD-OIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATA0","description":"ICD-MATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRE0","description":"ICD-KCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onsite Ac Tx Nsg Fac Res Fl/Elct Do/Deh Bill Sid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9683","description":"Onsite Ac Tx Nsg Fac Res Fl/Elct Do/Deh Bill Sid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Visual field examination(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92082","description":"Visual field examination(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tap block bi injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64488","description":"Tap block bi injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJE1","description":"ICD-GGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ceftriaxone sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0696","description":"Ceftriaxone sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLB0","description":"ICD-OBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJC0","description":"ICD-GGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Multi-durometer symes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5661","description":"Multi-durometer symes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chest x-ray 1 view frontal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71010","description":"Chest x-ray 1 view frontal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0559","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","description":"HCPCS-G0559","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of amylase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82150","description":"Assay of amylase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast)_ semiquantitative measurement of thymidine kinase activity by immunoassay_ serum_ results reported as risk of disease progression","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0404U","description":"Oncology (breast)_ semiquantitative measurement of thymidine kinase activity by immunoassay_ serum_ results reported as risk of disease progression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat metacarpal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26605","description":"Treat metacarpal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSC0","description":"ICD-GDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHE0","description":"ICD-CDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWD0","description":"ICD-GCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRA1","description":"ICD-DGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEA0","description":"ICD-MLEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPF1","description":"ICD-FGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJA0","description":"ICD-OEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBD1","description":"ICD-ECBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRD0","description":"ICD-GIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEME0","description":"ICD-JEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor >22.05 & Motor <28.75._without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0206","description":"Traumatic brain injury with Motor >22.05 & Motor <28.75._without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thyroid uptake measurement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78012","description":"Thyroid uptake measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Capecitabine_ oral_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8521","description":"Capecitabine_ oral_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGC1","description":"ICD-GCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEF0","description":"ICD-IEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQD0","description":"ICD-PAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXC1","description":"ICD-GFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Splice spleen/kidney veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37181","description":"Splice spleen/kidney veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYD0","description":"ICD-PGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTE0","description":"ICD-NHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAB0","description":"ICD-OKAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCC1","description":"ICD-ADCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4425","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","description":"HCPCS-Q4425","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGE1","description":"ICD-GFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGB1","description":"ICD-NJGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIE0","description":"ICD-IGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPD0","description":"ICD-NFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLE1","description":"ICD-OJLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove tunneled ip cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49422","description":"Remove tunneled ip cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Obstetrical care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59409","description":"Obstetrical care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHB0","description":"ICD-FHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJE1","description":"ICD-KAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGF0","description":"ICD-BEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBA0","description":"ICD-IFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDB0","description":"ICD-ICDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fosnetupitant 235 mg and palonosetron 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9033","description":"Injection_ fosnetupitant 235 mg and palonosetron 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLB0","description":"ICD-KCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMC0","description":"ICD-IFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc surv no stroke after cea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9261","description":"Doc surv no stroke after cea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lifestyle mod 1st stage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0340","description":"Lifestyle mod 1st stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67805","description":"Remove eyelid lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Semi precision attach abut","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6052","description":"Semi precision attach abut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No ahi or rdi initial dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8844","description":"No ahi or rdi initial dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKD0","description":"ICD-CFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUB1","description":"ICD-FFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lefort i-2 piece w/ graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21146","description":"Lefort i-2 piece w/ graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWC1","description":"ICD-PBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECB1","description":"ICD-MECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYC1","description":"ICD-HAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMC0","description":"ICD-FGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRE1","description":"ICD-KBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwr seat elevation sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2300","description":"Pwr seat elevation sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMA0","description":"ICD-OAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1492","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","description":"HCPCS-M1492","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; adipose tissue harvesting_ isolation and preparation of harvested cells_ i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0717T","description":"Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; adipose tissue harvesting_ isolation and preparation of harvested cells_ i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXE1","description":"ICD-OHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIC1","description":"ICD-KEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBA0","description":"ICD-KDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCA0","description":"ICD-KGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Factor viii recomb obizur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7188","description":"Factor viii recomb obizur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1477","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","description":"HCPCS-M1477","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX34","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPF1","description":"ICD-FAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOA1","description":"ICD-HDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE20A","description":"Clinically Complex _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBB1","description":"ICD-GCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sterile needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4215","description":"Sterile needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVA1","description":"ICD-JEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHE1","description":"ICD-JIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCF0","description":"ICD-BGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKF1","description":"ICD-CEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMD0","description":"ICD-CCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXA1","description":"ICD-GCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Programmer for transient_ orally ingested capsule","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9268","description":"Programmer for transient_ orally ingested capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00832","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00832","description":"CPT-00832","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUE1","description":"ICD-FCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59851","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGA1","description":"ICD-FBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq dev breast add mr guide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19288","description":"Perq dev breast add mr guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin pneum/hydra pneum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5780","description":"Knee-shin pneum/hydra pneum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0501","description":"HCPCS-C0501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00872","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00872","description":"CPT-00872","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"DMPK (DM1 protein kinase) (eg_ myotonic dystrophy type 1) gene analysis; characterization of alleles (eg_ expanded size)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81239","description":"DMPK (DM1 protein kinase) (eg_ myotonic dystrophy type 1) gene analysis; characterization of alleles (eg_ expanded size)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHA1","description":"ICD-CGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYC1","description":"ICD-GEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA13","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJF1","description":"ICD-BCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr epigastric hern blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49572","description":"Rpr epigastric hern blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHC0","description":"ICD-IIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYD1","description":"ICD-KEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chlamydia igm antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86632","description":"Chlamydia igm antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dx gastr intub w/asp spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43754","description":"Dx gastr intub w/asp spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSA0","description":"ICD-CDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pertuzumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9306","description":"Injection_ pertuzumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUA0","description":"ICD-AAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCD1","description":"ICD-FGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18D","description":"Special Care High _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chimeric antigen receptor T-cell (CAR-T) therapy; preparation of blood-derived T lymphocytes for transportation (eg_ cryopreservation_ storage)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0538T","description":"Chimeric antigen receptor T-cell (CAR-T) therapy; preparation of blood-derived T lymphocytes for transportation (eg_ cryopreservation_ storage)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUC1","description":"ICD-AEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"TERT (telomerase reverse transcriptase) (eg_ thyroid carcinoma_ glioblastoma multiforme) gene analysis_ targeted sequence analysis (eg_ promoter region)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81345","description":"TERT (telomerase reverse transcriptase) (eg_ thyroid carcinoma_ glioblastoma multiforme) gene analysis_ targeted sequence analysis (eg_ promoter region)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tx contour defects 5.1-10cc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11952","description":"Tx contour defects 5.1-10cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPD1","description":"ICD-OLPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surrogate viral neutralization test (sVNT)_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ ELISA_ plasma_ serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0226U","description":"Surrogate viral neutralization test (sVNT)_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ ELISA_ plasma_ serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAB1","description":"ICD-JCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0401","description":"HCPCS-C0401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOA0","description":"ICD-OCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens bifocal speciality","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2299","description":"Lens bifocal speciality","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLA1","description":"ICD-ICLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRC1","description":"ICD-KDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLE0","description":"ICD-MBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA5B","description":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCD0","description":"ICD-GCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVC1","description":"ICD-NGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFID1","description":"ICD-IFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJC0","description":"ICD-OHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6066","description":"Implant supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin a1c level is missing_ or was not performed during the measurement period (12 months)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1212","description":"Hemoglobin a1c level is missing_ or was not performed during the measurement period (12 months)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLC1","description":"ICD-BBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psa screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0103","description":"Psa screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt education noc individ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9445","description":"Pt education noc individ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGE1","description":"ICD-JCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDA0","description":"ICD-KGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clofarabine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9027","description":"Clofarabine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41007","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHE0","description":"ICD-CAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elbow child myoelectronic ct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7191","description":"Elbow child myoelectronic ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release knuckle contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26520","description":"Release knuckle contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKB1","description":"ICD-JDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bevacizumab-awwb_ biosimilar_ (Mvasi)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5107","description":"Injection_ bevacizumab-awwb_ biosimilar_ (Mvasi)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen supplies stand/rack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1355","description":"Oxygen supplies stand/rack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise & treat bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51020","description":"Incise & treat bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIB0","description":"ICD-KIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDC0","description":"ICD-CBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJA1","description":"ICD-NIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amalgam 4 or > surfaces perm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2161","description":"Amalgam 4 or > surfaces perm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIA0","description":"ICD-AHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1736","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1736","description":"HCPCS-C1736","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Scleral cover shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2627","description":"Scleral cover shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laetrile amygdalin vit b17","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3570","description":"Laetrile amygdalin vit b17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCC0","description":"ICD-BDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQB0","description":"ICD-PFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHE1","description":"ICD-BCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRE0","description":"ICD-PKRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAE1","description":"ICD-FIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSC0","description":"ICD-OKSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Med reas antibiotic pres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8709","description":"Med reas antibiotic pres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBA1","description":"ICD-MFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNA0","description":"ICD-NBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ evaluation of drugs present by LC-MS/MS_ urine_ 31 drug panel_ reported as quantitative results_ detected or not detected_ per date of service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0051U","description":"Prescription drug monitoring_ evaluation of drugs present by LC-MS/MS_ urine_ 31 drug panel_ reported as quantitative results_ detected or not detected_ per date of service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extraction of lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66920","description":"Extraction of lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect foot/toe tumor < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28046","description":"Resect foot/toe tumor < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRF1","description":"ICD-GIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYD0","description":"ICD-HDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLA1","description":"ICD-FFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc hip/pelv tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27045","description":"Exc hip/pelv tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVE1","description":"ICD-BGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD13A","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0563","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","description":"HCPCS-G0563","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery blockage each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75964","description":"Repair artery blockage each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUF0","description":"ICD-EHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXF1","description":"ICD-FFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPD0","description":"ICD-OLPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medical home level ii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9149","description":"Medical home level ii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Csit perf on low chd rsk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8965","description":"Csit perf on low chd rsk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Emergency tracheotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7990","description":"Emergency tracheotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIB1","description":"ICD-NBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUB0","description":"ICD-IBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nfct agent detection gi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87505","description":"Nfct agent detection gi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVE1","description":"ICD-KAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reopening of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49002","description":"Reopening of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERA0","description":"ICD-HERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDD0","description":"ICD-FFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electric wound treatment dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0769","description":"Electric wound treatment dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMB0","description":"ICD-BHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVC1","description":"ICD-GBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC25A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYA1","description":"ICD-PFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44366","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 100 mcg/0.5mL dosage_ for in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91301","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 100 mcg/0.5mL dosage_ for in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFME1","description":"ICD-CFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tah rad debulk/lymph remove","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58954","description":"Tah rad debulk/lymph remove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0681","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","description":"HCPCS-J0681","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng arm splint fbrg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4018","description":"Cast sup lng arm splint fbrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC0D","description":"Ultra High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOE1","description":"ICD-HHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCF0","description":"ICD-FDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comp comm supp svc_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2015","description":"Comp comm supp svc_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUE1","description":"ICD-JEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPA1","description":"ICD-NFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQE0","description":"ICD-PFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of insulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83527","description":"Assay of insulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62180","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth insert penis device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93851","description":"Anesth insert penis device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53020","description":"Incision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Maxilla open reduct simple","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7610","description":"Maxilla open reduct simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Part hand thumb rem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6000","description":"Part hand thumb rem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVF0","description":"ICD-FHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHB1","description":"ICD-NAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheeled cart_ port cyl/conc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1354","description":"Wheeled cart_ port cyl/conc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE11C","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75710","description":"Artery x-rays arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLC0","description":"ICD-OKLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc antibio given b/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4046F","description":"Doc antibio given b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Critical care first hour","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99291","description":"Critical care first hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Administration of a standardized_ evidence-based social determinants of health risk assessment tool_ 5-15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0136","description":"Administration of a standardized_ evidence-based social determinants of health risk assessment tool_ 5-15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXF0","description":"ICD-KDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D2001","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2001","description":"CDT-D2001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ viltolarsen_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9071","description":"Injection_ viltolarsen_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWF0","description":"ICD-LCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66150","description":"Glaucoma surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27254","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKE1","description":"ICD-FAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYB1","description":"ICD-PKYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1504","description":"HCPCS-B1504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJB0","description":"ICD-GBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITF0","description":"ICD-EITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nerve repair; with nerve allograft_ each nerve_ first strand (cable)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64912","description":"Nerve repair; with nerve allograft_ each nerve_ first strand (cable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDD1","description":"ICD-NHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRD1","description":"ICD-LBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA14C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIE1","description":"ICD-JIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWB0","description":"ICD-GAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWF0","description":"ICD-GCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0501T","description":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFD1","description":"ICD-FHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35450","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1DC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DC31","description":"ICD-1DC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41826","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCC0","description":"ICD-FDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8A","description":"Very High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental unspec restorative pr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2999","description":"Dental unspec restorative pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; complete system (electrode and implantable monitor)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0530T","description":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; complete system (electrode and implantable monitor)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHB1","description":"ICD-IAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient Had A Prior Influenza Virus Vaccine Adverse Reaction Any Time Before Or During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2164","description":"Patient Had A Prior Influenza Virus Vaccine Adverse Reaction Any Time Before Or During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMC0","description":"ICD-FCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAE1","description":"ICD-EGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFA0","description":"ICD-OAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pulp cap indirect","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3120","description":"Pulp cap indirect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doppler flow testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93990","description":"Doppler flow testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glucose test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82950","description":"Glucose test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chron care mgmt srvc 20 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99490","description":"Chron care mgmt srvc 20 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ casirivimab and imdevimab_ 600 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0240","description":"Injection_ casirivimab and imdevimab_ 600 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61850","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor <22.05._comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0207","description":"Traumatic brain injury with Motor <22.05._comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUF0","description":"ICD-MGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHA1","description":"ICD-CEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-52443","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","description":"CPT-52443","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acellular derm matrix implt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15777","description":"Acellular derm matrix implt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDA0","description":"ICD-MDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESD1","description":"ICD-LESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient had one or less emergency department visits in the last 30 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9851","description":"Patient had one or less emergency department visits in the last 30 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy & revise urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52275","description":"Cystoscopy & revise urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bridge porcelain/ceramic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6245","description":"Bridge porcelain/ceramic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXB0","description":"ICD-JIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA50","description":"Low Rehab_ ADL Index 0-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Image not std nomenclature","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9319","description":"Image not std nomenclature","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWB0","description":"ICD-OLWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOF0","description":"ICD-OAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJB1","description":"ICD-CHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCF1","description":"ICD-JCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBC0","description":"ICD-BBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLC1","description":"ICD-JBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ belinostat_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9032","description":"Injection_ belinostat_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mononuclear cell antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86356","description":"Mononuclear cell antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESD0","description":"ICD-DESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90382","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","description":"CPT-90382","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES244","description":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALE1","description":"ICD-EALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWA0","description":"ICD-DBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tissue culture placenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88235","description":"Tissue culture placenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIB0","description":"ICD-OJIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Note hring tst w/in 6 mon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3230F","description":"Note hring tst w/in 6 mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVD1","description":"ICD-FDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFD1","description":"ICD-JCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYF0","description":"ICD-DDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIE1","description":"ICD-CIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of hip prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27090","description":"Removal of hip prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ triamcinolone acetonide_ suprachoroidal (Xipere)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9092","description":"Injection_ triamcinolone acetonide_ suprachoroidal (Xipere)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDE0","description":"ICD-FHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQC1","description":"ICD-LBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSD0","description":"ICD-GFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCE0","description":"ICD-ECCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIB1","description":"ICD-MAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special eye evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92020","description":"Special eye evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1397","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","description":"HCPCS-M1397","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQC1","description":"ICD-KEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTA1","description":"ICD-CCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXA0","description":"ICD-OCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin fetal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85460","description":"Hemoglobin fetal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWE0","description":"ICD-DFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27727","description":"Repair of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wrist/elbow bowden cbl dir f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6582","description":"Wrist/elbow bowden cbl dir f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNA0","description":"ICD-KFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRD0","description":"ICD-KDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIF1","description":"ICD-EHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB22D","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote Afterloading High Dose Rate Radionuclide Brachytherapy; Over 12 Channels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77787","description":"Remote Afterloading High Dose Rate Radionuclide Brachytherapy; Over 12 Channels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy diagnostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32601","description":"Thoracoscopy diagnostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSF0","description":"ICD-HGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGE1","description":"ICD-BIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTC1","description":"ICD-NCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of chin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21122","description":"Reconstruction of chin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy control bleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43227","description":"Esophagoscopy control bleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0682U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682U","description":"CPT-0682U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29040","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNC0","description":"ICD-OCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQD1","description":"ICD-HCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVD1","description":"ICD-KCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFA0","description":"ICD-OFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt reas not rec hcv srn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9385","description":"Doc pt reas not rec hcv srn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMF0","description":"ICD-KHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure for chemonucleolysis_ including discography_ intervertebral disc_ single or multiple levels_ lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62292","description":"Injection procedure for chemonucleolysis_ including discography_ intervertebral disc_ single or multiple levels_ lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDF1","description":"ICD-CBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGD1","description":"ICD-FAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHB0","description":"ICD-NKHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCA1","description":"ICD-JGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBB1","description":"ICD-IGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUF0","description":"ICD-JEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHC0","description":"ICD-ACHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25530","description":"Treat fracture of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAA1","description":"ICD-GEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEF1","description":"ICD-CGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of iris prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0616T","description":"Insertion of iris prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunoglobulin Light Chains (Ie_ Kappa_ Lambda)_ Free_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83521","description":"Immunoglobulin Light Chains (Ie_ Kappa_ Lambda)_ Free_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pathogen reduced plasma pool","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9070","description":"Pathogen reduced plasma pool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBA1","description":"ICD-GIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMD0","description":"ICD-IIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Genitourinary nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78799","description":"Genitourinary nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21240","description":"Reconstruction of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBED0","description":"ICD-MBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug test presump optical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0477","description":"Drug test presump optical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWD0","description":"ICD-OFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHA0","description":"ICD-MEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDC0","description":"ICD-AIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of uterus lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58100","description":"Biopsy of uterus lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of cervical canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57800","description":"Dilation of cervical canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC15A","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33411","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDD0","description":"ICD-ODDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAB1","description":"ICD-KHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth pacemaker insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53051","description":"Anesth pacemaker insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTF1","description":"ICD-NHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Debride skin musc at fx site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11011","description":"Debride skin musc at fx site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place perm pacing cardiovert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0448","description":"Place perm pacing cardiovert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00700","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00700","description":"CPT-00700","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA02","description":"Ultra High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis_ administered by","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96203","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis_ administered by","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKF0","description":"ICD-KEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mast subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19304","description":"Mast subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHD0","description":"ICD-MFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous rf vein add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36476","description":"Endovenous rf vein add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of teeth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70300","description":"X-ray exam of teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC25","description":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67950","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB231","description":"Special Care Low _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99427","description":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHF1","description":"ICD-EAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4398","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","description":"HCPCS-Q4398","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac drug stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93024","description":"Cardiac drug stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 hd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0837","description":"Pwc gp 2 hd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMF1","description":"ICD-BCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPC0","description":"ICD-KHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Somatosensory testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95926","description":"Somatosensory testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMD1","description":"ICD-BFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOA1","description":"ICD-KGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHB1","description":"ICD-GFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plan 2 main dr by 1 month","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5050F","description":"Plan 2 main dr by 1 month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1029T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1029T","description":"CPT-1029T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB15C","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFB0","description":"ICD-OHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac MRI w/stress img","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75559","description":"Cardiac MRI w/stress img","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDD1","description":"ICD-MIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYD0","description":"ICD-HHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNB0","description":"ICD-FDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMB1","description":"ICD-EHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Optimizing Chronic Disease Management Mips Value Pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0056","description":"Optimizing Chronic Disease Management Mips Value Pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychological or neuropsychological test administration_ with single automated_ standardized instrument via electronic platform_ with automated result only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96146","description":"Psychological or neuropsychological test administration_ with single automated_ standardized instrument via electronic platform_ with automated result only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTA1","description":"ICD-OJTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAF1","description":"ICD-BEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMB1","description":"ICD-GDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exam synovial fluid crystals","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89060","description":"Exam synovial fluid crystals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBE0","description":"ICD-FBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patient That Requires The Supervision Of A Physician Or Other Qualified Health Care Profes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2083","description":"Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patient That Requires The Supervision Of A Physician Or Other Qualified Health Care Profes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prostate biopsy_ any mthd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0416","description":"Prostate biopsy_ any mthd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amniocentesis therapeutic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59001","description":"Amniocentesis therapeutic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKA0","description":"ICD-NKKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRF0","description":"ICD-KFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemo by both infusion and o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0085","description":"Chemo by both infusion and o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including neuronavigation_ delivery and management_ subsequent motor threshold re","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0892T","description":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including neuronavigation_ delivery and management_ subsequent motor threshold re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bitewings - three films","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0273","description":"Bitewings - three films","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLE1","description":"ICD-OHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEB1","description":"ICD-JBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ped home apnea rec downld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94776","description":"Ped home apnea rec downld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBE0","description":"ICD-AFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDE1","description":"ICD-BIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHB0","description":"ICD-BIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens pmma bifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2502","description":"Contact lens pmma bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGA0","description":"ICD-NCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert spine infusion device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62360","description":"Insert spine infusion device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBID1","description":"ICD-OBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJB0","description":"ICD-CAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUD1","description":"ICD-CBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAF1","description":"ICD-FGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMC1","description":"ICD-KDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPD0","description":"ICD-CHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt doc no burn prior to d/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8909","description":"Pt doc no burn prior to d/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fracture assessment via dxa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77086","description":"Fracture assessment via dxa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal Endo Surg; Balln Dilat Eust T","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9745","description":"Nasal Endo Surg; Balln Dilat Eust T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL22","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate_ inclusive of all imaging guidance and monitoring; multi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36466","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate_ inclusive of all imaging guidance and monitoring; multi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hhc pt assistant ea 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0157","description":"Hhc pt assistant ea 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLB0","description":"ICD-BCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGE1","description":"ICD-KBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBA0","description":"ICD-MKBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93015","description":"Cardiovascular stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESC0","description":"ICD-CESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMA1","description":"ICD-EHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct urethra/penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54352","description":"Reconstruct urethra/penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB151","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEB0","description":"ICD-EBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXF0","description":"ICD-CCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVE1","description":"ICD-FHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee ext/flex w act res ctrl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1812","description":"Knee ext/flex w act res ctrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUC1","description":"ICD-CCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCD0","description":"ICD-BHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISF0","description":"ICD-DISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antiviral not ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9244","description":"Antiviral not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Latex leg strap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5113","description":"Latex leg strap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0548","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","description":"HCPCS-G0548","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHD1","description":"ICD-EDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABA1","description":"ICD-CABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA15","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQC0","description":"ICD-CFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aldesleukin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9015","description":"Aldesleukin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSB1","description":"ICD-KGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cysto/uretero stricture tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52344","description":"Cysto/uretero stricture tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDC0","description":"ICD-BBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYB1","description":"ICD-CGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDE0","description":"ICD-CCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-81195","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","description":"CPT-81195","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo-myomectomy complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58546","description":"Laparo-myomectomy complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDF0","description":"ICD-GEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECD0","description":"ICD-FECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prep ak ischial open end","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5585","description":"Prep ak ischial open end","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inject r ventr/atrial angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93566","description":"Inject r ventr/atrial angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of ovary(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58920","description":"Partial removal of ovary(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam hip uni 4/> views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73503","description":"X-ray exam hip uni 4/> views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9184","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","description":"HCPCS-J9184","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFD1","description":"ICD-OJFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skn sub grft f/n/hf/g child","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15277","description":"Skn sub grft f/n/hf/g child","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC11A","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA10C","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1416","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","description":"HCPCS-M1416","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEF0","description":"ICD-AHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYE0","description":"ICD-OBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGE0","description":"ICD-BCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Below knee leather socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5638","description":"Below knee leather socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mammo result com to pt 5 day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5062F","description":"Mammo result com to pt 5 day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1452","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","description":"HCPCS-M1452","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of leg nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64840","description":"Repair of leg nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67904","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJF0","description":"ICD-BIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIC0","description":"ICD-FBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aerosol compressor adjust pr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0572","description":"Aerosol compressor adjust pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1704","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1704","description":"HCPCS-B1704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGF0","description":"ICD-CDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPC1","description":"ICD-JIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2JB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JB11","description":"ICD-2JB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEA0","description":"ICD-OKEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIF1","description":"ICD-NKIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA4D","description":"Default_ /PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1113","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Fluoroscopy And/Or Ultrasound Guidance_ When Performed; 6 Years And Older Without Congenita","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33017","description":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Fluoroscopy And/Or Ultrasound Guidance_ When Performed; 6 Years And Older Without Congenita","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1LA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LA11","description":"ICD-1LA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYC0","description":"ICD-PIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair bladder/vagina lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51900","description":"Repair bladder/vagina lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0167","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","description":"HCPCS-J0167","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-RUC01","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"RUC01","description":"ICD-RUC01","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fixation of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27570","description":"Fixation of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Afo molded plas rig ant tib","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1945","description":"Afo molded plas rig ant tib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAA1","description":"ICD-BFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx prostate clinical met","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9133","description":"Onc dx prostate clinical met","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQC1","description":"ICD-LCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1403","description":"HCPCS-B1403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVF1","description":"ICD-FAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aspirin or another antiplatelet therapy used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1055","description":"Aspirin or another antiplatelet therapy used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJC0","description":"ICD-CEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Docrsn for cath maint dia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9264","description":"Docrsn for cath maint dia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELC1","description":"ICD-NELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKF0","description":"ICD-NBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transfer skin pedicle flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15650","description":"Transfer skin pedicle flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILF0","description":"ICD-JILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFA0","description":"ICD-BGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nebulizer for use w/ regulat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0580","description":"Nebulizer for use w/ regulat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDB1","description":"ICD-OEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIF0","description":"ICD-EGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAE0","description":"ICD-GGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23929","description":"Shoulder surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJE1","description":"ICD-FCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL3C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFB1","description":"ICD-OFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shortening of hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26479","description":"Shortening of hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJB0","description":"ICD-JIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUA0","description":"ICD-KEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNE0","description":"ICD-OKNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTE1","description":"ICD-CBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair elbow w/deb open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24358","description":"Repair elbow w/deb open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFC1","description":"ICD-JFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4377","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","description":"HCPCS-Q4377","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDF0","description":"ICD-AEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD141","description":"Special Care Low _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nephrology (renal transplant)_ RNA expression by select transcriptome sequencing_ using pretransplant peripheral blood_ algorithm reported as a risk score for early acute reje","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0319U","description":"Nephrology (renal transplant)_ RNA expression by select transcriptome sequencing_ using pretransplant peripheral blood_ algorithm reported as a risk score for early acute reje","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUA1","description":"ICD-IGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMD0","description":"ICD-AGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Empiric antibiotic rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4045F","description":"Empiric antibiotic rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQB1","description":"ICD-LDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYF1","description":"ICD-LDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of upper arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24940","description":"Revision of upper arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVB1","description":"ICD-CEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBD0","description":"ICD-EBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"FY GNOTYP ACKR1 EXONS 1-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0187U","description":"FY GNOTYP ACKR1 EXONS 1-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Ocular (Ovemp)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92518","description":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Ocular (Ovemp)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHD0","description":"ICD-OIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ureter endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50980","description":"Ureter endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQD1","description":"ICD-OBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWA1","description":"ICD-PIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIB1","description":"ICD-MJIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dxa bone density/peripheral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77081","description":"Dxa bone density/peripheral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00548","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00548","description":"CPT-00548","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC21A","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of tonsil tags","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42860","description":"Excision of tonsil tags","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient Did Not Receive At Least One Td Vaccine Or One Tdap Vaccine Between Nine Years Prior To The Start Of The Measurement Period And The End Of The Measurement Period; Or H","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2156","description":"Patient Did Not Receive At Least One Td Vaccine Or One Tdap Vaccine Between Nine Years Prior To The Start Of The Measurement Period And The End Of The Measurement Period; Or H","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA22","description":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hkafo torsion cable hip pelv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2050","description":"Hkafo torsion cable hip pelv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBD1","description":"ICD-JCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGA0","description":"ICD-JEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01758","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01758","description":"CPT-01758","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQA1","description":"ICD-DBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLA1","description":"ICD-IDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28G","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Battery for hearing device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5266","description":"Battery for hearing device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBC1","description":"ICD-MEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGA0","description":"ICD-CFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trnscth renal symp denrv bil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0339T","description":"Trnscth renal symp denrv bil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHF0","description":"ICD-JEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINA0","description":"ICD-JINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iron sucrose injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1756","description":"Iron sucrose injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAF1","description":"ICD-IBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc fcn/care plan w/30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8942","description":"Doc fcn/care plan w/30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHB1","description":"ICD-MFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA13","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUC0","description":"ICD-ODUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFID0","description":"ICD-FFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00126","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00126","description":"CPT-00126","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYB1","description":"ICD-GFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavral qualit analys voice","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92524","description":"Behavral qualit analys voice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAB1","description":"ICD-EFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDD1","description":"ICD-NJDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFD0","description":"ICD-OIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ efgartigimod alfa_ 2 mg and hyaluronidase-qvfc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9334","description":"Injection_ efgartigimod alfa_ 2 mg and hyaluronidase-qvfc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oral dexamethasone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8540","description":"Oral dexamethasone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8G","description":"High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc med reas no pneumococcal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8865","description":"Doc med reas no pneumococcal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Multi-durometer below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5665","description":"Multi-durometer below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGID0","description":"ICD-AGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMA0","description":"ICD-EEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLND1","description":"ICD-NLND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Episiotomy or vaginal repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59300","description":"Episiotomy or vaginal repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAD1","description":"ICD-NEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPC0","description":"ICD-BIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair brain fluid leakage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62100","description":"Repair brain fluid leakage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATE0","description":"ICD-KATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAED0","description":"ICD-NAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVF1","description":"ICD-GHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ctlso milwauke initial model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1000","description":"Ctlso milwauke initial model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELB0","description":"ICD-EELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mechanical chest wall oscill","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94669","description":"Mechanical chest wall oscill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No oder pjp for med reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9219","description":"No oder pjp for med reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc exten prosth addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34826","description":"Endovasc exten prosth addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCF0","description":"ICD-OBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIID0","description":"ICD-EIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUE0","description":"ICD-GFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Copd mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8757","description":"Copd mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMD0","description":"ICD-GGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYB1","description":"ICD-HGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgery electrocorticogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95829","description":"Surgery electrocorticogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx orbit periorbtl implt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21390","description":"Opn tx orbit periorbtl implt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX0A","description":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eye photography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92285","description":"Eye photography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67935","description":"Repair eyelid wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ef ped complete intact nut","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4158","description":"Ef ped complete intact nut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLC1","description":"ICD-BHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFB1","description":"ICD-CEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rigid lined pre one pie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0488","description":"Tlso rigid lined pre one pie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65272","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCE0","description":"ICD-ACCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Professional services for the administration of subcutaneous immunotherapy for each infusion drug administration calendar day i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0069","description":"Professional services for the administration of subcutaneous immunotherapy for each infusion drug administration calendar day i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1099T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1099T","description":"CPT-1099T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILA0","description":"ICD-CILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWF1","description":"ICD-DDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCD0","description":"ICD-OLCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hip flexible cover system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5966","description":"Hip flexible cover system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behav chng smoking 3-10 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99406","description":"Behav chng smoking 3-10 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA11C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJC1","description":"ICD-OCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic image jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70336","description":"Magnetic image jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter implantation of wireless pulmonary artery pressure sensor for long-term hemodynamic monitoring_ including deployment and calibration of the sensor_ right heart c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33289","description":"Transcatheter implantation of wireless pulmonary artery pressure sensor for long-term hemodynamic monitoring_ including deployment and calibration of the sensor_ right heart c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Red Cell Antigen (Mns Blood Group) Genotyping (Gypa)_ Gene Analysis_ Gypa (Glycophorin A [Mns Blood Group]) Introns 1_ 5_ Exon 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1089U","description":"Red Cell Antigen (Mns Blood Group) Genotyping (Gypa)_ Gene Analysis_ Gypa (Glycophorin A [Mns Blood Group]) Introns 1_ 5_ Exon 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTA0","description":"ICD-ADTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRD1","description":"ICD-LHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPC0","description":"ICD-JDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mini-prop remote joystick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2312","description":"Mini-prop remote joystick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCB1","description":"ICD-ABCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUA1","description":"ICD-OEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat slipped epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27181","description":"Treat slipped epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlso 3 piece rigid shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0492","description":"Tlso 3 piece rigid shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thorac cont lat support upri","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2680","description":"Thorac cont lat support upri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQA1","description":"ICD-PKQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ argatroban_ 1 mg (for non-ESRD use)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0883","description":"Injection_ argatroban_ 1 mg (for non-ESRD use)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHB1","description":"ICD-AAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESD0","description":"ICD-KESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBC0","description":"ICD-CBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMC1","description":"ICD-KEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJC1","description":"ICD-GBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMB1","description":"ICD-NBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26770","description":"Treat finger dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLC1","description":"ICD-NJLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9985","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKA0","description":"ICD-KBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETE0","description":"ICD-AETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYE0","description":"ICD-PEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ meloxicam_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9059","description":"Injection_ meloxicam_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYD1","description":"ICD-OAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD246","description":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYA1","description":"ICD-GBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDA1","description":"ICD-MDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACC1","description":"ICD-EACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIC1","description":"ICD-GAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLF1","description":"ICD-NBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27391","description":"Incision of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote therapeutic monitoring (eg_ therapy adherence_ therapy response); device(s) supply with scheduled (eg_ daily) recording(s) and/or programmed alert(s) transmission to mo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98978","description":"Remote therapeutic monitoring (eg_ therapy adherence_ therapy response); device(s) supply with scheduled (eg_ daily) recording(s) and/or programmed alert(s) transmission to mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cosyntropin cortrosyn inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0834","description":"Cosyntropin cortrosyn inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECB0","description":"ICD-FECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Backbench standard preparation of cadaver or living donor uterine allograft prior to transplantation_ including dissection and removal of surrounding soft tissues and preparat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0668T","description":"Backbench standard preparation of cadaver or living donor uterine allograft prior to transplantation_ including dissection and removal of surrounding soft tissues and preparat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28104","description":"Removal of foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt ref doc oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8559","description":"Pt ref doc oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMB1","description":"ICD-BHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hfo nontorsion jnts pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3930","description":"Hfo nontorsion jnts pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Receiver (Monitor)_ dedicated_ for use with therapeutic continuous glucose mnitor system.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0554","description":"Receiver (Monitor)_ dedicated_ for use with therapeutic continuous glucose mnitor system.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCE1","description":"ICD-KDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastro-Enterology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4006","description":"Gastro-Enterology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNE1","description":"ICD-JCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICE0","description":"ICD-CICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHB0","description":"ICD-GCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIME0","description":"ICD-MIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Procuren or other growth fac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9055","description":"Procuren or other growth fac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ligate leg veins open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37761","description":"Ligate leg veins open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36583","description":"Replace tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLC1","description":"ICD-GHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERB0","description":"ICD-DERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKA0","description":"ICD-NHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAA1","description":"ICD-BHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAE1","description":"ICD-BGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXD1","description":"ICD-GDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRD1","description":"ICD-HHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYE0","description":"ICD-DFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB14B","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSD0","description":"ICD-CDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35475","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAE0","description":"ICD-NEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAB0","description":"ICD-GIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tongue suspension","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41512","description":"Tongue suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGD1","description":"ICD-NIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application long leg splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29505","description":"Application long leg splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEND1","description":"ICD-BEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQC1","description":"ICD-OKQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXE1","description":"ICD-FDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDB1","description":"ICD-EDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTB0","description":"ICD-OKTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABC0","description":"ICD-JABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEME0","description":"ICD-GEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB146","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Salicylate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6038","description":"Salicylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pin finger dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26776","description":"Pin finger dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient recorded spirometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94014","description":"Patient recorded spirometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOC0","description":"ICD-HBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anabolic steroid 3 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80328","description":"Anabolic steroid 3 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUC0","description":"ICD-OLUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPA1","description":"ICD-FHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGD1","description":"ICD-NHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEA0","description":"ICD-AHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18H","description":"Clinically Complex _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kanamycin sulfate 75 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1850","description":"Kanamycin sulfate 75 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALF0","description":"ICD-AALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93642","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEF1","description":"ICD-JDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBE1","description":"ICD-GFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUC1","description":"ICD-CIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOA1","description":"ICD-GBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18E","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clsd red simpl mandible fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7640","description":"Clsd red simpl mandible fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain external ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69005","description":"Drain external ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAA0","description":"ICD-OAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1035T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1035T","description":"CPT-1035T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB145","description":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTD1","description":"ICD-OBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replant forearm complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20805","description":"Replant forearm complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXA0","description":"ICD-CAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIED1","description":"ICD-NIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home infusion each addtl hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99602","description":"Home infusion each addtl hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC03","description":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMF0","description":"ICD-MAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enteral stomach tube levine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4083","description":"Enteral stomach tube levine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Factor viii recomb novoeight","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7182","description":"Factor viii recomb novoeight","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMF1","description":"ICD-MKMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGB1","description":"ICD-NHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMD0","description":"ICD-AFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHE1","description":"ICD-IEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foot longitud/metatarsal sup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3020","description":"Foot longitud/metatarsal sup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD10B","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat eyelid by injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68200","description":"Treat eyelid by injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMF0","description":"ICD-BFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMB0","description":"ICD-GIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISF0","description":"ICD-KISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUC1","description":"ICD-IHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEB0","description":"ICD-MKEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57720","description":"Revision of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orphenadrine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2360","description":"Orphenadrine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB106","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOF0","description":"ICD-OBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair urethrovaginal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57311","description":"Repair urethrovaginal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25931","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA115","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove hip pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15941","description":"Remove hip pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acesso_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4311","description":"Acesso_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACD0","description":"ICD-OACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC251","description":"Special Care High _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antihemophilic viii/vwf comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7186","description":"Antihemophilic viii/vwf comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJB0","description":"ICD-OCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE117","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flunisolide comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7641","description":"Flunisolide comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA30","description":"Low Rehab_ ADL Index 0-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8D","description":"High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYF1","description":"ICD-PEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX15","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB15B","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mammo bx proven malig docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3350F","description":"Mammo bx proven malig docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neostim dl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4267","description":"Neostim dl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIF1","description":"ICD-EBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ped power wheelchair nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1239","description":"Ped power wheelchair nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64657","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","description":"CPT-64657","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ftl cgen abnor two proteins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81508","description":"Ftl cgen abnor two proteins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LA21","description":"ICD-2LA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50280","description":"Removal of kidney lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUE0","description":"ICD-CCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXE1","description":"ICD-KIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTF1","description":"ICD-IGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rubella virus vaccine_ live_ for subcutaneous or jet injection use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90706","description":"Rubella virus vaccine_ live_ for subcutaneous or jet injection use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Solid skin barrier 8x8","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5122","description":"Solid skin barrier 8x8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPC0","description":"ICD-BFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSC1","description":"ICD-DGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVE1","description":"ICD-BAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWF0","description":"ICD-PJWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay carbamazepine free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80157","description":"Assay carbamazepine free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87634","description":"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCB0","description":"ICD-OFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUC1","description":"ICD-JIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMD1","description":"ICD-KDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLA0","description":"ICD-JDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECC0","description":"ICD-KECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of upper jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31225","description":"Removal of upper jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLD1","description":"ICD-IFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCD0","description":"ICD-FDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intra-vaginal motion sensor system_ provides biofeedback for pelvic floor muscle rehabilitation device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9002","description":"Intra-vaginal motion sensor system_ provides biofeedback for pelvic floor muscle rehabilitation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA24D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens fitting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92310","description":"Contact lens fitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYE0","description":"ICD-LHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chest x-ray stereo frontal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71015","description":"Chest x-ray stereo frontal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUC0","description":"ICD-NHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYE0","description":"ICD-OEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWB0","description":"ICD-HIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ibandronate sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1740","description":"Ibandronate sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive management and care coordination for advanced illness_ per calendar month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0311","description":"Comprehensive management and care coordination for advanced illness_ per calendar month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj pembrolizumab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9271","description":"Inj pembrolizumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pathology Clinical Consultation; For A Moderately Complex Clinical Problem_ With Review Of Patient_S History And Medical Records And Moderate Level Of Medical Decision Making","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80504","description":"Pathology Clinical Consultation; For A Moderately Complex Clinical Problem_ With Review Of Patient_S History And Medical Records And Moderate Level Of Medical Decision Making","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBF0","description":"ICD-GEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive ear canal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69150","description":"Extensive ear canal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXB0","description":"ICD-BAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21470","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0401","description":"HCPCS-A0401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQA1","description":"ICD-CIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intrpulmnry percuss vent sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0481","description":"Intrpulmnry percuss vent sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAF0","description":"ICD-AGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nvr cndj tst 1-2 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95907","description":"Nvr cndj tst 1-2 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBD1","description":"ICD-OKBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Imp/abut fixed dent part man","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6117","description":"Imp/abut fixed dent part man","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAE0","description":"ICD-FBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIE0","description":"ICD-NFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWF1","description":"ICD-DFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGF1","description":"ICD-BEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap proctopexy w/sig resect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45402","description":"Lap proctopexy w/sig resect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHC0","description":"ICD-KEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc abd les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22903","description":"Exc abd les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX07","description":"Medium Rehab plus Extensive_ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainable pch ex wear convex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4390","description":"Drainable pch ex wear convex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25690","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJID0","description":"ICD-MJID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTA0","description":"ICD-KDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00620","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00620","description":"CPT-00620","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTD0","description":"ICD-MFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMC1","description":"ICD-FDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUF0","description":"ICD-NCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENB1","description":"ICD-FENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOF0","description":"ICD-PAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC105","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant mandible for augment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7996","description":"Implant mandible for augment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove sympathetic nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64804","description":"Remove sympathetic nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gr24 sealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2363","description":"Gr24 sealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYD1","description":"ICD-GDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEB1","description":"ICD-NEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUF1","description":"ICD-CFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1487","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","description":"HCPCS-M1487","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat dislocation/fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23665","description":"Treat dislocation/fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYA0","description":"ICD-LFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl & rplcmt dfb gen mlt ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33264","description":"Rmvl & rplcmt dfb gen mlt ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVA0","description":"ICD-FHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary rehabilitation pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9473","description":"Pulmonary rehabilitation pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKB1","description":"ICD-JIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patients with diabetes who have a most recent fasting or direct LDL- C laboratory test result < 70 mg/dl and are not taking statin therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9783","description":"Documentation of patients with diabetes who have a most recent fasting or direct LDL- C laboratory test result < 70 mg/dl and are not taking statin therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACB1","description":"ICD-MACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE25B","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pancreatic duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48148","description":"Removal of pancreatic duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYD0","description":"ICD-PIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUF1","description":"ICD-AIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBC0","description":"ICD-IDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ccp antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86200","description":"Ccp antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay glucose blood quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82947","description":"Assay glucose blood quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Limited autopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88036","description":"Limited autopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Appendico-vesicostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50845","description":"Appendico-vesicostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB25D","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAC0","description":"ICD-FAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPB0","description":"ICD-NKPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Av fuse uppr arm cephalic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36818","description":"Av fuse uppr arm cephalic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHD0","description":"ICD-GHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFF0","description":"ICD-KBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pos back post/lat wdth <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2615","description":"Pos back post/lat wdth <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE246","description":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQE1","description":"ICD-OFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amniocentesis diagnostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59000","description":"Amniocentesis diagnostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB56","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reproductive Medicine (Endometrial Receptivity Analysis)_ Rna Gene Expression Profile_ 238 Genes By Next-Generation Sequencing_ Endometrial Tissue_ Predictive Algorithm Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0253U","description":"Reproductive Medicine (Endometrial Receptivity Analysis)_ Rna Gene Expression Profile_ 238 Genes By Next-Generation Sequencing_ Endometrial Tissue_ Predictive Algorithm Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUE0","description":"ICD-BEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOD0","description":"ICD-CIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEE1","description":"ICD-MLEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Realignment of knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27457","description":"Realignment of knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"NFCT AGT HIV GNRJ SEQ ALYS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0219U","description":"NFCT AGT HIV GNRJ SEQ ALYS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Whole blood for transfusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9010","description":"Whole blood for transfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCB0","description":"ICD-KBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKD0","description":"ICD-NEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8D","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEE1","description":"ICD-CEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXF1","description":"ICD-GIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACA1","description":"ICD-GACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA51","description":"Very High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; transvenous stimulation or sens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33279","description":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; transvenous stimulation or sens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITE0","description":"ICD-EITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJE1","description":"ICD-NDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOF0","description":"ICD-OFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIB0","description":"ICD-FDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBD1","description":"ICD-NHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pos air press prescribe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8852","description":"Pos air press prescribe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doripenem injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1267","description":"Doripenem injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGB1","description":"ICD-FHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fuse bile ducts and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47780","description":"Fuse bile ducts and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLC0","description":"ICD-FCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEB1","description":"ICD-GFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBE0","description":"ICD-IDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPE0","description":"ICD-GEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMF1","description":"ICD-CGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Complex drainage wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10180","description":"Complex drainage wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJD1","description":"ICD-KAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A5104","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5104","description":"HCPCS-A5104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJE1","description":"ICD-FGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fuse bile ducts and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47785","description":"Fuse bile ducts and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDB0","description":"ICD-AHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth kidney stone destruct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87351","description":"Anesth kidney stone destruct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEA0","description":"ICD-ABEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUE0","description":"ICD-MCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompressive lobectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61323","description":"Decompressive lobectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVA1","description":"ICD-NFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLB1","description":"ICD-NKLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXE0","description":"ICD-NJXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFA1","description":"ICD-CBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26426","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mastoid surgery revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69602","description":"Mastoid surgery revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOA0","description":"ICD-HCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC31","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBD1","description":"ICD-CHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69645","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMB0","description":"ICD-KBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Albumin (human)_ 25%_ 50ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9047","description":"Albumin (human)_ 25%_ 50ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap revision perm ip cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49325","description":"Lap revision perm ip cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTD0","description":"ICD-EFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFD1","description":"ICD-BIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJD1","description":"ICD-NHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPC0","description":"ICD-FCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMF0","description":"ICD-BIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67420","description":"Explore/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Primatrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4110","description":"Primatrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0574","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0574","description":"HCPCS-G0574","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEC1","description":"ICD-CFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUB1","description":"ICD-CFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWA0","description":"ICD-LAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Seg pneumatic appli half leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0669","description":"Seg pneumatic appli half leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESB0","description":"ICD-OESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWB0","description":"ICD-GDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam unilat ribs/chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71101","description":"X-ray exam unilat ribs/chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGD0","description":"ICD-NAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMD0","description":"ICD-JGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt has docd immun to hep c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3515F","description":"Pt has docd immun to hep c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDD1","description":"ICD-IIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUD1","description":"ICD-MKUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; Unmonitored","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95711","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; Unmonitored","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Housing & integrated adhesiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7508","description":"Housing & integrated adhesiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUD0","description":"ICD-IGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFE1","description":"ICD-FFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Case presentation_ subsequent to detailed and extensive treatment planning","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9450","description":"Case presentation_ subsequent to detailed and extensive treatment planning","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open drainage liver lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47010","description":"Open drainage liver lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCE0","description":"ICD-JBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILA0","description":"ICD-NILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amiodarone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80151","description":"Amiodarone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXC0","description":"ICD-JAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote monitoring of a wireless pulmonary artery pressure sensor for up to 30 days_ including at least weekly downloads of pulmonary artery pressure recordings_ interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93264","description":"Remote monitoring of a wireless pulmonary artery pressure sensor for up to 30 days_ including at least weekly downloads of pulmonary artery pressure recordings_ interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30460","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9485","description":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUF1","description":"ICD-GAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSB1","description":"ICD-HHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPF0","description":"ICD-JFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ck (cpk)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82550","description":"Assay of ck (cpk)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Melphalan oral 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8600","description":"Melphalan oral 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGA1","description":"ICD-CFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect enlarged toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28341","description":"Resect enlarged toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of salivary cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42409","description":"Drainage of salivary cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQA1","description":"ICD-LEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/cont_ pelvis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8918","description":"Mra w/cont_ pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD101","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Door to punc time >2hr_ nrg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9582","description":"Door to punc time >2hr_ nrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD126","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal scalp blood sample","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59030","description":"Fetal scalp blood sample","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC30","description":"High Rehab _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD22D","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAME0","description":"ICD-KAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore orbit/remove lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61333","description":"Explore orbit/remove lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1805","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1805","description":"HCPCS-A1805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYE1","description":"ICD-KBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTA0","description":"ICD-ECTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAE0","description":"ICD-NBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFD0","description":"ICD-ODFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pros sheath/sock w gel cushn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8417","description":"Pros sheath/sock w gel cushn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compact travel hemodialyzer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1635","description":"Compact travel hemodialyzer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor intestine/artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44721","description":"Prep donor intestine/artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMD0","description":"ICD-JBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D2002","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2002","description":"CDT-D2002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical exposure of root surface without apicoectomy or repair of root resorption - molar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3503","description":"Surgical exposure of root surface without apicoectomy or repair of root resorption - molar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC256","description":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHC0","description":"ICD-BDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA33","description":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYA1","description":"ICD-LEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Recement space maintainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1550","description":"Recement space maintainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYD0","description":"ICD-DGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepatic function panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80076","description":"Hepatic function panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIE0","description":"ICD-JFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25675","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA34","description":"Low Rehab_ ADL Index 0-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWF1","description":"ICD-OKWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFA0","description":"ICD-GDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cultr oocyte/embryo <4 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89251","description":"Cultr oocyte/embryo <4 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJF1","description":"ICD-CGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCME1","description":"ICD-MCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMB0","description":"ICD-CIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prescription drug_brand name","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5001","description":"Prescription drug_brand name","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth cabg w/pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56752","description":"Anesth cabg w/pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLC0","description":"ICD-CGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1085T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1085T","description":"CPT-1085T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth intrcrn nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22051","description":"Anesth intrcrn nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFF0","description":"ICD-OBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJF1","description":"ICD-BBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKB1","description":"ICD-GAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esrd serv 1 visit p mo 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90962","description":"Esrd serv 1 visit p mo 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIF1","description":"ICD-OGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0704","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0704","description":"HCPCS-A0704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65765","description":"Revision of cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKC1","description":"ICD-CIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sock fracture or equal each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3995","description":"Sock fracture or equal each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWC1","description":"ICD-OGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWA1","description":"ICD-KEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tmj arthroscopy synovectomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7875","description":"Tmj arthroscopy synovectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINE1","description":"ICD-GINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0740T","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA231","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLF0","description":"ICD-BHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCC1","description":"ICD-OFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTB0","description":"ICD-MFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behav chng smoking > 10 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99407","description":"Behav chng smoking > 10 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Semen analysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0027","description":"Semen analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA CYTOMEGALOVIRUS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87332","description":"IAAD IA CYTOMEGALOVIRUS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRE1","description":"ICD-PLRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMB0","description":"ICD-CAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEF0","description":"ICD-FFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flowcytometry/tc add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88185","description":"Flowcytometry/tc add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of abdominal wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49900","description":"Repair of abdominal wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES24C","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHA0","description":"ICD-CHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGD0","description":"ICD-FAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53450","description":"Revision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat hand bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26034","description":"Treat hand bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVE1","description":"ICD-KEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Whfo nontorsion joint prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3931","description":"Whfo nontorsion joint prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC24D","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFF1","description":"ICD-CCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPD1","description":"ICD-KDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bio-connekt per square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4161","description":"Bio-connekt per square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMF1","description":"ICD-FBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAB0","description":"ICD-KIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"The MDPP b eneficiary achieved at least 5% weight loss (WL) from his/he r baseline weight in months 1-12 of the MDPP services period under the MDPP Expanded Model (EM).","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9880","description":"The MDPP b eneficiary achieved at least 5% weight loss (WL) from his/he r baseline weight in months 1-12 of the MDPP services period under the MDPP Expanded Model (EM).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAD1","description":"ICD-OCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61891","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00834","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00834","description":"CPT-00834","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTB1","description":"ICD-CBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FA11","description":"ICD-1FA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of leg epiphyses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27742","description":"Repair of leg epiphyses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMC1","description":"ICD-JFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Certified nurse midwife mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0064","description":"Certified nurse midwife mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Report_ prev care measures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8486","description":"Report_ prev care measures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialyzer_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4690","description":"Dialyzer_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOA0","description":"ICD-PGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKB1","description":"ICD-FFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lo rig pos pnl l1-l5 pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0641","description":"Lo rig pos pnl l1-l5 pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ moxifloxacin 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2280","description":"Inj_ moxifloxacin 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of ankle bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28302","description":"Incision of ankle bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repr pul art unifocal w/cpb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33926","description":"Repr pul art unifocal w/cpb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJD0","description":"ICD-GCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAD0","description":"ICD-IIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOA0","description":"ICD-OIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKC0","description":"ICD-GCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67915","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","description":"HCPCS-J2004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEB0","description":"ICD-AEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ext amb infusn pump insulin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0784","description":"Ext amb infusn pump insulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVF1","description":"ICD-BIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIA0","description":"ICD-BIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLD0","description":"ICD-CCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCD0","description":"ICD-MBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2753","description":"Crown - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFA1","description":"ICD-JHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove ventricular device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33977","description":"Remove ventricular device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUB1","description":"ICD-CBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ loncastuximab tesirine-lpyl_ 0.075 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9359","description":"Injection_ loncastuximab tesirine-lpyl_ 0.075 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOC1","description":"ICD-OJOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEA0","description":"ICD-OGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No early ind/delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9355","description":"No early ind/delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAD0","description":"ICD-OEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEF0","description":"ICD-EIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote 30 day ecg rev/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93270","description":"Remote 30 day ecg rev/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"I131 iodide sol_ rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9530","description":"I131 iodide sol_ rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPF1","description":"ICD-GEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVE0","description":"ICD-KEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace g/c tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49450","description":"Replace g/c tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC4B","description":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDD0","description":"ICD-JBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enterostomal therapy by a re","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9474","description":"Enterostomal therapy by a re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYC0","description":"ICD-PEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETF0","description":"ICD-JETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE23D","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Zidovudine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3485","description":"Zidovudine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYE0","description":"ICD-LFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at 12 months as demons","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1020","description":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at 12 months as demons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALE1","description":"ICD-JALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBB0","description":"ICD-IIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIF1","description":"ICD-OFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thrombin time plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85670","description":"Thrombin time plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECC0","description":"ICD-JECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient received chemotherapy in the last 14 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9847","description":"Patient received chemotherapy in the last 14 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETC0","description":"ICD-CETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cysto w/renal stricture tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52343","description":"Cysto w/renal stricture tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACD0","description":"ICD-NACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDE1","description":"ICD-CIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1503","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1503","description":"CDT-D1503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone imaging 3 phase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78315","description":"Bone imaging 3 phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc med pt reas no hcc scrn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9456","description":"Doc med pt reas no hcc scrn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWD0","description":"ICD-HGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECC1","description":"ICD-KECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYA0","description":"ICD-ODYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Whfo w/o joints pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3807","description":"Whfo w/o joints pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Carry d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8986","description":"Carry d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHE0","description":"ICD-EHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy w/tumor excise","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31640","description":"Bronchoscopy w/tumor excise","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraop cyst eval trac inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9606","description":"Intraop cyst eval trac inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of residual cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57540","description":"Removal of residual cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGC1","description":"ICD-KHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVA1","description":"ICD-KBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIE1","description":"ICD-KBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct angiography chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71275","description":"Ct angiography chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIB0","description":"ICD-NAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHE1","description":"ICD-NEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYE0","description":"ICD-LDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAND1","description":"ICD-CAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDE1","description":"ICD-FGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flow cyto done b/4 tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3170F","description":"Flow cyto done b/4 tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Factor xiii anti-hem factor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7180","description":"Factor xiii anti-hem factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDC1","description":"ICD-CHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOC0","description":"ICD-HAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIE1","description":"ICD-MFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPA0","description":"ICD-OBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunohistochemical stains","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0478","description":"Immunohistochemical stains","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBD0","description":"ICD-MLBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise stomach-bowel fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43860","description":"Revise stomach-bowel fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFE1","description":"ICD-OHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27513","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr s/a/l 1.1-2.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13120","description":"Cmplx rpr s/a/l 1.1-2.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB124","description":"Special Care High _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTB1","description":"ICD-ECTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOD0","description":"ICD-PDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSA0","description":"ICD-GDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDA1","description":"ICD-BDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB15","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam l-s spine bending","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72114","description":"X-ray exam l-s spine bending","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICB0","description":"ICD-KICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tocilizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3262","description":"Tocilizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart damage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33545","description":"Repair of heart damage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTC1","description":"ICD-JFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIC0","description":"ICD-NBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41000","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Red blood cell antigen typing_ DNA_ human erythrocyte antigen gene analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0106U","description":"Red blood cell antigen typing_ DNA_ human erythrocyte antigen gene analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATC1","description":"ICD-KATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOE1","description":"ICD-DCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Uv lens/es","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2755","description":"Uv lens/es","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJA0","description":"ICD-NGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Splint digit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8450","description":"Splint digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPB1","description":"ICD-BCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome analysis 20-25","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88264","description":"Chromosome analysis 20-25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDB0","description":"ICD-ADDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARD1","description":"ICD-GARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70360","description":"X-ray exam of neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIE1","description":"ICD-OIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQE0","description":"ICD-PAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients between 50 and 85 years of age who received a screening colonoscopy during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2204","description":"Patients between 50 and 85 years of age who received a screening colonoscopy during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCF0","description":"ICD-CDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11310","description":"Shave skin lesion 0.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4CA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CA21","description":"ICD-4CA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPF0","description":"ICD-FGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGE0","description":"ICD-NJGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBND1","description":"ICD-GBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNC1","description":"ICD-BFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ spine_ entire_ survey study_ anteroposterior an lateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72010","description":"Radiologic examination_ spine_ entire_ survey study_ anteroposterior an lateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAE1","description":"ICD-MHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of upper jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31230","description":"Removal of upper jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI orbit/face/neck w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70542","description":"MRI orbit/face/neck w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of bowel pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44800","description":"Excision of bowel pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB23","description":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFE0","description":"ICD-GAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOF0","description":"ICD-DDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPB0","description":"ICD-CDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB206","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC13A","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation therapy planning","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77261","description":"Radiation therapy planning","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA251","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQF0","description":"ICD-OAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1402","description":"HCPCS-B1402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUF1","description":"ICD-AAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIF1","description":"ICD-EAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31255","description":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Med reas no perf foot exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9502","description":"Med reas no perf foot exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRC1","description":"ICD-DDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYE0","description":"ICD-KHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANC0","description":"ICD-CANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTB1","description":"ICD-FGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFE1","description":"ICD-JAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTA0","description":"ICD-OLTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFB1","description":"ICD-NIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKC1","description":"ICD-OAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair laminectomy defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63295","description":"Repair laminectomy defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAE0","description":"ICD-FHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed total elect w/o mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0297","description":"Hosp bed total elect w/o mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of rectocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45560","description":"Repair of rectocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHD1","description":"ICD-FEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replc sockt shldr dis/interc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6885","description":"Replc sockt shldr dis/interc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMF0","description":"ICD-NJMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBA1","description":"ICD-JIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFD0","description":"ICD-BFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWB1","description":"ICD-OHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01150","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01150","description":"CPT-01150","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMA1","description":"ICD-CGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMB0","description":"ICD-JFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","description":"HCPCS-M1402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"20+ cc syringe only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4213","description":"20+ cc syringe only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVE1","description":"ICD-JIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEF0","description":"ICD-CEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDD0","description":"ICD-BCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rem mntr pulm flu mntr alys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0608T","description":"Rem mntr pulm flu mntr alys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKE0","description":"ICD-KGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNB0","description":"ICD-OCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKB0","description":"ICD-OJKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMD0","description":"ICD-BIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHF0","description":"ICD-EHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECB0","description":"ICD-BECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18D","description":"Special Care Low _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0454U","description":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay urine catecholamines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82382","description":"Assay urine catecholamines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLB1","description":"ICD-EHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mediastinoscpy w/medstnl bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39401","description":"Mediastinoscpy w/medstnl bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGID1","description":"ICD-IGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKF0","description":"ICD-FEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFB0","description":"ICD-NHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIME0","description":"ICD-IIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/abn lvef inelig b-bloc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8451","description":"Pt w/abn lvef inelig b-bloc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXD0","description":"ICD-NIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Self-adher band w <3in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6453","description":"Self-adher band w <3in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUE1","description":"ICD-CHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEC1","description":"ICD-ADEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMA0","description":"ICD-OGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0959T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","description":"CPT-0959T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apply long arm splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29105","description":"Apply long arm splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPD1","description":"ICD-NIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of vein clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34421","description":"Removal of vein clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTA0","description":"ICD-NJTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKD0","description":"ICD-BBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eeg awake and drowsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95816","description":"Eeg awake and drowsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAE1","description":"ICD-IFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDC0","description":"ICD-NIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJD1","description":"ICD-NEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ mon_ bte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5247","description":"Hearing aid_ prog_ mon_ bte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0599U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","description":"CPT-0599U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYA0","description":"ICD-KAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noner transport meals recip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0190","description":"Noner transport meals recip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILF1","description":"ICD-FILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Brolucizumab-Dbll_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0179","description":"Injection_ Brolucizumab-Dbll_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mold socket bent knee shin s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5160","description":"Mold socket bent knee shin s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYF1","description":"ICD-GFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFF1","description":"ICD-KDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise finger tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26055","description":"Incise finger tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHA1","description":"ICD-OEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEED0","description":"ICD-EEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AC21","description":"ICD-3AC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATC0","description":"ICD-MATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement breastpump tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4281","description":"Replacement breastpump tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Including Data Preparation And Transmission_ Quan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0710T","description":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Including Data Preparation And Transmission_ Quan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB20C","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ suprapubic/cystoscopic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2627","description":"Cath_ suprapubic/cystoscopic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX0A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoe sole wedge between sole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3370","description":"Shoe sole wedge between sole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANE1","description":"ICD-CANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9611","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","description":"HCPCS-A9611","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBE1","description":"ICD-ADBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMD1","description":"ICD-NEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTE1","description":"ICD-AFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Obstructive sleep apnea mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8900","description":"Obstructive sleep apnea mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rig fram pelvic pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0469","description":"Tlso rig fram pelvic pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESD1","description":"ICD-OESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBB1","description":"ICD-JDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient is not dysarthric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3763F","description":"Patient is not dysarthric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC15B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMA0","description":"ICD-ADMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPB0","description":"ICD-FBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3290","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3290","description":"HCPCS-J3290","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Other pt/ot goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8991","description":"Other pt/ot goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIB1","description":"ICD-CFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEB1","description":"ICD-CDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise spin&cord 2 stgs crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63198","description":"Incise spin&cord 2 stgs crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBB1","description":"ICD-MKBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPE0","description":"ICD-JEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laser Interstitial Thermal Therapy (Litt) Of Lesion_ Intracranial_ Including Burr Hole(S)_ With Magnetic Resonance Imaging Guidance_ When Performed; Multiple Trajectories For","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61737","description":"Laser Interstitial Thermal Therapy (Litt) Of Lesion_ Intracranial_ Including Burr Hole(S)_ With Magnetic Resonance Imaging Guidance_ When Performed; Multiple Trajectories For","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dstry eye lesn_fdr vssl tech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0186","description":"Dstry eye lesn_fdr vssl tech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA41","description":"High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHE0","description":"ICD-KBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVA0","description":"ICD-OKVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace/irrigate catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62225","description":"Replace/irrigate catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXC1","description":"ICD-OLXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain spinal cord cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62268","description":"Drain spinal cord cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Av fusion direct any site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36821","description":"Av fusion direct any site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vis 20/40/> w/in 90 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4175F","description":"Vis 20/40/> w/in 90 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1002","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1002","description":"CDT-D1002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28H","description":"Clinically Complex _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLME1","description":"ICD-OLME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr s/a/t/ext 2.6-7.5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12032","description":"Intmd rpr s/a/t/ext 2.6-7.5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXB0","description":"ICD-CFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAF1","description":"ICD-EAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDME1","description":"ICD-JDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUE1","description":"ICD-JHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANC1","description":"ICD-FANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSF1","description":"ICD-CCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAF0","description":"ICD-CHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic passive restor comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6360","description":"Thoracic passive restor comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lengthening of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27394","description":"Lengthening of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTA0","description":"ICD-FDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBA1","description":"ICD-ICBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foam filled drive wheel tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2386","description":"Foam filled drive wheel tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJA0","description":"ICD-JEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise max/zygoma mal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21034","description":"Excise max/zygoma mal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9613","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9613","description":"HCPCS-A9613","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore treat shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23107","description":"Explore treat shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ durvalumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9173","description":"Injection_ durvalumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ext ecg review and interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0298T","description":"Ext ecg review and interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hernia repair w/mesh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49568","description":"Hernia repair w/mesh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFD1","description":"ICD-JHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOE1","description":"ICD-OGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJB0","description":"ICD-OKJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of miscarriage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59821","description":"Treatment of miscarriage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIA1","description":"ICD-AGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0716","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0716","description":"HCPCS-E0716","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interprof phone/online 5-10","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99446","description":"Interprof phone/online 5-10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vasc embolize/occlude artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37242","description":"Vasc embolize/occlude artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lymph choriomeningitis ab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86727","description":"Lymph choriomeningitis ab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLF1","description":"ICD-BFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDD1","description":"ICD-NDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLA0","description":"ICD-OLLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81189","description":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ translumin non-laser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1725","description":"Cath_ translumin non-laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJB0","description":"ICD-BGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEME0","description":"ICD-KEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC13D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nb resuscitation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99465","description":"Nb resuscitation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLE0","description":"ICD-CFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCF1","description":"ICD-FHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason for not receiving combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperative","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9957","description":"Documentation of medical reason for not receiving combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECD1","description":"ICD-KECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMB0","description":"ICD-NLMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spleen imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78185","description":"Spleen imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hysteroscopy lysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58559","description":"Hysteroscopy lysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWB1","description":"ICD-OIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion catheter artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36620","description":"Insertion catheter artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE151","description":"Clinically Complex _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychosis_ Depression_ Anxiety_ Apathy_ And Impulse Control Disorder Not Assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2122","description":"Psychosis_ Depression_ Anxiety_ Apathy_ And Impulse Control Disorder Not Assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXB1","description":"ICD-FAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWC1","description":"ICD-CIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTE1","description":"ICD-OJTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth chest surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54051","description":"Anesth chest surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRC0","description":"ICD-GDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWE1","description":"ICD-KEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFE1","description":"ICD-OKFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHA0","description":"ICD-AEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ emapalumab-lzsg_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9210","description":"Injection_ emapalumab-lzsg_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove eye implant material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67121","description":"Remove eye implant material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0101","description":"HCPCS-A0101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQF1","description":"ICD-PHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote physiologic monitoring treatment management services_ 20 minutes or more of clinical staff/physician/other qualified health care professional time in a calendar month r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99457","description":"Remote physiologic monitoring treatment management services_ 20 minutes or more of clinical staff/physician/other qualified health care professional time in a calendar month r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00702","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00702","description":"CPT-00702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKE0","description":"ICD-FIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42210","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor liver/venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47146","description":"Prep donor liver/venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kafo plas sing free knee mol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2037","description":"Kafo plas sing free knee mol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX2C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29044","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLE0","description":"ICD-NDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1098T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1098T","description":"CPT-1098T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRC1","description":"ICD-OGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Direct refer hospital observ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0379","description":"Direct refer hospital observ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIC0","description":"ICD-NAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFA1","description":"ICD-GDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tissue for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20926","description":"Removal of tissue for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAF1","description":"ICD-ACAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPE0","description":"ICD-FGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPD0","description":"ICD-KBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHB1","description":"ICD-BIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKF1","description":"ICD-JFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBB0","description":"ICD-MBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAA0","description":"ICD-KIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sho insert w arch toe filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5000","description":"Sho insert w arch toe filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOF0","description":"ICD-OEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA25","description":"Default_ /14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of glucagon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82943","description":"Assay of glucagon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq plmt bile duct stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47538","description":"Perq plmt bile duct stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEF1","description":"ICD-JIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMA0","description":"ICD-FDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRF0","description":"ICD-PIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALD0","description":"ICD-AALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD23A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES21C","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICA0","description":"ICD-EICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKC0","description":"ICD-JFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eval opioid use instr/pt int","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9584","description":"Eval opioid use instr/pt int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIC0","description":"ICD-CGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Over-bed table","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0274","description":"Over-bed table","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBC1","description":"ICD-CBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERA1","description":"ICD-GERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLC0","description":"ICD-AFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ enfortumab vedotin-ejfv_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9177","description":"Injection_ enfortumab vedotin-ejfv_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMC1","description":"ICD-NLMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise graft w/nonauto graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35883","description":"Revise graft w/nonauto graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOE1","description":"ICD-HDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTA1","description":"ICD-IHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHD0","description":"ICD-FBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEA1","description":"ICD-MKEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE241","description":"Special Care Low _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30400","description":"Reconstruction of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Change of bladder tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51710","description":"Change of bladder tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Post and core cast + crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2952","description":"Post and core cast + crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUB0","description":"ICD-KHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilated macul exam done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2019F","description":"Dilated macul exam done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair skull cavity lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62120","description":"Repair skull cavity lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sensory integration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97533","description":"Sensory integration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement bulb th lightbox","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4634","description":"Replacement bulb th lightbox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKD0","description":"ICD-CIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEE0","description":"ICD-AHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICA0","description":"ICD-KICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Virus inoculation tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87252","description":"Virus inoculation tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No doc elder mal scrn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8536","description":"No doc elder mal scrn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLME1","description":"ICD-NLME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFC1","description":"ICD-KDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACF1","description":"ICD-BACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARF0","description":"ICD-CARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXE1","description":"ICD-GIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPA1","description":"ICD-CDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auric/peri pain assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1116F","description":"Auric/peri pain assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAC1","description":"ICD-FFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8H","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0201","description":"HCPCS-B0201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA15B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Legg perthes orth scottish r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1730","description":"Legg perthes orth scottish r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB4D","description":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQE0","description":"ICD-OIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXB0","description":"ICD-BHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/ultrasound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44406","description":"Colonoscopy w/ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMF1","description":"ICD-MLMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD125","description":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAC0","description":"ICD-NCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-35602","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","description":"CPT-35602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRB1","description":"ICD-CHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASE0","description":"ICD-PASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYA1","description":"ICD-GDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 1-2 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP02","description":"Auto.test pane pricing code_ 1-2 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEA0","description":"ICD-NHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHD1","description":"ICD-JFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx nsclc stg2 no progres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9064","description":"Onc dx nsclc stg2 no progres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC216","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQC1","description":"ICD-CDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMA1","description":"ICD-AAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transport portable ekg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"R0076","description":"Transport portable ekg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKA0","description":"ICD-NGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rbc membranes fatty acids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0111T","description":"Rbc membranes fatty acids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kne-shin exo sng axi mnl loc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5710","description":"Kne-shin exo sng axi mnl loc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXF0","description":"ICD-NJXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/90d mrs 0-2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9646","description":"Pt w/90d mrs 0-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0672U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672U","description":"CPT-0672U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENA1","description":"ICD-BENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABB0","description":"ICD-CABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKD1","description":"ICD-BBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth chest procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52051","description":"Anesth chest procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1433","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","description":"HCPCS-M1433","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18A","description":"Clinically Complex _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCB0","description":"ICD-BGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0587U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","description":"CPT-0587U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYF0","description":"ICD-GEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLA0","description":"ICD-FCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXE0","description":"ICD-KFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENB1","description":"ICD-GENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGB0","description":"ICD-KAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUA1","description":"ICD-JDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Right And Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone(S); Abnormal Nat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93597","description":"Right And Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone(S); Abnormal Nat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove kidney living donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50320","description":"Remove kidney living donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0679U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679U","description":"CPT-0679U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1242","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKF0","description":"ICD-OJKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB5A","description":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8B","description":"High Rehab _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXF1","description":"ICD-OHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMF0","description":"ICD-BHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNB0","description":"ICD-FCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXE1","description":"ICD-BDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive estimate of absolute quantitation of myocardial blood flow (AQMBF)_ derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnet","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0900T","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (AQMBF)_ derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBE0","description":"ICD-JHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCA1","description":"ICD-GDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL23","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYD1","description":"ICD-OBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exsufflation belt_ includes all supplies and accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4468","description":"Exsufflation belt_ includes all supplies and accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kne sing axis fric shin sach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5200","description":"Kne sing axis fric shin sach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove cervix/repair pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57545","description":"Remove cervix/repair pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIE0","description":"ICD-GDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cabg artery-vein five","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33522","description":"Cabg artery-vein five","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"External Ambulatory Infusion Pump_ Insulin_ Dosage Rate Adjustment Using Therapeutic Continuous Glucose Sensing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0787","description":"External Ambulatory Infusion Pump_ Insulin_ Dosage Rate Adjustment Using Therapeutic Continuous Glucose Sensing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove spinal lamina add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63048","description":"Remove spinal lamina add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cochlear device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8614","description":"Cochlear device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJD0","description":"ICD-NDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWE1","description":"ICD-OKWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flowcytometry/read 9-15","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88188","description":"Flowcytometry/read 9-15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIF0","description":"ICD-IEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Levalbuterol non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7614","description":"Levalbuterol non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Body-worn hearing aid air","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5030","description":"Body-worn hearing aid air","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of throat abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42725","description":"Drainage of throat abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCC0","description":"ICD-MGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEE1","description":"ICD-GGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Approp anticonvuls tstng","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4191F","description":"Approp anticonvuls tstng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGD1","description":"ICD-OAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOF1","description":"ICD-GCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAC1","description":"ICD-GAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93017","description":"Cardiovascular stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPD1","description":"ICD-OGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCA1","description":"ICD-FGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Octreotide injection_ depot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2353","description":"Octreotide injection_ depot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove femur lesion/bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27062","description":"Remove femur lesion/bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHB0","description":"ICD-JBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRC1","description":"ICD-CCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"A Model Participant (Ambulance Supplier/Provider)_ The Beneficiary Refuses Services Covered Under The Model (Transport To An Alternate Destination/Treatment In Place)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2022","description":"A Model Participant (Ambulance Supplier/Provider)_ The Beneficiary Refuses Services Covered Under The Model (Transport To An Alternate Destination/Treatment In Place)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx colon t4_ n0 w/o prog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9085","description":"Onc dx colon t4_ n0 w/o prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTA0","description":"ICD-IFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompress small bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44021","description":"Decompress small bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGE0","description":"ICD-OLGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCE0","description":"ICD-ODCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMA0","description":"ICD-BGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATD1","description":"ICD-AATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt surv improv bsline tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9603","description":"Pt surv improv bsline tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFE0","description":"ICD-NBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pathology Clinical Consultation; For A Highly Complex Clinical Problem_ With Comprehensive Review Of Patient_S History And Medical Records And High Level Of Medical Decision M","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80505","description":"Pathology Clinical Consultation; For A Highly Complex Clinical Problem_ With Comprehensive Review Of Patient_S History And Medical Records And High Level Of Medical Decision M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home health services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0320","description":"Home health services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX32","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACD0","description":"ICD-IACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGC1","description":"ICD-BIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHB1","description":"ICD-MBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp fem-ant-post tib/prl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35666","description":"Art byp fem-ant-post tib/prl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOA1","description":"ICD-PIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWD0","description":"ICD-DDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFB0","description":"ICD-OEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUF1","description":"ICD-GBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMB1","description":"ICD-AAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX11","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIA0","description":"ICD-IDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Syringe w/wo needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4657","description":"Syringe w/wo needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHD0","description":"ICD-BGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0476U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","description":"CPT-0476U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYC0","description":"ICD-LHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1037T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1037T","description":"CPT-1037T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNE1","description":"ICD-BDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC214","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUA0","description":"ICD-OCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wound(s) care non-selective","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97602","description":"Wound(s) care non-selective","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEB1","description":"ICD-NIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUF1","description":"ICD-JCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX20","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay rbc glutathione","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82979","description":"Assay rbc glutathione","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEA0","description":"ICD-KBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRF0","description":"ICD-DGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNE1","description":"ICD-JGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwr seat recline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1003","description":"Pwr seat recline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Particle agglut antbdy scrn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86403","description":"Particle agglut antbdy scrn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVA1","description":"ICD-NAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERF1","description":"ICD-LERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oral hiv-1/hiv-2 screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0435","description":"Oral hiv-1/hiv-2 screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC50","description":"Ultra High Rehab _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADF1","description":"ICD-FADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bk back check","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5686","description":"Bk back check","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTD0","description":"ICD-MBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWC0","description":"ICD-ODWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSB0","description":"ICD-PDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIB1","description":"ICD-KBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHD0","description":"ICD-ECHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incis w/discectomy thoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22222","description":"Incis w/discectomy thoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01610","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01610","description":"CPT-01610","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ovary/tube(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58720","description":"Removal of ovary/tube(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIED0","description":"ICD-BIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neck/chest surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21899","description":"Neck/chest surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6794","description":"Crown titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGF1","description":"ICD-CHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0970T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","description":"CPT-0970T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJB1","description":"ICD-GFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTD1","description":"ICD-OCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90616","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90616","description":"CPT-90616","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWF0","description":"ICD-LFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOC0","description":"ICD-OJOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWF1","description":"ICD-GAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIF1","description":"ICD-EGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXE0","description":"ICD-JGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKB0","description":"ICD-BEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMF1","description":"ICD-KFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEE1","description":"ICD-JDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDD0","description":"ICD-JFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-84394","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","description":"CPT-84394","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEB1","description":"ICD-CAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYD1","description":"ICD-OKYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBED0","description":"ICD-IBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYE0","description":"ICD-GHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4360","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","description":"HCPCS-Q4360","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICA0","description":"ICD-AICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Head control nonproportional","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2329","description":"Head control nonproportional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Expandable controller_ initl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2377","description":"Expandable controller_ initl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIB1","description":"ICD-JHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC26","description":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYB0","description":"ICD-HGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUE1","description":"ICD-JFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAND0","description":"ICD-FAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB126","description":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interprofessional telephone/Internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified health care professional_ 30 m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99452","description":"Interprofessional telephone/Internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified health care professional_ 30 m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDE0","description":"ICD-AHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8A","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFD0","description":"ICD-BEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPA0","description":"ICD-JCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1108T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1108T","description":"CPT-1108T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES210","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABA1","description":"ICD-MABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ inclisiran_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1306","description":"Injection_ inclisiran_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove brain lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61519","description":"Remove brain lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE21A","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of heart lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33130","description":"Removal of heart lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for intraoral procedures_ including biopsy; not otherwise specif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0125U","description":"Anesthesia for intraoral procedures_ including biopsy; not otherwise specif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medical services after hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99050","description":"Medical services after hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQF0","description":"ICD-PJQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sio flex pelvisacral custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0622","description":"Sio flex pelvisacral custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18B","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tte f-up or lmtd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93308","description":"Tte f-up or lmtd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA11","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEB0","description":"ICD-BBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBD1","description":"ICD-NCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXB1","description":"ICD-GCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEE0","description":"ICD-IGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Icatibant injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1744","description":"Icatibant injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of knee ligaments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27409","description":"Repair of knee ligaments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of glutathione","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82978","description":"Assay of glutathione","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fluoro polarize fetal lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83663","description":"Fluoro polarize fetal lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCC0","description":"ICD-GDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE240","description":"Special Care Low _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEB1","description":"ICD-GAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCF0","description":"ICD-KFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVB1","description":"ICD-JGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCA1","description":"ICD-OCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD23B","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incisional biopsy of skin (eg_ wedge) (including simple closure_ when performed); single lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11106","description":"Incisional biopsy of skin (eg_ wedge) (including simple closure_ when performed); single lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not screening for tobacco use (e.g._ limited life expectancy_ other medical reason)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9904","description":"Documentation of medical reason(s) for not screening for tobacco use (e.g._ limited life expectancy_ other medical reason)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tr retinal les preterm inf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67229","description":"Tr retinal les preterm inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPE0","description":"ICD-FEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENC1","description":"ICD-OENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHD1","description":"ICD-OEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKF1","description":"ICD-OBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTD1","description":"ICD-GDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ etranacogene dezaparvovec-drlb_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1411","description":"Injection_ etranacogene dezaparvovec-drlb_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HIV-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87391","description":"IAAD IA HIV-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB4B","description":"High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/ndl aspir/bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44407","description":"Colonoscopy w/ndl aspir/bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGC0","description":"ICD-BDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNA1","description":"ICD-GHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVD0","description":"ICD-GHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX52","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYD1","description":"ICD-KCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation that the patient declined therapy change or alternative therapies were unavailable_ has documented contraindications_ or has not been treated with an oral system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9765","description":"Documentation that the patient declined therapy change or alternative therapies were unavailable_ has documented contraindications_ or has not been treated with an oral system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49596","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Malig tumor exc to 1.25 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7440","description":"Malig tumor exc to 1.25 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRE1","description":"ICD-DCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removable prosthodontic proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5899","description":"Removable prosthodontic proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSD1","description":"ICD-CCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anticoag thx rx at dischrg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4075F","description":"Anticoag thx rx at dischrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA CRYPTOCOCCUS NEOFORMANS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87327","description":"IAAD IA CRYPTOCOCCUS NEOFORMANS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not have a net increase in pam score of at least 3 points within 6 to 12 month period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1349","description":"Patients who did not have a net increase in pam score of at least 3 points within 6 to 12 month period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ risperidone_ (Uzedy)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9158","description":"Injection_ risperidone_ (Uzedy)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nabilone oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8650","description":"Nabilone oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tiss exam molecular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88387","description":"Tiss exam molecular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFND0","description":"ICD-BFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair Of Nasal Valve Collapse With Subcutaneous/Submucosal Lateral Wall Implant(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30468","description":"Repair Of Nasal Valve Collapse With Subcutaneous/Submucosal Lateral Wall Implant(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKB1","description":"ICD-OJKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESE1","description":"ICD-CESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient transferred to practice after initiation of chemotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9826","description":"Patient transferred to practice after initiation of chemotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrocardiogram complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93000","description":"Electrocardiogram complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Total hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58150","description":"Total hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0636U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0636U","description":"CPT-0636U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amnt pain noted none prsnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1126F","description":"Amnt pain noted none prsnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAD1","description":"ICD-IBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who have an order for or are receiving hospice or palliative care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1186","description":"Patients who have an order for or are receiving hospice or palliative care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYA1","description":"ICD-LBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct interprete max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0366","description":"Cone beam ct interprete max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB4D","description":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQD1","description":"ICD-CGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brain image 4+ views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78605","description":"Brain image 4+ views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRC1","description":"ICD-CGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Matrion_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4201","description":"Matrion_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ esmolol hydrochloride_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1805","description":"Injection_ esmolol hydrochloride_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect arm/elbow tum < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24077","description":"Resect arm/elbow tum < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28200","description":"Repair of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMB0","description":"ICD-CEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFA0","description":"ICD-GAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYB1","description":"ICD-KIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ epinephrine (belcher) not therapeutically equivalent to j0171_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0173","description":"Injection_ epinephrine (belcher) not therapeutically equivalent to j0171_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy pouch liq deodorant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4394","description":"Ostomy pouch liq deodorant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGE1","description":"ICD-FFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of caries arresting medicament-per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1354","description":"Application of caries arresting medicament-per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduction of skull defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62115","description":"Reduction of skull defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0501U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","description":"CPT-0501U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWA0","description":"ICD-LDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWE0","description":"ICD-DHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ waist length_ 40 mmhg or greater_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6564","description":"Gradient compression stocking_ waist length_ 40 mmhg or greater_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endo knee-shin pneum swg frc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5822","description":"Endo knee-shin pneum swg frc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATC0","description":"ICD-EATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCD1","description":"ICD-KHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Temporary tear duct plug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4262","description":"Temporary tear duct plug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prosthetic(s) training_ upper and/or lower extremity(ies)_ initial prosthetic(s) encounter_ each 15 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97761","description":"Prosthetic(s) training_ upper and/or lower extremity(ies)_ initial prosthetic(s) encounter_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDB1","description":"ICD-KFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALB1","description":"ICD-MALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLB1","description":"ICD-ACLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBF0","description":"ICD-CIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40843","description":"Reconstruction of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYE1","description":"ICD-LGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIF1","description":"ICD-JDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUA0","description":"ICD-EEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36565","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPD1","description":"ICD-BHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCA1","description":"ICD-NJCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPF0","description":"ICD-KFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01202","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01202","description":"CPT-01202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGA1","description":"ICD-CGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA3D","description":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBC1","description":"ICD-JHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastroenterology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91299","description":"Gastroenterology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICA0","description":"ICD-GICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amnio quad-core_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4294","description":"Amnio quad-core_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJB0","description":"ICD-OIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCA1","description":"ICD-ICCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove bilat space maintain","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1525","description":"Remove bilat space maintain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOF1","description":"ICD-PBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skull base/brainstem surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61575","description":"Skull base/brainstem surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYC1","description":"ICD-PDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHF0","description":"ICD-BDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERC1","description":"ICD-HERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remis 6m w/6mos phq-9 <5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9573","description":"Remis 6m w/6mos phq-9 <5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Pancreatic Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1099","description":"Radiation Therapy For Pancreatic Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB34","description":"High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism Speed of Care_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1016","description":"Clinical decision support mechanism Speed of Care_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPA0","description":"ICD-CCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLD0","description":"ICD-OFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDA0","description":"ICD-CEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMC1","description":"ICD-EFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGED0","description":"ICD-IGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASA1","description":"ICD-CASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Weight mgmt class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9449","description":"Weight mgmt class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLC1","description":"ICD-ACLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIB1","description":"ICD-NEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Budesonide non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7626","description":"Budesonide non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICF0","description":"ICD-AICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYB0","description":"ICD-DCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHA1","description":"ICD-JAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSC1","description":"ICD-DFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"implant/abutment supported interim fixed denture for edentulous arch - mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6118","description":"implant/abutment supported interim fixed denture for edentulous arch - mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including CT guidance; each additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10010","description":"Fine needle aspiration biopsy_ including CT guidance; each additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mammo probably bengn docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3343F","description":"Mammo probably bengn docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATD1","description":"ICD-IATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWB1","description":"ICD-GHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ko adj jnt pos r sup pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1833","description":"Ko adj jnt pos r sup pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Group psychotherapy service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder provided remotely by hospital staff who are licensed to provid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7903","description":"Group psychotherapy service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder provided remotely by hospital staff who are licensed to provid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoe metatarsal bar wedge ro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3400","description":"Shoe metatarsal bar wedge ro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUF1","description":"ICD-BIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUF0","description":"ICD-IDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPA0","description":"ICD-FEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTB0","description":"ICD-FHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTE1","description":"ICD-NDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEB0","description":"ICD-NJEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cult skin graft f/n/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15155","description":"Cult skin graft f/n/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPD0","description":"ICD-JFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRB0","description":"ICD-DHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Podiatry Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4028","description":"Podiatry Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lysis penil circumic lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54162","description":"Lysis penil circumic lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1008T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","description":"CPT-1008T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Myelography neck spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72240","description":"Myelography neck spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNB1","description":"ICD-CGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHE0","description":"ICD-CBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of fetal heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76827","description":"Echo exam of fetal heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Smear fluorescent/acid stai","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87206","description":"Smear fluorescent/acid stai","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4399","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","description":"HCPCS-Q4399","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise pharynx lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42808","description":"Excise pharynx lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt tx sys bio med psori 6mth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9652","description":"Pt tx sys bio med psori 6mth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAC0","description":"ICD-BFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWC0","description":"ICD-LFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ofloxacin_ 400 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0034","description":"Injection_ ofloxacin_ 400 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOD0","description":"ICD-HIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOB1","description":"ICD-GBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLF1","description":"ICD-MLLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGB1","description":"ICD-BEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQC1","description":"ICD-DDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWA1","description":"ICD-HIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nras gene variants exon 2&3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81311","description":"Nras gene variants exon 2&3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAA0","description":"ICD-MKAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX35","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDD0","description":"ICD-MFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJF1","description":"ICD-CBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cervical cap contraceptive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4261","description":"Cervical cap contraceptive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES354","description":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Radrite_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1024","description":"Clinical Decision Support Mechanism Radrite_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHA0","description":"ICD-GCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC36","description":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHF1","description":"ICD-FCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWE1","description":"ICD-GDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUA0","description":"ICD-MBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Via matrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4309","description":"Via matrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES131","description":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNF0","description":"ICD-CHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAB0","description":"ICD-IGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIA0","description":"ICD-CBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAB1","description":"ICD-OFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Utility services waiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2035","description":"Utility services waiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQC0","description":"ICD-DAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mifepristone_ oral_ 200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0190","description":"Mifepristone_ oral_ 200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art pancreas system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1034","description":"Art pancreas system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJB0","description":"ICD-JAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES230","description":"Extensive Services _ ADL Index 2-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVE1","description":"ICD-OJVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fosphenytoin inj pe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2009","description":"Fosphenytoin inj pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPA1","description":"ICD-FCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Icar ischm mntrng prgrm eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0305T","description":"Icar ischm mntrng prgrm eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPD0","description":"ICD-CDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGC0","description":"ICD-GGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQC1","description":"ICD-OEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intrinsic factor antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86340","description":"Intrinsic factor antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTB0","description":"ICD-GFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insulin cartridge 150 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5565","description":"Insulin cartridge 150 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ht inj noc per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9542","description":"Ht inj noc per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI upper extremity w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73219","description":"MRI upper extremity w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDC0","description":"ICD-CHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRC0","description":"ICD-PDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Supply/ext inf pump syr type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0552","description":"Supply/ext inf pump syr type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Benesch boot pair child","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3213","description":"Benesch boot pair child","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBF0","description":"ICD-CHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEME0","description":"ICD-BEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trg gene rearrangement anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81342","description":"Trg gene rearrangement anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEF0","description":"ICD-CIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVD0","description":"ICD-FBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFC1","description":"ICD-JEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair calf rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0995","description":"Wheelchair calf rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0505U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","description":"CPT-0505U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behind ear hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5060","description":"Behind ear hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92992","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lymph nodes neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38724","description":"Removal of lymph nodes neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lobar lung transplantation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2060","description":"Lobar lung transplantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0802","description":"HCPCS-C0802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1903","description":"HCPCS-A1903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGD0","description":"ICD-JGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home visit new pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99324","description":"Domicil/r-home visit new pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Automated diff wbc count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85004","description":"Automated diff wbc count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYD0","description":"ICD-PKYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX0C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSB1","description":"ICD-PHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX5A","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGF1","description":"ICD-KGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1091T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1091T","description":"CPT-1091T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML11","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCA0","description":"ICD-EBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGF1","description":"ICD-BBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ methylprednisolone sodium succinate_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2919","description":"Injection_ methylprednisolone sodium succinate_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCED1","description":"ICD-MCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74220","description":"Contrast x-ray esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Protein e-phoresis serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84165","description":"Protein e-phoresis serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCF0","description":"ICD-MKCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHC0","description":"ICD-BCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGA1","description":"ICD-BGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place gastrostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43832","description":"Place gastrostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUC1","description":"ICD-IEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc cln cncr stage 1 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3384F","description":"Ajcc cln cncr stage 1 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFB0","description":"ICD-FFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUC1","description":"ICD-JGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD210","description":"Special Care High _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Lung Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1095","description":"Radiation Therapy For Lung Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect prox finger tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26260","description":"Resect prox finger tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg_ drug metabolism)_ gene analysis_ common variant(s) (eg_ *2_ *22)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81230","description":"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg_ drug metabolism)_ gene analysis_ common variant(s) (eg_ *2_ *22)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHC0","description":"ICD-KAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDA1","description":"ICD-BGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place cecostomy tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49442","description":"Place cecostomy tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who died during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1362","description":"Patients who died during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fall risk assessment docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3288F","description":"Fall risk assessment docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBF1","description":"ICD-GHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDF1","description":"ICD-ADDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLF1","description":"ICD-ODLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0981T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","description":"CPT-0981T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOC1","description":"ICD-KIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAD0","description":"ICD-MGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWA0","description":"ICD-OLWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stool cultr aerobic bact ea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87046","description":"Stool cultr aerobic bact ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKF1","description":"ICD-GIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lat lumbar spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22533","description":"Lat lumbar spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA16","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYB1","description":"ICD-DAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tmj cutting into joint","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7860","description":"Tmj cutting into joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQA1","description":"ICD-PFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOA1","description":"ICD-LHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAB1","description":"ICD-KCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHD0","description":"ICD-MAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOF0","description":"ICD-CCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq transcath septal reduxn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93583","description":"Perq transcath septal reduxn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTC0","description":"ICD-NFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Srs cranial lesion complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61798","description":"Srs cranial lesion complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEC1","description":"ICD-EBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKE0","description":"ICD-JGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Group adaptive behavior treatment by protocol_ administered by technician_ face-to-face with two or more patients; each additional 30 minutes of technician time (List separate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0367T","description":"Group adaptive behavior treatment by protocol_ administered by technician_ face-to-face with two or more patients; each additional 30 minutes of technician time (List separate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; anomalous or persistent superior vena cava when it ex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93584","description":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; anomalous or persistent superior vena cava when it ex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSE1","description":"ICD-GFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB212","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYD0","description":"ICD-DCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB23A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFB1","description":"ICD-OGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary angiography of major aortopulmonary colla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93575","description":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary angiography of major aortopulmonary colla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc tempory vessel occl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61623","description":"Endovasc tempory vessel occl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMD0","description":"ICD-IDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUD1","description":"ICD-FBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implnt/abut fixed dent mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6115","description":"Implnt/abut fixed dent mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDC0","description":"ICD-KEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repl batt lithium 4.5 v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0605","description":"Repl batt lithium 4.5 v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0951T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","description":"CPT-0951T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPA0","description":"ICD-KEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovas aaa repr w/2-p part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34802","description":"Endovas aaa repr w/2-p part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove maxilla cyst complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21048","description":"Remove maxilla cyst complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Syme typ expandabl wall sckt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5630","description":"Syme typ expandabl wall sckt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNF1","description":"ICD-BBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBF1","description":"ICD-FBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQE1","description":"ICD-HDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assess hlth/behave init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96150","description":"Assess hlth/behave init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBF1","description":"ICD-CDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC241","description":"Special Care High _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDC1","description":"ICD-NEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYF1","description":"ICD-OKYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tension ring_ vac erect dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7902","description":"Tension ring_ vac erect dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCA0","description":"ICD-ICCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of urethra abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53040","description":"Drainage of urethra abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB05","description":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIE0","description":"ICD-KBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Visc & infraren abd 4+ prost","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34848","description":"Visc & infraren abd 4+ prost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJE1","description":"ICD-KHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAE0","description":"ICD-OIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTD1","description":"ICD-ACTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc no comp or mort w in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9270","description":"Doc no comp or mort w in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exome sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81415","description":"Exome sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTE1","description":"ICD-IBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOB1","description":"ICD-DEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAE0","description":"ICD-EBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTC1","description":"ICD-EHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIF0","description":"ICD-EBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQA1","description":"ICD-LBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bladder stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51050","description":"Removal of bladder stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCND0","description":"ICD-GCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFE1","description":"ICD-CAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bridge resin base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6251","description":"Bridge resin base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDF0","description":"ICD-KEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYC1","description":"ICD-DBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD13D","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Supports brokerage_ self-directed_ waiver; per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2051","description":"Supports brokerage_ self-directed_ waiver; per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Slitting of prepuce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54001","description":"Slitting of prepuce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transperineal laser ablation of benign prostatic hyperplasia_ including imaging guidance; prostate volume greater or equal to 50 mL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0867T","description":"Transperineal laser ablation of benign prostatic hyperplasia_ including imaging guidance; prostate volume greater or equal to 50 mL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOB1","description":"ICD-PEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aqueous shunt eye w/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66180","description":"Aqueous shunt eye w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of ovary(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58900","description":"Biopsy of ovary(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Penile vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93980","description":"Penile vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Functional status measurement with score was obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1048","description":"Functional status measurement with score was obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMB1","description":"ICD-JBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 22 Or Functional Status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2144","description":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 22 Or Functional Status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC33","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD224","description":"Special Care Low _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMB1","description":"ICD-ODMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc s/n/h/f/g mal+mrg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11626","description":"Exc s/n/h/f/g mal+mrg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAB0","description":"ICD-JAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETA1","description":"ICD-IETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVD1","description":"ICD-KDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASA0","description":"ICD-CASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHC0","description":"ICD-KDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laminotomy addl cervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63043","description":"Laminotomy addl cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYE1","description":"ICD-PDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1442","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","description":"HCPCS-M1442","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0093A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHF1","description":"ICD-MJHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMB1","description":"ICD-CBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXC1","description":"ICD-NFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBE1","description":"ICD-GCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81462","description":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of estradiol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82670","description":"Assay of estradiol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHA1","description":"ICD-CAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAF1","description":"ICD-MCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8002","description":"HCPCS-C8002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine/uric acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84560","description":"Assay of urine/uric acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inlay porcelain/ceramic 2 su","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2620","description":"Inlay porcelain/ceramic 2 su","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDC0","description":"ICD-EBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIID0","description":"ICD-JIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE20D","description":"Special Care High _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA30","description":"Very High Rehab _ ADL Index 0-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt_ pn_ hist grade doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8721","description":"Pt_ pn_ hist grade doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGB1","description":"ICD-OAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at 12 months as demonstrated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1019","description":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at 12 months as demonstrated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1438","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","description":"HCPCS-M1438","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWA1","description":"ICD-PDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Octreotide inj_ non-depot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2354","description":"Octreotide inj_ non-depot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Herpes simplex 1 ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87274","description":"Herpes simplex 1 ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB20","description":"High Rehab _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0451T","description":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA35","description":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC5B","description":"High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sleeve pneumonectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32442","description":"Sleeve pneumonectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93644","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sex offend tx svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2029","description":"Sex offend tx svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC254","description":"Special Care High _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAF1","description":"ICD-MIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Christian sci pract visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9900","description":"Christian sci pract visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNB0","description":"ICD-CCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATC1","description":"ICD-CATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADC1","description":"ICD-MADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2046","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2046","description":"HCPCS-A2046","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECD1","description":"ICD-JECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTC0","description":"ICD-BGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBA0","description":"ICD-CIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove pulse generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33241","description":"Remove pulse generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCB1","description":"ICD-JGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQB1","description":"ICD-LCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath smear other source","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88160","description":"Cytopath smear other source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBA1","description":"ICD-MGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Visualization of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31615","description":"Visualization of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removable Unilateral Partial Denture - One Piece Resin - Per Quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5286","description":"Removable Unilateral Partial Denture - One Piece Resin - Per Quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAB0","description":"ICD-CBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"repair resin partial denture base_ maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5612","description":"repair resin partial denture base_ maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEA1","description":"ICD-GCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVD0","description":"ICD-GGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2AB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AB21","description":"ICD-2AB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINF0","description":"ICD-BINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3HC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HC31","description":"ICD-3HC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCD1","description":"ICD-OHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4428","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","description":"HCPCS-Q4428","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHB0","description":"ICD-NAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHB0","description":"ICD-EIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFD1","description":"ICD-NGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Habil res waiver per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2016","description":"Habil res waiver per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKC1","description":"ICD-CGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGND1","description":"ICD-CGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dexmedetomidine_ oral_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1105","description":"Dexmedetomidine_ oral_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAC1","description":"ICD-IIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXB0","description":"ICD-GGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6004","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIE0","description":"ICD-GGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPC0","description":"ICD-KIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLB1","description":"ICD-NDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct urethra stage 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53420","description":"Reconstruct urethra stage 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYF0","description":"ICD-PIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX5D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKC0","description":"ICD-FBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFC1","description":"ICD-GHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psytx crisis initial 60 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90839","description":"Psytx crisis initial 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIA0","description":"ICD-GGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise nerve back of head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64744","description":"Incise nerve back of head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQF0","description":"ICD-GIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAF0","description":"ICD-BEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUC1","description":"ICD-FEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTF0","description":"ICD-KDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"RARE DS XOM DNA ALYS PROBAND","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0214U","description":"RARE DS XOM DNA ALYS PROBAND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFD1","description":"ICD-KGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBF1","description":"ICD-JGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diab shoe for density insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5500","description":"Diab shoe for density insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC0C","description":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAA1","description":"ICD-MBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1497","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","description":"HCPCS-M1497","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJE0","description":"ICD-NDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Commode chair electric","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0170","description":"Commode chair electric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB35","description":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSF1","description":"ICD-HDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKE0","description":"ICD-OCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC13D","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch drain 2 piece system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4426","description":"Ost pch drain 2 piece system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDD0","description":"ICD-JIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWD0","description":"ICD-CCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUA0","description":"ICD-MGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEC1","description":"ICD-IIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKF1","description":"ICD-NBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medicaid certified community behavioral health clinic services_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1040","description":"Medicaid certified community behavioral health clinic services_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFA1","description":"ICD-BIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDB1","description":"ICD-GIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54699","description":"Laparoscope proc testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVE1","description":"ICD-OLVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insulin tolerance panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80435","description":"Insulin tolerance panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chloroprocaine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2400","description":"Chloroprocaine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8I","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLF0","description":"ICD-EHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIA0","description":"ICD-OJIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRE0","description":"ICD-DBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6031","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","description":"HCPCS-L6031","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0522U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","description":"CPT-0522U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNA0","description":"ICD-BHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCE1","description":"ICD-NLCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD245","description":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Peroneal straps pair pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0980","description":"Peroneal straps pair pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDF0","description":"ICD-BDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEF0","description":"ICD-OGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFD0","description":"ICD-NIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGE1","description":"ICD-CHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"SARSCOV2 VACCINE BIVALENT 50 MCG/0.5 ML IM USE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91313","description":"SARSCOV2 VACCINE BIVALENT 50 MCG/0.5 ML IM USE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEA0","description":"ICD-FHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWD0","description":"ICD-LIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUD1","description":"ICD-JAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKD0","description":"ICD-CGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair leg fascia defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27656","description":"Repair leg fascia defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYA1","description":"ICD-CBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWA1","description":"ICD-LGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chest x-ray frnt lat oblique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71022","description":"Chest x-ray frnt lat oblique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIB0","description":"ICD-FIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLA0","description":"ICD-GHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOF1","description":"ICD-CCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNE1","description":"ICD-GCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDF0","description":"ICD-FCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHME0","description":"ICD-CHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gs mg intent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9237","description":"Gs mg intent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1479","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","description":"HCPCS-M1479","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt w out cath maint dia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9241","description":"Doc pt w out cath maint dia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUA1","description":"ICD-IEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLD0","description":"ICD-IDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Male condom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4267","description":"Male condom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Soft tissue allograft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4275","description":"Soft tissue allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65222","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAC1","description":"ICD-EIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap inc hern repair comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49655","description":"Lap inc hern repair comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIC0","description":"ICD-NLIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD135","description":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB11C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Statin therapy/currently tkn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4013F","description":"Statin therapy/currently tkn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDB0","description":"ICD-JBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc antibio given b/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4048F","description":"Doc antibio given b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTA0","description":"ICD-BDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPE0","description":"ICD-OEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVF0","description":"ICD-KIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYE0","description":"ICD-GBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQB0","description":"ICD-DCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECE1","description":"ICD-NECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILE0","description":"ICD-MILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLB1","description":"ICD-JGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0997T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","description":"CPT-0997T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","description":"HCPCS-J9003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOB0","description":"ICD-KIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Overdenture partial max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5864","description":"Overdenture partial max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nonpneumatic sequential compression garment_ full arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1025","description":"Nonpneumatic sequential compression garment_ full arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0941T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","description":"CPT-0941T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAB0","description":"ICD-KFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSC0","description":"ICD-LGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERA0","description":"ICD-OERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEID1","description":"ICD-JEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA3C","description":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3D) mammography results were not documented and reviewed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9900","description":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3D) mammography results were not documented and reviewed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGD0","description":"ICD-KAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOB0","description":"ICD-HCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWE1","description":"ICD-DIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOE0","description":"ICD-LCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid exam both ears","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92591","description":"Hearing aid exam both ears","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastroesophageal reflux exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78262","description":"Gastroesophageal reflux exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of big toe joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28750","description":"Fusion of big toe joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFE1","description":"ICD-GCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tissue culture skin/biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88233","description":"Tissue culture skin/biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytomegalovirus imm iv /vial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0850","description":"Cytomegalovirus imm iv /vial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of toe lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28092","description":"Removal of toe lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESC0","description":"ICD-PESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Measles virus vaccine_ live_ for subcutaneous or jet injection use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90705","description":"Measles virus vaccine_ live_ for subcutaneous or jet injection use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient Is Using Palliative Care Services Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9994","description":"Patient Is Using Palliative Care Services Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablate pulm tumors extnsn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0340T","description":"Ablate pulm tumors extnsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Upper facial prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8043","description":"Upper facial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA SARSCOV & INFLUENZA VIRUS TYPES A&B","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87428","description":"IAAD IA SARSCOV & INFLUENZA VIRUS TYPES A&B","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWE0","description":"ICD-OFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ hydroxyprogesterone caproate_ (Makena)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1726","description":"Injection_ hydroxyprogesterone caproate_ (Makena)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic Radiology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4001","description":"Diagnostic Radiology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWC1","description":"ICD-GHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEC1","description":"ICD-CHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGA0","description":"ICD-JHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKA0","description":"ICD-CDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGE0","description":"ICD-FIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Init nb em per day non-fac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99461","description":"Init nb em per day non-fac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGF1","description":"ICD-GEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0304","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0304","description":"CDT-D0304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEC0","description":"ICD-NLEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECID1","description":"ICD-ECID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBC1","description":"ICD-GHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Part hand little/ring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6010","description":"Part hand little/ring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Friction dampening arm supp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2629","description":"Friction dampening arm supp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis be antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86707","description":"Hepatitis be antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGA1","description":"ICD-FIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMF0","description":"ICD-CEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE23A","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICD1","description":"ICD-AICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTC1","description":"ICD-JBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA130","description":"Reduced Physical Function _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interscap-thor myoelectronic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6975","description":"Interscap-thor myoelectronic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBID0","description":"ICD-IBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dermatology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4000","description":"Dermatology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44345","description":"Revision of colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCC0","description":"ICD-EFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFD1","description":"ICD-NHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vein access cutdown < 1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36420","description":"Vein access cutdown < 1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX4B","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Poliovirus ipv sc/im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90713","description":"Poliovirus ipv sc/im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9170","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9170","description":"HCPCS-C9170","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINA1","description":"ICD-OINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX01","description":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDE0","description":"ICD-JDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cerv sr 2pc thor ext pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0174","description":"Cerv sr 2pc thor ext pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amnio or biodmatrix_ inj 1cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4139","description":"Amnio or biodmatrix_ inj 1cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE150","description":"Clinically Complex _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAE1","description":"ICD-GAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDC0","description":"ICD-JHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMC0","description":"ICD-OBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLD1","description":"ICD-CBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Indexing for osteotomy using dynamic robotic assisted or dynamic navigation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7939","description":"Indexing for osteotomy using dynamic robotic assisted or dynamic navigation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBE1","description":"ICD-FHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDE1","description":"ICD-MGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD221","description":"Special Care High _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTF1","description":"ICD-CDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEA1","description":"ICD-ODEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRB0","description":"ICD-OFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUB1","description":"ICD-NKUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIB0","description":"ICD-FCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fabrication and delivery of oral appliance therapy (OAT) morning repositioning device","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9954","description":"Fabrication and delivery of oral appliance therapy (OAT) morning repositioning device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hmes/trachvalve adhesivedisk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7506","description":"Hmes/trachvalve adhesivedisk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWD0","description":"ICD-CIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIA1","description":"ICD-OBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Individual_ Face-To-Face; Initial 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96158","description":"Health Behavior Intervention_ Individual_ Face-To-Face; Initial 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDC0","description":"ICD-OLDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJC0","description":"ICD-GAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA3B","description":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8H","description":"Medium Rehab _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brief (20 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-appro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2001","description":"Brief (20 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-appro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAA1","description":"ICD-CBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA151","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLF0","description":"ICD-MFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBF1","description":"ICD-MCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUE1","description":"ICD-JDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE20A","description":"Special Care Low _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGF0","description":"ICD-NIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARE0","description":"ICD-OARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQC1","description":"ICD-KFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAC0","description":"ICD-IDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (Cuvitru)_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1555","description":"Injection_ immune globulin (Cuvitru)_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8E","description":"High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCND1","description":"ICD-KCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFB1","description":"ICD-OBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHC0","description":"ICD-IHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of blood pku","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84030","description":"Assay of blood pku","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIE1","description":"ICD-CBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACC1","description":"ICD-KACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPF0","description":"ICD-JGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCC1","description":"ICD-NFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOB0","description":"ICD-OIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE21B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4KB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KB21","description":"ICD-4KB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1BC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BC11","description":"ICD-1BC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Number of patients screened for food insecurity_ housing instability_ transportation needs_ utility difficulties_ and interpersonal safety","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1207","description":"Number of patients screened for food insecurity_ housing instability_ transportation needs_ utility difficulties_ and interpersonal safety","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPF1","description":"ICD-NHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBC0","description":"ICD-JEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKF1","description":"ICD-FGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGD0","description":"ICD-BAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noner transport mini-bus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0120","description":"Noner transport mini-bus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pre-visit patient screening","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9912","description":"Pre-visit patient screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDB1","description":"ICD-ODDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPA1","description":"ICD-CCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intracran angioplsty w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61635","description":"Intracran angioplsty w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBD1","description":"ICD-BIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKC0","description":"ICD-KEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUD0","description":"ICD-BEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Physical Therapy/Occupational Therapy Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4026","description":"Physical Therapy/Occupational Therapy Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOB0","description":"ICD-PJOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41018","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVF1","description":"ICD-JBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARE0","description":"ICD-GARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRC1","description":"ICD-CBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETB1","description":"ICD-CETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of procainamide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80190","description":"Assay of procainamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPB0","description":"ICD-GCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMF1","description":"ICD-BDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNC0","description":"ICD-BFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNC1","description":"ICD-GDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUE0","description":"ICD-OKUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Humidif extens supple w ippb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0550","description":"Humidif extens supple w ippb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHB0","description":"ICD-FAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBA1","description":"ICD-FBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Telecare equipment installation and removal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W2024","description":"Telecare equipment installation and removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICB1","description":"ICD-BICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18E","description":"Clinically Complex _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIC1","description":"ICD-NCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Odontics endosteal implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6010","description":"Odontics endosteal implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comprehen metabolic panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80053","description":"Comprehen metabolic panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICA0","description":"ICD-OICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKF1","description":"ICD-GEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression arm sleeve_ custom_ medium weight_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6576","description":"Gradient compression arm sleeve_ custom_ medium weight_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Personal care item nos each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5199","description":"Personal care item nos each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who received cervical cytology or an HPV test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9806","description":"Patients who received cervical cytology or an HPV test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKE1","description":"ICD-GCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; known familial variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81248","description":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; known familial variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64630","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intestinal stricturoplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44615","description":"Intestinal stricturoplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal contract stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59020","description":"Fetal contract stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mra_ w/o dye_ upper extr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8935","description":"Mra_ w/o dye_ upper extr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No admit w/in 180d req remov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9411","description":"No admit w/in 180d req remov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA156","description":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAA1","description":"ICD-MJAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYB0","description":"ICD-LIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCC0","description":"ICD-ACCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ morphine sulfate (fresenius kabi) not therapeutically equivalent to j2270_ up to 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2272","description":"Injection_ morphine sulfate (fresenius kabi) not therapeutically equivalent to j2270_ up to 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVB0","description":"ICD-NKVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Preop anes or proxy b/4 surg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9497","description":"Preop anes or proxy b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES345","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18I","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Deli/install chrg hemo equip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1600","description":"Deli/install chrg hemo equip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Calc bmi out nrm param nof/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8419","description":"Calc bmi out nrm param nof/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFA0","description":"ICD-NIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj dihydroergotamine mesylt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1110","description":"Inj dihydroergotamine mesylt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHB0","description":"ICD-FBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTD0","description":"ICD-GBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Head control proximity switc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2330","description":"Head control proximity switc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIB1","description":"ICD-FCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55812","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBED0","description":"ICD-OBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFA0","description":"ICD-OLFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-medical Transportation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W6110","description":"Non-medical Transportation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMC0","description":"ICD-BHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28D","description":"Clinically Complex _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQE1","description":"ICD-LIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINC0","description":"ICD-GINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHE1","description":"ICD-EIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAA0","description":"ICD-OKAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including fluoroscopic guidance; first lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10007","description":"Fine needle aspiration biopsy_ including fluoroscopic guidance; first lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYD1","description":"ICD-KIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYD0","description":"ICD-OBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOB0","description":"ICD-DIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rna tstng hep c docd done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3218F","description":"Rna tstng hep c docd done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDF0","description":"ICD-NIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIA0","description":"ICD-OEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise/graft eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68320","description":"Revise/graft eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARF0","description":"ICD-DARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQA1","description":"ICD-PAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBC0","description":"ICD-GFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Creatinine clearance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82575","description":"Creatinine clearance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPC1","description":"ICD-ODPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSC1","description":"ICD-DCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSF1","description":"ICD-OHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASB1","description":"ICD-DASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat hand dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26685","description":"Treat hand dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Speech volume modulation system_ any type_ including all components and accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1009","description":"Speech volume modulation system_ any type_ including all components and accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transab esoph hiat hern rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43333","description":"Transab esoph hiat hern rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMD0","description":"ICD-KIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQD1","description":"ICD-CFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCD1","description":"ICD-IDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDD0","description":"ICD-NEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUD0","description":"ICD-JBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ustekinumab-auub (Wezlana)_ biosimilar_ SC_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5137","description":"Injection_ ustekinumab-auub (Wezlana)_ biosimilar_ SC_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urinary pouch w st wear barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4392","description":"Urinary pouch w st wear barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57410","description":"Pelvic examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noner transport lodgng escrt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0200","description":"Noner transport lodgng escrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ftrst lower extension tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0043","description":"Ftrst lower extension tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37281","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","description":"CPT-37281","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Post 2 srfc resinbased cmpst","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2392","description":"Post 2 srfc resinbased cmpst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct colonography dx w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74262","description":"Ct colonography dx w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4423","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","description":"HCPCS-Q4423","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICD1","description":"ICD-IICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTA0","description":"ICD-MLTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJC1","description":"ICD-FIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLB0","description":"ICD-ABLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXE1","description":"ICD-KFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWE1","description":"ICD-CCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUE1","description":"ICD-NFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMA0","description":"ICD-FCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert pleural cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32550","description":"Insert pleural cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01232","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01232","description":"CPT-01232","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXF0","description":"ICD-NDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJF0","description":"ICD-FGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl artific disc addl crvcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0095T","description":"Rmvl artific disc addl crvcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPB0","description":"ICD-NDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC101","description":"Special Care Low _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mycoplasma antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86738","description":"Mycoplasma antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDF1","description":"ICD-NDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLD1","description":"ICD-OCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJC0","description":"ICD-JDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIB1","description":"ICD-GBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leg pain was measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 to 20 weeks) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9947","description":"Leg pain was measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 to 20 weeks) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHE1","description":"ICD-GFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc no pt rsk death w/in 1yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1151F","description":"Doc no pt rsk death w/in 1yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sign lang/oral interpreter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1013","description":"Sign lang/oral interpreter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"SARSCOV2 VAC 5MCG/0.5ML AS03","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91310","description":"SARSCOV2 VAC 5MCG/0.5ML AS03","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54520","description":"Removal of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice care_ in the home_ p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9126","description":"Hospice care_ in the home_ p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISD1","description":"ICD-DISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWD0","description":"ICD-PIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBE0","description":"ICD-NBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEF1","description":"ICD-MBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of intrinsic factor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83528","description":"Assay of intrinsic factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDD1","description":"ICD-BFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMC0","description":"ICD-GBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1341","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHA0","description":"ICD-NDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA234","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDC1","description":"ICD-EEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Measure ureter pressure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50686","description":"Measure ureter pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDC0","description":"ICD-OCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRC1","description":"ICD-ODRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of creatine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82540","description":"Assay of creatine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSA0","description":"ICD-LGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHC1","description":"ICD-FAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE24A","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTE1","description":"ICD-KGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLE0","description":"ICD-GHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCF0","description":"ICD-NKCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGA0","description":"ICD-KFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA216","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj mepivacaine hcl/10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0670","description":"Inj mepivacaine hcl/10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES25D","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Caloric vstblr test w/rec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92537","description":"Caloric vstblr test w/rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAB0","description":"ICD-ECAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANE1","description":"ICD-GANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraop image confirm excise","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8872","description":"Intraop image confirm excise","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJE0","description":"ICD-GFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSB0","description":"ICD-CDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERE0","description":"ICD-HERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMA1","description":"ICD-CFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQE0","description":"ICD-PIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Culture type immunologic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87147","description":"Culture type immunologic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fluid pressure muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20950","description":"Fluid pressure muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB14C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRF0","description":"ICD-ODRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPB1","description":"ICD-FBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJB1","description":"ICD-KIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Food thickener oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4100","description":"Food thickener oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of external ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69105","description":"Biopsy of external ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJA0","description":"ICD-KHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0990T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","description":"CPT-0990T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thyroidectomy_ total or complete with parathyroid autotransplantation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7555","description":"Thyroidectomy_ total or complete with parathyroid autotransplantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0569","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","description":"HCPCS-G0569","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIC0","description":"ICD-NGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ triptorelin extended release_ 3.75 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9016","description":"Injection_ triptorelin extended release_ 3.75 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hhc ot assistant ea 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0158","description":"Hhc ot assistant ea 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTF1","description":"ICD-NCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHD0","description":"ICD-ADHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit corticosteroid/diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9490","description":"Hit corticosteroid/diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTE1","description":"ICD-MBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC210","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hgb <10g/dl_ med rsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8975","description":"Hgb <10g/dl_ med rsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopy bowel pouch/biop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44386","description":"Endoscopy bowel pouch/biop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINC0","description":"ICD-KINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Complement antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86160","description":"Complement antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFE1","description":"ICD-CFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBF0","description":"ICD-KGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8G","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOE1","description":"ICD-HAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD230","description":"Reduced Physical Function _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Uvl replacement bulb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4633","description":"Uvl replacement bulb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJA0","description":"ICD-GIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEE1","description":"ICD-GFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray of lower spine disk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72295","description":"X-ray of lower spine disk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIE0","description":"ICD-GAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home Delivered Meals-Special Meal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1764","description":"Home Delivered Meals-Special Meal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ piperacillin sodi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0081","description":"Injection_ piperacillin sodi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pharm thx for op rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4005F","description":"Pharm thx for op rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6090","description":"Repair implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYE1","description":"ICD-DFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDE0","description":"ICD-OGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMC1","description":"ICD-MDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYC0","description":"ICD-HIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67903","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB125","description":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDC1","description":"ICD-OIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFC1","description":"ICD-GDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA10","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEF0","description":"ICD-GHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLD1","description":"ICD-OLLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Appliance cleaner","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5131","description":"Appliance cleaner","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGB1","description":"ICD-JFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHB0","description":"ICD-BAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUD1","description":"ICD-MEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKA1","description":"ICD-CGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB210","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); orthopoxvirus (e.g._ monkeypox virus_ cowpox virus_ vaccinia virus)_ amplified probe technique_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87593","description":"Infectious agent detection by nucleic acid (DNA or RNA); orthopoxvirus (e.g._ monkeypox virus_ cowpox virus_ vaccinia virus)_ amplified probe technique_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8H","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBA0","description":"ICD-BHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESC0","description":"ICD-GESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFD0","description":"ICD-CCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUD0","description":"ICD-OLUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUE1","description":"ICD-NHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bleomycin sulfate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9040","description":"Bleomycin sulfate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cases in which an inhalational anesthetic is used only for induction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9955","description":"Cases in which an inhalational anesthetic is used only for induction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bld typing serologic rh phnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86906","description":"Bld typing serologic rh phnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBC1","description":"ICD-ABBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDD1","description":"ICD-JCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLA1","description":"ICD-CDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHC1","description":"ICD-BDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Developmental test administration (including assessment of fine and/or gross motor_ language_ cognitive level_ social_ memory and/or executive functions by standardized develo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96113","description":"Developmental test administration (including assessment of fine and/or gross motor_ language_ cognitive level_ social_ memory and/or executive functions by standardized develo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYC0","description":"ICD-HDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIE0","description":"ICD-CIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEE0","description":"ICD-CIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bicarbonate conc sol per gal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4706","description":"Bicarbonate conc sol per gal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJA1","description":"ICD-GFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no statin therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8815","description":"Doc reas no statin therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Visual field examination(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92083","description":"Visual field examination(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTE0","description":"ICD-FBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Case management","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1016","description":"Case management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOE1","description":"ICD-GAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMC0","description":"ICD-NCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKC0","description":"ICD-FHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDF0","description":"ICD-MHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKD1","description":"ICD-GGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOB1","description":"ICD-CIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75251","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES313","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE117","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL60","description":"High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFD0","description":"ICD-OLFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56634","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Motion analysis video/3d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96000","description":"Motion analysis video/3d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAA0","description":"ICD-JIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOD0","description":"ICD-OIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUF1","description":"ICD-ABUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMD1","description":"ICD-EHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18X","description":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTF0","description":"ICD-IFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27450","description":"Incision of thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Posturography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92548","description":"Posturography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRA0","description":"ICD-CGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL5B","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pca3 testing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3721","description":"Pca3 testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1017T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","description":"CPT-1017T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01502","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01502","description":"CPT-01502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYA0","description":"ICD-OEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1HC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HC21","description":"ICD-1HC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt doc no wrong event","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8913","description":"Pt doc no wrong event","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECB1","description":"ICD-JECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD240","description":"Special Care High _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB13C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD24D","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIE1","description":"ICD-OGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBA1","description":"ICD-EFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extracranial bilat study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93880","description":"Extracranial bilat study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"AJCC stage at breast cancer diagnosis = II or III","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9831","description":"AJCC stage at breast cancer diagnosis = II or III","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Arthrodesis_ sacroiliac joint_ percutaneous_ with image guidance_ including placement of intra-articular implant(s) (eg_ bone allograft[s]_ synthetic device[s])_ without place","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27278","description":"Arthrodesis_ sacroiliac joint_ percutaneous_ with image guidance_ including placement of intra-articular implant(s) (eg_ bone allograft[s]_ synthetic device[s])_ without place","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise & repair chest wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32905","description":"Revise & repair chest wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of esophageal sphincter augmentation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43285","description":"Removal of esophageal sphincter augmentation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dentures repair resin base","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5610","description":"Dentures repair resin base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-91124","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","description":"CPT-91124","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory syncytial ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87280","description":"Respiratory syncytial ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hla ii typing 1 locus lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81376","description":"Hla ii typing 1 locus lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rbc pretx incubatj w/density","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86972","description":"Rbc pretx incubatj w/density","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPF0","description":"ICD-JCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ak open end sach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5321","description":"Ak open end sach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTC0","description":"ICD-KHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score ls pt no elg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8661","description":"Fun stat score ls pt no elg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISA0","description":"ICD-PISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMD0","description":"ICD-CHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAID0","description":"ICD-JAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNE0","description":"ICD-GBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"vaccine administration-human papillomavirus - Dose 1","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1781","description":"vaccine administration-human papillomavirus - Dose 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair venous blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35476","description":"Repair venous blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVC0","description":"ICD-GIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of wrist bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25215","description":"Removal of wrist bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ argatroban (accord)_ not therapeutically equivalent to j0883_ 1 mg (for non-esrd use)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0891","description":"Injection_ argatroban (accord)_ not therapeutically equivalent to j0883_ 1 mg (for non-esrd use)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUF1","description":"ICD-ECUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMA0","description":"ICD-OLMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJF1","description":"ICD-NJJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29046","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVC0","description":"ICD-KBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTC0","description":"ICD-BCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIF0","description":"ICD-FGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERE0","description":"ICD-DERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Levetiracetam injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1953","description":"Levetiracetam injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath impl vasc access portal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4300","description":"Cath impl vasc access portal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comp ext fixate strut change","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20697","description":"Comp ext fixate strut change","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of middle ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69440","description":"Exploration of middle ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA25D","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28290","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise abdomen-venous shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49426","description":"Revise abdomen-venous shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Attach bladder/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51841","description":"Attach bladder/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMF0","description":"ICD-KAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISA1","description":"ICD-KISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXF1","description":"ICD-JHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLA1","description":"ICD-OKLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSA0","description":"ICD-KDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELF0","description":"ICD-AELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL3A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC10D","description":"Special Care Low _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous pulmonary artery revascularization by stent placement_ initial; normal native connections_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33900","description":"Percutaneous pulmonary artery revascularization by stent placement_ initial; normal native connections_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dorsi & plantar flex ass/res","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2220","description":"Dorsi & plantar flex ass/res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98970","description":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adjustment gastric band","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2083","description":"Adjustment gastric band","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWB0","description":"ICD-HDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAA0","description":"ICD-EAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDD0","description":"ICD-MJDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Culture aerobic identify","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87077","description":"Culture aerobic identify","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Solid caster tire_ integrate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2392","description":"Solid caster tire_ integrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDE1","description":"ICD-KDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICB0","description":"ICD-MICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0608U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","description":"CPT-0608U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEE1","description":"ICD-GHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lso sag r an/pos pnl pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0631","description":"Lso sag r an/pos pnl pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMF0","description":"ICD-MJMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOA0","description":"ICD-GIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA01","description":"Default_ /Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Photodynamic tx addl 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96571","description":"Photodynamic tx addl 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28I","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJD0","description":"ICD-NBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJA1","description":"ICD-JDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVE1","description":"ICD-GDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open bowel to skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44300","description":"Open bowel to skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCA1","description":"ICD-AFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJD1","description":"ICD-GHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNF1","description":"ICD-JCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMD1","description":"ICD-IHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ brexanolone_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1632","description":"Injection_ brexanolone_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGF0","description":"ICD-OBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66155","description":"Glaucoma surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWF0","description":"ICD-CHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IA21","description":"ICD-1IA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Punch biopsy of skin (including simple closure_ when performed); single lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11104","description":"Punch biopsy of skin (including simple closure_ when performed); single lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ercp ea duct/ampulla dilate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43277","description":"Ercp ea duct/ampulla dilate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHB0","description":"ICD-MEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQF1","description":"ICD-DFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYA0","description":"ICD-GFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAA0","description":"ICD-NCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWA1","description":"ICD-OHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERF1","description":"ICD-GERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEA1","description":"ICD-OGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFE0","description":"ICD-OJFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHC0","description":"ICD-OFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHID0","description":"ICD-AHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMA1","description":"ICD-BDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILC1","description":"ICD-KILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQA1","description":"ICD-CEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVB0","description":"ICD-BGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIE1","description":"ICD-MEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXD1","description":"ICD-BCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE234","description":"Special Care High _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Casting/strapping procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29799","description":"Casting/strapping procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXF0","description":"ICD-OKXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"System reason for no beta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9192","description":"System reason for no beta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICF0","description":"ICD-CICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transplant ureter to skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50860","description":"Transplant ureter to skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUC1","description":"ICD-BEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC3A","description":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"(Blincyto)Injection_ Blinatumomab_ 1mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9449","description":"(Blincyto)Injection_ Blinatumomab_ 1mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUD1","description":"ICD-ADUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1095T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1095T","description":"CPT-1095T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg 3.1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11644","description":"Exc f/e/e/n/l mal+mrg 3.1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQF0","description":"ICD-PEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75827","description":"Vein x-ray chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSE0","description":"ICD-HDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMF1","description":"ICD-KBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRE1","description":"ICD-PHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGC0","description":"ICD-OHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSB0","description":"ICD-PJSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of a subcutaneously implanted peritoneal ascites pump system_ any component (ascites pump_ associated peritoneal catheter_ associated bladder catheter)_ including ima","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0873T","description":"Revision of a subcutaneously implanted peritoneal ascites pump system_ any component (ascites pump_ associated peritoneal catheter_ associated bladder catheter)_ including ima","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHF0","description":"ICD-JIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBC0","description":"ICD-OHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Imp neurosti pls gn any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8679","description":"Imp neurosti pls gn any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor ix ptc/chrstmas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85250","description":"Clot factor ix ptc/chrstmas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCA1","description":"ICD-OGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of arm & girdle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23900","description":"Amputation of arm & girdle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESD0","description":"ICD-OESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth nose/sinus surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16251","description":"Anesth nose/sinus surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICD0","description":"ICD-CICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWC0","description":"ICD-PLWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPA1","description":"ICD-FIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0516T","description":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC4C","description":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB226","description":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ torso and shoulder_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6568","description":"Gradient compression garment_ torso and shoulder_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg 1.1-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11422","description":"Exc h-f-nk-sp b9+marg 1.1-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBA1","description":"ICD-KEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMA0","description":"ICD-MAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00164","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00164","description":"CPT-00164","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63273","description":"Excise intrspinl lesion scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVA1","description":"ICD-JBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHF1","description":"ICD-CAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cangrelor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9460","description":"Injection_ cangrelor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens fitting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92312","description":"Contact lens fitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ leuprolide acetate for depot suspension (fensolvi)_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1951","description":"Injection_ leuprolide acetate for depot suspension (fensolvi)_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had documentation of use of anticoagulant medications overlapping the measurement year","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9724","description":"Patients who had documentation of use of anticoagulant medications overlapping the measurement year","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMD0","description":"ICD-OKMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIF0","description":"ICD-FFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ nerve(s) and accompanying structures throughout their entire anatomic course in one extremity_ comprehensive_ including real-time cine imaging with image documenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76883","description":"Ultrasound_ nerve(s) and accompanying structures throughout their entire anatomic course in one extremity_ comprehensive_ including real-time cine imaging with image documenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAC1","description":"ICD-OJAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound exam follow-up","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76970","description":"Ultrasound exam follow-up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX5C","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thi/glut/ischia wgt bearing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2500","description":"Thi/glut/ischia wgt bearing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cognit impairment assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3720F","description":"Cognit impairment assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDE1","description":"ICD-IBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thyroid met uptake","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78020","description":"Thyroid met uptake","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal endoscopy_ surgical_ ethmoid sinus_ placement of drug eluting implant;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0406T","description":"Nasal endoscopy_ surgical_ ethmoid sinus_ placement of drug eluting implant;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIA1","description":"ICD-AEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endocerv curettage w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57456","description":"Endocerv curettage w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Md home visit outside cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0273","description":"Md home visit outside cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBF1","description":"ICD-MHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct head/brain w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70470","description":"Ct head/brain w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVB1","description":"ICD-KAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHF1","description":"ICD-OGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC2A","description":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98016","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","description":"CPT-98016","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCE0","description":"ICD-OKCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUE1","description":"ICD-MIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of percutaneous electrode array_ peripheral nerve_ with integrated neurostimulator_ including imaging guidance_ when performed; each additional electr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64597","description":"Insertion or replacement of percutaneous electrode array_ peripheral nerve_ with integrated neurostimulator_ including imaging guidance_ when performed; each additional electr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAF1","description":"ICD-FBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNA1","description":"ICD-KFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETE1","description":"ICD-OETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAC1","description":"ICD-EEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNC0","description":"ICD-ODNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plmt ureteral stent prq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50693","description":"Plmt ureteral stent prq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insulin (lyumjev)_ per 5 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1814","description":"Insulin (lyumjev)_ per 5 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDF1","description":"ICD-MDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE240","description":"Clinically Complex _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rgd ped wc adjstabl w/o seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1237","description":"Rgd ped wc adjstabl w/o seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","description":"HCPCS-J0603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE24D","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15958","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSB0","description":"ICD-GGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Guardant360 CDX_ Guardant Health Inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0242U","description":"Guardant360 CDX_ Guardant Health Inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise excess skin & tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15839","description":"Excise excess skin & tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNA1","description":"ICD-CFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDF1","description":"ICD-ACDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home Delivered Meals-Sandwich","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1761","description":"Home Delivered Meals-Sandwich","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; physician or other qualified health care professiona","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95250","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; physician or other qualified health care professiona","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18G","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEA1","description":"ICD-ACEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tacrine hydrochloride_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0014","description":"Tacrine hydrochloride_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSA1","description":"ICD-OLSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAC0","description":"ICD-KGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lancets per box","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4259","description":"Lancets per box","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Detect agent nos dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87799","description":"Detect agent nos dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inject spine w/cath lmb/scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62319","description":"Inject spine w/cath lmb/scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCF0","description":"ICD-CBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQC0","description":"ICD-GIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home visit mech ventilator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99504","description":"Home visit mech ventilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwr wc drivewheel gear repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2369","description":"Pwr wc drivewheel gear repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXD0","description":"ICD-KIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABC0","description":"ICD-CABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1061T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1061T","description":"CPT-1061T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNC0","description":"ICD-JBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Beclomethasone comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7622","description":"Beclomethasone comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSD0","description":"ICD-DDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLA1","description":"ICD-OFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CYTOG CONST ALYS INTERROG","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0209U","description":"CYTOG CONST ALYS INTERROG","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWE1","description":"ICD-HBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nerve palsy muscle graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15841","description":"Nerve palsy muscle graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTD1","description":"ICD-FHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYF1","description":"ICD-CDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Msh2 gene dup/delete variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81297","description":"Msh2 gene dup/delete variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEA1","description":"ICD-OKEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Near-infrared spectroscopy studies of lower extremity wounds (eg_ for oxyhemoglobin measurement)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0493T","description":"Near-infrared spectroscopy studies of lower extremity wounds (eg_ for oxyhemoglobin measurement)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bk joint covers pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5678","description":"Bk joint covers pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62190","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEF1","description":"ICD-BGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX1C","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient has been treated with an oral systemic or biologic medication for psoriasis vulgaris","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9764","description":"Patient has been treated with an oral systemic or biologic medication for psoriasis vulgaris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSC1","description":"ICD-KDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8008","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8008","description":"HCPCS-C8008","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28298","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMC0","description":"ICD-AHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVF0","description":"ICD-GAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXA1","description":"ICD-NBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAB1","description":"ICD-BIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADE0","description":"ICD-CADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEC0","description":"ICD-GBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNF0","description":"ICD-KFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSF0","description":"ICD-LBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXC1","description":"ICD-FBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"User adjustable heel height","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5990","description":"User adjustable heel height","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFD1","description":"ICD-OHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place cath thoracic aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36221","description":"Place cath thoracic aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antihist/decong rx/recom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4133F","description":"Antihist/decong rx/recom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAB1","description":"ICD-CGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPE0","description":"ICD-CBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWD1","description":"ICD-KIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amalgam two surfaces permane","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2150","description":"Amalgam two surfaces permane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARA1","description":"ICD-LARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Commode chair pail or pan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0167","description":"Commode chair pail or pan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXF1","description":"ICD-BAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Counseling_ group_ by department of veterans affairs chaplain services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9003","description":"Counseling_ group_ by department of veterans affairs chaplain services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27245","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWE0","description":"ICD-GFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFE1","description":"ICD-FAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67710","description":"Incision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rbc serum pretx incubj drugs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86975","description":"Rbc serum pretx incubj drugs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise spine & cord cervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63194","description":"Incise spine & cord cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB16","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLE1","description":"ICD-NFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18X","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient Did Not Receive At Least One Dose Of The Herpes Zoster Live Vaccine Or Two Doses Of The Herpes Zoster Recombinant Vaccine (At Least 28 Days Apart) Anytime On Or After","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2162","description":"Patient Did Not Receive At Least One Dose Of The Herpes Zoster Live Vaccine Or Two Doses Of The Herpes Zoster Recombinant Vaccine (At Least 28 Days Apart) Anytime On Or After","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPC0","description":"ICD-OIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBA1","description":"ICD-BGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28X","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHD1","description":"ICD-GFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj foramen epidural c/t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64479","description":"Inj foramen epidural c/t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair pulmonary atresia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33920","description":"Repair pulmonary atresia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFF1","description":"ICD-GCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTF0","description":"ICD-FGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTD1","description":"ICD-IFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orthopedic shoe modifica nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3649","description":"Orthopedic shoe modifica nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25375","description":"Revise radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGB0","description":"ICD-CEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laundry serv_ext_prof_/order","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5175","description":"Laundry serv_ext_prof_/order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Closure of salivary fistula","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7983","description":"Closure of salivary fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSC1","description":"ICD-DHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIA1","description":"ICD-ECIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWE0","description":"ICD-HAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQB0","description":"ICD-OCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBB0","description":"ICD-KFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVE1","description":"ICD-KGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQD0","description":"ICD-DBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBF0","description":"ICD-MIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc fx & test/txmnt for op","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5015F","description":"Doc fx & test/txmnt for op","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33426","description":"Repair of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMF0","description":"ICD-EGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCF1","description":"ICD-OCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed fixd ht w/o mattres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0251","description":"Hosp bed fixd ht w/o mattres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28G","description":"Special Care High _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion or subcutaneous injection_ casirivimaband imdevimab_ includes infusion or injection_ and post administration monitoring in the home or residence","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0241","description":"Intravenous infusion or subcutaneous injection_ casirivimaband imdevimab_ includes infusion or injection_ and post administration monitoring in the home or residence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rickettsia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86757","description":"Rickettsia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRF1","description":"ICD-OCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVC0","description":"ICD-BGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTD1","description":"ICD-CGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAF0","description":"ICD-AFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iadna-dna/rna probe tq 12-25","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87507","description":"Iadna-dna/rna probe tq 12-25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18I","description":"Clinically Complex _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1LA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LA31","description":"ICD-1LA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEC1","description":"ICD-JAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHD1","description":"ICD-IDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXD1","description":"ICD-OJXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test panel pricing code_ 22+ tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP22","description":"Auto.test panel pricing code_ 22+ tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOA1","description":"ICD-DGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise reconst elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24371","description":"Revise reconst elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERD0","description":"ICD-LERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUE1","description":"ICD-OIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVE0","description":"ICD-JBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Us exam abdo back wall comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76770","description":"Us exam abdo back wall comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX36","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prednisone_ oral_ per 5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7506","description":"Prednisone_ oral_ per 5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Employment - Employment Skills Development (1:1)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1728","description":"Employment - Employment Skills Development (1:1)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMF0","description":"ICD-KIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heat lamp with stand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0205","description":"Heat lamp with stand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchial valve addl insert","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31651","description":"Bronchial valve addl insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Offset/lat rocker arm w/ela","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2632","description":"Offset/lat rocker arm w/ela","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1373","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","description":"HCPCS-M1373","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBF0","description":"ICD-FIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"VitoGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4317","description":"VitoGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGB1","description":"ICD-CFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRE1","description":"ICD-PKRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBF0","description":"ICD-ECBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJC0","description":"ICD-JGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELE1","description":"ICD-JELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMA0","description":"ICD-FAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ benralizumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9466","description":"Injection_ benralizumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kafo femoral fx cast rigid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2136","description":"Kafo femoral fx cast rigid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft kneecap tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27381","description":"Repair/graft kneecap tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aspergillus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86606","description":"Aspergillus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Erwinaze injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9019","description":"Erwinaze injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKC1","description":"ICD-ODKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICF1","description":"ICD-MICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"R hrt coronary artery angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93456","description":"R hrt coronary artery angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEA0","description":"ICD-NKEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of skull with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62146","description":"Repair of skull with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Streptococcus_ group B","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87802","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Streptococcus_ group B","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open reduc compd alveolus fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7770","description":"Open reduc compd alveolus fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28H","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPD1","description":"ICD-CHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOC0","description":"ICD-OLOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flex/ext/rotation wrist unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6624","description":"Flex/ext/rotation wrist unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC135","description":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRC1","description":"ICD-PJRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGE1","description":"ICD-FDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB110","description":"Special Care High _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCC1","description":"ICD-OLCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heredtry nurondcrn tum dsrdr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81438","description":"Heredtry nurondcrn tum dsrdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystourethro w/addl implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52442","description":"Cystourethro w/addl implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sleeve_ inter limb comp dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4600","description":"Sleeve_ inter limb comp dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lso sc r pos/lat pnl pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0649","description":"Lso sc r pos/lat pnl pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAED0","description":"ICD-GAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJD0","description":"ICD-BEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETA1","description":"ICD-FETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNE0","description":"ICD-KCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ golodirsen_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1429","description":"Injection_ golodirsen_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61530","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEE1","description":"ICD-GDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDC0","description":"ICD-JBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOB1","description":"ICD-OGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGB0","description":"ICD-FGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQB0","description":"ICD-HHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUE1","description":"ICD-NDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37257","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","description":"CPT-37257","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9983","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFF0","description":"ICD-NKFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epi etiol synd rvwd and docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1205F","description":"Epi etiol synd rvwd and docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCC1","description":"ICD-IFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEE1","description":"ICD-KGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray nose to rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76010","description":"X-ray nose to rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTF0","description":"ICD-OLTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interprof phone/online 21-30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99448","description":"Interprof phone/online 21-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCD1","description":"ICD-NDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE204","description":"Reduced Physical Function _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plmt ureteral stent prq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50694","description":"Plmt ureteral stent prq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of head of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23195","description":"Removal of head of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDC0","description":"ICD-MFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAF0","description":"ICD-EAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE23C","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-rays bone survey limited","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77074","description":"X-rays bone survey limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPD0","description":"ICD-JGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA106","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRC0","description":"ICD-CCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUE1","description":"ICD-KBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGB1","description":"ICD-GCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDC0","description":"ICD-KDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hib prp-omp vacc 3 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90647","description":"Hib prp-omp vacc 3 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL17","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYE1","description":"ICD-GDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc comp or mort w in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9268","description":"Doc comp or mort w in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMD1","description":"ICD-CIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory syncytial virus vaccine_ mRNA lipid nanoparticles_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90683","description":"Respiratory syncytial virus vaccine_ mRNA lipid nanoparticles_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDD1","description":"ICD-MLDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Refill/maint pump/resvr syst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96522","description":"Refill/maint pump/resvr syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr epigastric hern reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49570","description":"Rpr epigastric hern reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMC1","description":"ICD-IHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Temporary replacement eqpmnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0462","description":"Temporary replacement eqpmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18A","description":"Clinically Complex _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALA0","description":"ICD-BALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXD1","description":"ICD-BFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOB0","description":"ICD-LFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (respiratory infection)_ Myxovirus resistance protein A (MxA) and C-reactive protein (CRP)_ fingerstick whole blood specimen_ each biomarker reported as pre","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0442U","description":"Infectious disease (respiratory infection)_ Myxovirus resistance protein A (MxA) and C-reactive protein (CRP)_ fingerstick whole blood specimen_ each biomarker reported as pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Necropsy (autopsy) procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88099","description":"Necropsy (autopsy) procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBF0","description":"ICD-GHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUA1","description":"ICD-MKUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRC1","description":"ICD-DBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFF0","description":"ICD-BFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMC1","description":"ICD-OLMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Furosemide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1940","description":"Furosemide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJB0","description":"ICD-GGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens pmma spherical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2500","description":"Contact lens pmma spherical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQB1","description":"ICD-HHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection for cholangiogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47532","description":"Injection for cholangiogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-93898","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","description":"CPT-93898","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAC1","description":"ICD-MBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1GB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GB11","description":"ICD-1GB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44382","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAE0","description":"ICD-NAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTE0","description":"ICD-OKTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWA0","description":"ICD-OKWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepagam b intravenous_ inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1573","description":"Hepagam b intravenous_ inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAD0","description":"ICD-FBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Recording of fetal magnetic cardiac signal using at least 3 channels; signal extraction_ technical analysis_ and result","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0477T","description":"Recording of fetal magnetic cardiac signal using at least 3 channels; signal extraction_ technical analysis_ and result","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTF1","description":"ICD-OGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGB0","description":"ICD-KIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQF0","description":"ICD-KHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Paclitaxel protein bound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9264","description":"Paclitaxel protein bound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRC0","description":"ICD-LDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEC0","description":"ICD-IGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAA0","description":"ICD-EHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHD1","description":"ICD-MKHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ exosome-based analysis of 442 small noncoding RNAs (sncRNAs) by quantitative reverse transcription polymerase chain reaction (RT-qPCR)_ urine_ reported as","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0343U","description":"Oncology (prostate)_ exosome-based analysis of 442 small noncoding RNAs (sncRNAs) by quantitative reverse transcription polymerase chain reaction (RT-qPCR)_ urine_ reported as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent leadless pacemaker_ ventricular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0388T","description":"Transcatheter removal of permanent leadless pacemaker_ ventricular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUE1","description":"ICD-GFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFE0","description":"ICD-CBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vc lesion w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31545","description":"Remove vc lesion w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Permanent Fallopian Tube Occlusion With Degradable Biopolymer Implant_ Transcervical Approach_ Including Transvaginal Ultrasound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0567T","description":"Permanent Fallopian Tube Occlusion With Degradable Biopolymer Implant_ Transcervical Approach_ Including Transvaginal Ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALC0","description":"ICD-GALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEF1","description":"ICD-JAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tech other than surfc cultr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4261F","description":"Tech other than surfc cultr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJE0","description":"ICD-ODJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Caspofungin acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0637","description":"Caspofungin acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0303","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0303","description":"CDT-D0303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18I","description":"Clinically Complex _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneumat walking boot pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4360","description":"Pneumat walking boot pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD221","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKE1","description":"ICD-CEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMB1","description":"ICD-CGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Seven Standard Field Stereoscopic Photos With Interpretation By An Ophthalmologist Or Optometrist Documented And Reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2103","description":"Seven Standard Field Stereoscopic Photos With Interpretation By An Ophthalmologist Or Optometrist Documented And Reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTE0","description":"ICD-OJTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient is not ambulatory_ bed ridden_ immobile_ confined to chair_ wheelchair bound_ dependent on helper pushing wheelchair_ independent in wheelchair or minimal help in whee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9719","description":"Patient is not ambulatory_ bed ridden_ immobile_ confined to chair_ wheelchair bound_ dependent on helper pushing wheelchair_ independent in wheelchair or minimal help in whee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFA0","description":"ICD-JHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Impr med time edarr pain med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9426","description":"Impr med time edarr pain med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8I","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFB1","description":"ICD-KCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEF0","description":"ICD-EEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIF1","description":"ICD-GDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2042","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","description":"HCPCS-A2042","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elbow socket ins use w/lock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6694","description":"Elbow socket ins use w/lock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXD1","description":"ICD-GAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ocular implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8610","description":"Ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Peritoneal lavage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49084","description":"Peritoneal lavage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bevacizumab-maly_ biosimilar_ (Alymsys)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9142","description":"Injection_ bevacizumab-maly_ biosimilar_ (Alymsys)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQC1","description":"ICD-PKQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJA0","description":"ICD-FCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC13D","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onlay cst nbl mtl 2 surfaces","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6614","description":"Onlay cst nbl mtl 2 surfaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHA1","description":"ICD-BIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA4C","description":"Default_ /PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXB0","description":"ICD-NIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFE0","description":"ICD-BGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD212","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq lamot/lam crv/thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0274T","description":"Perq lamot/lam crv/thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIA0","description":"ICD-IFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENC1","description":"ICD-JENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOA1","description":"ICD-PDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove mandible cyst complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21046","description":"Remove mandible cyst complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of nasal septum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30520","description":"Repair of nasal septum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18E","description":"Special Care Low _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBA1","description":"ICD-NIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHA0","description":"ICD-OJHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXD0","description":"ICD-GGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC14B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTE0","description":"ICD-AGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPE0","description":"ICD-BBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lso full corset","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0976","description":"Lso full corset","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCC1","description":"ICD-KHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOA0","description":"ICD-KFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB20C","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient spent less than three days in hospice care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9860","description":"Patient spent less than three days in hospice care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perc drug-el cor stent sing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9600","description":"Perc drug-el cor stent sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEF1","description":"ICD-OKEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOC0","description":"ICD-GAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBE0","description":"ICD-JIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFA1","description":"ICD-NLFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FA31","description":"ICD-1FA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Venous pressure clamp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4918","description":"Venous pressure clamp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAD1","description":"ICD-OBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWA1","description":"ICD-CDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg 2.1-3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11443","description":"Exc face-mm b9+marg 2.1-3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGB1","description":"ICD-KCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAA1","description":"ICD-KFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETF1","description":"ICD-BETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEF0","description":"ICD-NGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMA0","description":"ICD-GHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMA1","description":"ICD-ADMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINE1","description":"ICD-FINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDF1","description":"ICD-OGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA06","description":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXD0","description":"ICD-GEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE230","description":"Special Care Low _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98971","description":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"At least two orders for high-risk medications from the same drug class_ (table 4)_ not ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1209","description":"At least two orders for high-risk medications from the same drug class_ (table 4)_ not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHE0","description":"ICD-CEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exoskeletal bk ultralt mater","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5785","description":"Exoskeletal bk ultralt mater","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPD0","description":"ICD-BGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal pelvic lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38562","description":"Removal pelvic lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reimplant ureter in bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50783","description":"Reimplant ureter in bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33735","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEB1","description":"ICD-EHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apply intrcav radiat interm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77762","description":"Apply intrcav radiat interm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPF0","description":"ICD-NHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX21","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKB1","description":"ICD-OFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKB1","description":"ICD-CAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of finger(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73140","description":"X-ray exam of finger(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE22B","description":"Clinically Complex _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDD1","description":"ICD-FHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0759","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","description":"HCPCS-J0759","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Evoked auditory test qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92558","description":"Evoked auditory test qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJF0","description":"ICD-CCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth hernia repair < 1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83451","description":"Anesth hernia repair < 1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGF0","description":"ICD-KFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE213","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLB0","description":"ICD-IDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEE1","description":"ICD-JCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVE0","description":"ICD-CBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Limb nerve surgery add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64783","description":"Limb nerve surgery add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC15C","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Finger tendon transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26498","description":"Finger tendon transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intervene hlth/behave group","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96153","description":"Intervene hlth/behave group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGF0","description":"ICD-JCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory syncytial virus vaccine_ preF_ subunit_ bivalent_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90678","description":"Respiratory syncytial virus vaccine_ preF_ subunit_ bivalent_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKE1","description":"ICD-BHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCME0","description":"ICD-CCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACF1","description":"ICD-OACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEB1","description":"ICD-GBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELB0","description":"ICD-FELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECA1","description":"ICD-CECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic outlet reduction_ gastric pouch application_ with endoscopy and intraluminal tube insertion_ if performed_ including all system and tissue anchoring components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9785","description":"Endoscopic outlet reduction_ gastric pouch application_ with endoscopy and intraluminal tube insertion_ if performed_ including all system and tissue anchoring components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug/bio noc part b drug cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4082","description":"Drug/bio noc part b drug cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES20C","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tear film img uni/bi w/i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0330T","description":"Tear film img uni/bi w/i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18H","description":"Special Care Low _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJD1","description":"ICD-NJJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMC0","description":"ICD-CIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0477U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","description":"CPT-0477U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0609U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","description":"CPT-0609U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSB0","description":"ICD-OGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ob us nuchal meas add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76814","description":"Ob us nuchal meas add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hd trapeze bar attach to bed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0911","description":"Hd trapeze bar attach to bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIF1","description":"ICD-KCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1EC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EC21","description":"ICD-1EC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD224","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA24A","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUD1","description":"ICD-MAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDF0","description":"ICD-ODDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVE0","description":"ICD-CFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90613","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","description":"CPT-90613","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNE1","description":"ICD-KGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMB0","description":"ICD-NIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFA0","description":"ICD-CAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHE1","description":"ICD-MJHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infuse radioactive materials","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77750","description":"Infuse radioactive materials","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXC1","description":"ICD-NCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOC0","description":"ICD-PJOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tenolysis triceps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24332","description":"Tenolysis triceps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCD1","description":"ICD-EFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx colon metas evid dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9087","description":"Onc dx colon metas evid dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C7562","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7562","description":"HCPCS-C7562","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elec lock on manual pw elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6638","description":"Elec lock on manual pw elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Construct bowel bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50825","description":"Construct bowel bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCF1","description":"ICD-KBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKA0","description":"ICD-FBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove pilonidal cyst simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11770","description":"Remove pilonidal cyst simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDE1","description":"ICD-MKDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ankle implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27704","description":"Removal of ankle implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVE1","description":"ICD-KDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vitamin d 25 hydroxy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82306","description":"Vitamin d 25 hydroxy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1115","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ald for cochlear implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5273","description":"Ald for cochlear implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHED1","description":"ICD-MHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKE0","description":"ICD-NAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC11B","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDE0","description":"ICD-FCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMC1","description":"ICD-FFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL3A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMF0","description":"ICD-AFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient/caregiver training for initiation of home international normalized ratio (INR) monitoring under the direction of a physician or other qualified health care professiona","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93792","description":"Patient/caregiver training for initiation of home international normalized ratio (INR) monitoring under the direction of a physician or other qualified health care professiona","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of tongue lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41110","description":"Excision of tongue lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAC1","description":"ICD-JBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Addition to lower extremity_ user adjustable_ mechanical_ residual limb volume management system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5783","description":"Addition to lower extremity_ user adjustable_ mechanical_ residual limb volume management system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Angina absent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1012F","description":"Angina absent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDE1","description":"ICD-GDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31760","description":"Repair of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJB1","description":"ICD-JCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"P2y inhib presc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9438","description":"P2y inhib presc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILE1","description":"ICD-KILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINF1","description":"ICD-JINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration for testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54550","description":"Exploration for testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMF0","description":"ICD-CIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compatibility test incubate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86921","description":"Compatibility test incubate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGD1","description":"ICD-JAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01840","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01840","description":"CPT-01840","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWD1","description":"ICD-DHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Palliative Care Services Given To Patient Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0031","description":"Palliative Care Services Given To Patient Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIE1","description":"ICD-MDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine infusion device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62365","description":"Remove spine infusion device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of forehead wrinkles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15824","description":"Removal of forehead wrinkles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth chest lining biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52251","description":"Anesth chest lining biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGF0","description":"ICD-FFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cold agglutinin screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86156","description":"Cold agglutinin screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oxytocin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2590","description":"Oxytocin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Microfluid analy tears","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83861","description":"Microfluid analy tears","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUD0","description":"ICD-BFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBF1","description":"ICD-OEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPC0","description":"ICD-NFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGE1","description":"ICD-KFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoe molded plastazote cust","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3252","description":"Shoe molded plastazote cust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAF1","description":"ICD-CHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65815","description":"Drainage of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCID1","description":"ICD-NCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFA1","description":"ICD-KEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUA0","description":"ICD-MJUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOA1","description":"ICD-PJOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA23","description":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"I&d abscess extraoral","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7520","description":"I&d abscess extraoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHB1","description":"ICD-BDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJA0","description":"ICD-NJJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNC0","description":"ICD-OFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHF0","description":"ICD-KAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc brstcncr stage 4 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3380F","description":"Ajcc brstcncr stage 4 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Correction of astigmatism","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65772","description":"Correction of astigmatism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUB1","description":"ICD-BIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No abd imag w/o reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9457","description":"No abd imag w/o reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of feces for trypsin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84490","description":"Assay of feces for trypsin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUE0","description":"ICD-GHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEE0","description":"ICD-CDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Minimally invasive direct co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2207","description":"Minimally invasive direct co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hcg free betachain test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84704","description":"Hcg free betachain test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRC0","description":"ICD-CGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat pelvic ring fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27218","description":"Treat pelvic ring fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial imaging by magnetocardiography (MCG) for detection of cardiac ischemia_ by signal acquisition using minimum 36 channel grid_ generation of magnetic-field time-serie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0542T","description":"Myocardial imaging by magnetocardiography (MCG) for detection of cardiac ischemia_ by signal acquisition using minimum 36 channel grid_ generation of magnetic-field time-serie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of upper eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15823","description":"Revision of upper eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPB1","description":"ICD-OIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of hydrocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55000","description":"Drainage of hydrocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITA0","description":"ICD-IITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dev delay prev dp ch_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2037","description":"Dev delay prev dp ch_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQC0","description":"ICD-PCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploratory shoulder surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23040","description":"Exploratory shoulder surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUA1","description":"ICD-GIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPE1","description":"ICD-JEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nerve repair w/allograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64910","description":"Nerve repair w/allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIE0","description":"ICD-ICIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSD0","description":"ICD-PGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELB1","description":"ICD-NELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for electron microscopy_ diagnostic (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0856T","description":"Digitization of glass microscope slides for electron microscopy_ diagnostic (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinician Determines Patient Does Not Require Referral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0038","description":"Clinician Determines Patient Does Not Require Referral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8001","description":"HCPCS-C8001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPB1","description":"ICD-NCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0805","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0805","description":"HCPCS-C0805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJA0","description":"ICD-CBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBE0","description":"ICD-CCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cltx med ankle fx w/mnpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27762","description":"Cltx med ankle fx w/mnpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone biopsy trocar/needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20220","description":"Bone biopsy trocar/needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0042A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIE1","description":"ICD-CHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES321","description":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOD1","description":"ICD-OFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEC1","description":"ICD-CGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXC0","description":"ICD-CIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFA0","description":"ICD-FIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAD1","description":"ICD-EGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Provision splnt intracoronal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4320","description":"Provision splnt intracoronal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stereotactic radiation trmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77432","description":"Stereotactic radiation trmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIC0","description":"ICD-FDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJC1","description":"ICD-BFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEB0","description":"ICD-CCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGD0","description":"ICD-JHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of hip bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27146","description":"Incision of hip bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGF0","description":"ICD-CHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMB1","description":"ICD-GAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Retainer - Porcelain Fused To Predominantly Base Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6098","description":"Implant Supported Retainer - Porcelain Fused To Predominantly Base Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSA1","description":"ICD-CBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBME1","description":"ICD-IBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lso sag-coronal panel custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0638","description":"Lso sag-coronal panel custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPD0","description":"ICD-JCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENA1","description":"ICD-FENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLC1","description":"ICD-JGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA22D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Positional nystagmus test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92532","description":"Positional nystagmus test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPD1","description":"ICD-CDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNC1","description":"ICD-CGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment Of Amblyopia Using An Online Digital Program; Device Supply_ Educational Set-Up_ And Initial Session","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0687T","description":"Treatment Of Amblyopia Using An Online Digital Program; Device Supply_ Educational Set-Up_ And Initial Session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fix g/colon tube w/device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49460","description":"Fix g/colon tube w/device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3379","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","description":"HCPCS-J3379","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEME0","description":"ICD-MEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJD0","description":"ICD-KGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dengue vaccine_ quadrivalent_ live_ 3 dose schedule_ for subcutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90587","description":"Dengue vaccine_ quadrivalent_ live_ 3 dose schedule_ for subcutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDA0","description":"ICD-IIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pjp proph ordered cd4 low","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9223","description":"Pjp proph ordered cd4 low","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner_ including a patient navigator; 60 m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0023","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner_ including a patient navigator; 60 m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJB0","description":"ICD-FAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3BC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BC11","description":"ICD-3BC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEC0","description":"ICD-AEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABD1","description":"ICD-GABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIF1","description":"ICD-IAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHB1","description":"ICD-IGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Correct rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45541","description":"Correct rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stab phleb veins xtr 10-20","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37765","description":"Stab phleb veins xtr 10-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBD1","description":"ICD-CEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEF0","description":"ICD-FHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBND1","description":"ICD-CBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suicide risk based on their clinician_s evaluation or a clinician-rated tool","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1355","description":"Suicide risk based on their clinician_s evaluation or a clinician-rated tool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intravascular ultrasound (non-coronary vessel) during diagnostic evaluation and/or therapeutic intervention; initial vessel (list separately in addition to code f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37250","description":"Intravascular ultrasound (non-coronary vessel) during diagnostic evaluation and/or therapeutic intervention; initial vessel (list separately in addition to code f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBC0","description":"ICD-GBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA234","description":"Clinically Complex _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lepirudin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1945","description":"Lepirudin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33927","description":"Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Management of new patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0519","description":"Management of new patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXB0","description":"ICD-BGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of phrenic nerve stimulator transvenous sensing lead (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33277","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBF0","description":"ICD-FDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1736","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","description":"HCPCS-J1736","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Njx paravert w/us lumb/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0217T","description":"Njx paravert w/us lumb/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMC0","description":"ICD-JIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Breast)_ Semiquantitative Analysis Of 32 Phosphoproteins And Protein Analytes_ Includes Laser Capture Microdissection_ With Algorithmic Analysis And Interpretative R","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0249U","description":"Oncology (Breast)_ Semiquantitative Analysis Of 32 Phosphoproteins And Protein Analytes_ Includes Laser Capture Microdissection_ With Algorithmic Analysis And Interpretative R","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACC0","description":"ICD-KACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKE0","description":"ICD-OHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 10 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP10","description":"Auto.test pane pricing code_ 10 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"W/c component-accessory nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0108","description":"W/c component-accessory nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydration iv infusion init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96360","description":"Hydration iv infusion init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fabric wrapping of aneurysm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0301","description":"Fabric wrapping of aneurysm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLB0","description":"ICD-NBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLB0","description":"ICD-EDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open nasoethmoid fx w/ fixj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21339","description":"Open nasoethmoid fx w/ fixj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDE1","description":"ICD-KFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor xii hageman","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85280","description":"Clot factor xii hageman","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCC1","description":"ICD-BHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRB1","description":"ICD-OHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for level II_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0751T","description":"Digitization of glass microscope slides for level II_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLA0","description":"ICD-KFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise circulation to head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61708","description":"Revise circulation to head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct thorax w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71260","description":"Ct thorax w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATC1","description":"ICD-GATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDD0","description":"ICD-MDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBF1","description":"ICD-BIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Technetium tc-99m aerosol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9567","description":"Technetium tc-99m aerosol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA240","description":"Clinically Complex _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYF0","description":"ICD-OJYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPB0","description":"ICD-NEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNA0","description":"ICD-JHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB10","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ isavuconazonium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1833","description":"Injection_ isavuconazonium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNA1","description":"ICD-NHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Euglobulin lysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85360","description":"Euglobulin lysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytogenetics 25-99","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88274","description":"Cytogenetics 25-99","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLF0","description":"ICD-OKLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB116","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIE1","description":"ICD-MHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEC1","description":"ICD-EGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0571","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","description":"HCPCS-G0571","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42235","description":"Repair palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKC0","description":"ICD-NLKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Physician standby services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99360","description":"Physician standby services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSD1","description":"ICD-PCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Asthma measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8645","description":"Asthma measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removable retainer adjust","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8681","description":"Removable retainer adjust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LC21","description":"ICD-3LC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNA1","description":"ICD-CHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1AC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AC21","description":"ICD-1AC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainable plastic pch w fcpl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4375","description":"Drainable plastic pch w fcpl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVC1","description":"ICD-GEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELC0","description":"ICD-IELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHME0","description":"ICD-BHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove eye/revise socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65112","description":"Remove eye/revise socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of lumbar spine region cancer at the time of the procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1037","description":"Patients with a diagnosis of lumbar spine region cancer at the time of the procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive (75 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0085","description":"Extensive (75 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOF1","description":"ICD-PHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Njx paravert w/us cer/thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0215T","description":"Njx paravert w/us cer/thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB15D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVB1","description":"ICD-FEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray assay calculus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82370","description":"X-ray assay calculus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCF1","description":"ICD-ODCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRC1","description":"ICD-GIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKD1","description":"ICD-FCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDD0","description":"ICD-CGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore abdominal vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35840","description":"Explore abdominal vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of brow nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64732","description":"Incision of brow nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Taking statin or recd order","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9664","description":"Taking statin or recd order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0504","description":"HCPCS-C0504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"John cunningham antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86711","description":"John cunningham antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWF0","description":"ICD-PAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVA1","description":"ICD-CDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Commode chair non-electric","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0171","description":"Commode chair non-electric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQE1","description":"ICD-HIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cromolyn sodium noncomp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7631","description":"Cromolyn sodium noncomp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVA0","description":"ICD-FAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACE1","description":"ICD-JACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDB0","description":"ICD-AGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ uns","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA1C","description":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ uns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostomy tube collar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7526","description":"Tracheostomy tube collar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo drain lymphocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49323","description":"Laparo drain lymphocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient screened for future fall risk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1069","description":"Patient screened for future fall risk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRD1","description":"ICD-DDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL2C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lyme disease antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86617","description":"Lyme disease antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENA0","description":"ICD-FENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"External heart rate and 3-axis accelerometer data recording from 15 to 30 days to assess changes in heart rate and to monitor motion analysis for the purposes of diagnosing no","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0384T","description":"External heart rate and 3-axis accelerometer data recording from 15 to 30 days to assess changes in heart rate and to monitor motion analysis for the purposes of diagnosing no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWC0","description":"ICD-KDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDB0","description":"ICD-IDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove exostosis maxilla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21032","description":"Remove exostosis maxilla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRF0","description":"ICD-DHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgery to stop leg growth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27477","description":"Surgery to stop leg growth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hip orthosis (HO)_ bilateral hip joints and thigh cuffs_ adjustable flexion_ extension_ abduction control of hip joint_ postoperative hip abduction type_ prefabricated item th","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1681","description":"Hip orthosis (HO)_ bilateral hip joints and thigh cuffs_ adjustable flexion_ extension_ abduction control of hip joint_ postoperative hip abduction type_ prefabricated item th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTE1","description":"ICD-IHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD154","description":"Special Care High _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVA0","description":"ICD-JHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCC0","description":"ICD-MCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL10","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0693U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693U","description":"CPT-0693U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oral everolimus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7527","description":"Oral everolimus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPD1","description":"ICD-JCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastric electrophysiology mapping with simultaneous patient symptom profiling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9787","description":"Gastric electrophysiology mapping with simultaneous patient symptom profiling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc 2x re-assess filt remov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9543","description":"Doc 2x re-assess filt remov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place cath vertebral art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36226","description":"Place cath vertebral art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (fungi)_ fungal pathogen identification_ DNA (15 fungal targets)_ blood culture_ amplified probe technique_ each target reported as detected or not detected","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0140U","description":"Infectious disease (fungi)_ fungal pathogen identification_ DNA (15 fungal targets)_ blood culture_ amplified probe technique_ each target reported as detected or not detected","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEE1","description":"ICD-MJEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Levalbuterol comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7615","description":"Levalbuterol comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL15","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSB0","description":"ICD-OLSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIA0","description":"ICD-KGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAC0","description":"ICD-OKAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKF0","description":"ICD-BIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBB1","description":"ICD-FEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMC0","description":"ICD-OCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of eye fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67010","description":"Partial removal of eye fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11470","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc fe+ stores b/4 epo thx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3160F","description":"Doc fe+ stores b/4 epo thx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6011","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFB1","description":"ICD-FHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of miscarriage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59812","description":"Treatment of miscarriage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELE1","description":"ICD-CELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUD0","description":"ICD-FEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXB1","description":"ICD-FIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQF1","description":"ICD-KAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQC1","description":"ICD-HCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC20","description":"Very High Rehab _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pelv band/spread bar thigh c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1640","description":"Pelv band/spread bar thigh c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1BA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BA21","description":"ICD-1BA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40840","description":"Reconstruction of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJD0","description":"ICD-CCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic induction of intra-brain hypothermia_ including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head_ including monit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0776T","description":"Therapeutic induction of intra-brain hypothermia_ including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head_ including monit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYC0","description":"ICD-LBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEB0","description":"ICD-NAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWE1","description":"ICD-HHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCF1","description":"ICD-NHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYA0","description":"ICD-DDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI lumbar spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72148","description":"MRI lumbar spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIA0","description":"ICD-NCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFF1","description":"ICD-BHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCB1","description":"ICD-FFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood glucose/reagent strips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4253","description":"Blood glucose/reagent strips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth head nerve surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22251","description":"Anesth head nerve surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFE0","description":"ICD-KFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gas system stationary compre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0425","description":"Gas system stationary compre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEE0","description":"ICD-MAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYF1","description":"ICD-LAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Continuous_ Real-Time Monitoring And Mai","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95716","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Continuous_ Real-Time Monitoring And Mai","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole_ (Abilify Asimtufii)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9152","description":"Injection_ aripiprazole_ (Abilify Asimtufii)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAC0","description":"ICD-MKAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDA1","description":"ICD-MEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLD1","description":"ICD-ODLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNC1","description":"ICD-CHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove renal tube w/fluoro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50389","description":"Remove renal tube w/fluoro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRB1","description":"ICD-LBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDA1","description":"ICD-MBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Report ckd measures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8487","description":"Report ckd measures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc antibio given b/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4047F","description":"Doc antibio given b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL3C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reinsert spinal fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22849","description":"Reinsert spinal fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"The collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (i.e._ remote patient monitoring)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0322","description":"The collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (i.e._ remote patient monitoring)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Penicillin g benzathine inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0561","description":"Penicillin g benzathine inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABA0","description":"ICD-IABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision malig les complicat","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7415","description":"Excision malig les complicat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINF1","description":"ICD-NINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVC0","description":"ICD-JDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCC0","description":"ICD-FFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYD0","description":"ICD-CCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gear reduction drive wheel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2227","description":"Gear reduction drive wheel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVA0","description":"ICD-JAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breast surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19499","description":"Breast surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATB0","description":"ICD-AATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66605","description":"Removal of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA3C","description":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIB0","description":"ICD-MBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26428","description":"Repair/graft finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAD0","description":"ICD-NHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGE0","description":"ICD-GCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Standard wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0001","description":"Standard wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES22A","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUF0","description":"ICD-CHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Topical ox deliver sys_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0446","description":"Topical ox deliver sys_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0611U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","description":"CPT-0611U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVC1","description":"ICD-JIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEB0","description":"ICD-OGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYE1","description":"ICD-DBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX2A","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUB0","description":"ICD-MIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46760","description":"Repair of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Family (With The Patient Present)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96168","description":"Health Behavior Intervention_ Family (With The Patient Present)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Temp anchorage dev w/o flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7294","description":"Temp anchorage dev w/o flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHB0","description":"ICD-NIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht leg splnt ped f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4048","description":"Cast sup sht leg splnt ped f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28D","description":"Special Care Low _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam knee 4 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73564","description":"X-ray exam knee 4 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCME1","description":"ICD-OCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Periodic Assessment; Assessing Periodically By Qualified Personnel To Determine The Most Appropriate Combination Of Services And Treatment (Provision Of The Services By A Medi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2077","description":"Periodic Assessment; Assessing Periodically By Qualified Personnel To Determine The Most Appropriate Combination Of Services And Treatment (Provision Of The Services By A Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6036","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","description":"HCPCS-L6036","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVD1","description":"ICD-OIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAA1","description":"ICD-EBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj bulking agent anal canal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8605","description":"Inj bulking agent anal canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLD0","description":"ICD-NJLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA217","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMB0","description":"ICD-NAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bevacizumab-maly_ biosimilar_ (alymsys)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5126","description":"Injection_ bevacizumab-maly_ biosimilar_ (alymsys)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytal_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4166","description":"Cytal_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95165","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQF0","description":"ICD-KIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hair analysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P2031","description":"Hair analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92972","description":"Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of knee prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27488","description":"Removal of knee prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFC0","description":"ICD-JHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLF1","description":"ICD-FBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Organic acids total quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83918","description":"Organic acids total quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prochlorperazine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0780","description":"Prochlorperazine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystouretero w/congen repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52400","description":"Cystouretero w/congen repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKE0","description":"ICD-OLKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood type antigen donor ea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86902","description":"Blood type antigen donor ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver_ including craniectomy or craniotomy_ when performed_ with direct or inductive coupling_ with co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61889","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver_ including craniectomy or craniotomy_ when performed_ with direct or inductive coupling_ with co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCC1","description":"ICD-NBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLB0","description":"ICD-MFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0576U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","description":"CPT-0576U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Olanzapine long-acting inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2358","description":"Olanzapine long-acting inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25927","description":"Amputation of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAA1","description":"ICD-IAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNC1","description":"ICD-KBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Complete aa_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4303","description":"Complete aa_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHE0","description":"ICD-OGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGC1","description":"ICD-GGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray exam of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74280","description":"Contrast x-ray exam of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX16","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHA1","description":"ICD-NEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNB0","description":"ICD-JBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADED0","description":"ICD-ADED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Set radiation therapy field","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77285","description":"Set radiation therapy field","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01990","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01990","description":"CPT-01990","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of urethra injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53510","description":"Repair of urethra injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCE1","description":"ICD-NHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft brachial-brchl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35525","description":"Art byp grft brachial-brchl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Health And Well-Being Coaching Face-To-Face; Group (2 Or More Individuals)_ At Least 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0593T","description":"Health And Well-Being Coaching Face-To-Face; Group (2 Or More Individuals)_ At Least 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt notrcvng1st antitnf txmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6150F","description":"Pt notrcvng1st antitnf txmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDB0","description":"ICD-NDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFB1","description":"ICD-GCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHB1","description":"ICD-AIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGF0","description":"ICD-FEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPE0","description":"ICD-KAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVC1","description":"ICD-KIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE136","description":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL07","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA204","description":"Clinically Complex _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXC1","description":"ICD-NKXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"External bleaching home app","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9975","description":"External bleaching home app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hhv-6 dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87533","description":"Hhv-6 dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rerevise eye muscles add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67332","description":"Rerevise eye muscles add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFE1","description":"ICD-JCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00916","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00916","description":"CPT-00916","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pierce skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61156","description":"Pierce skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61680","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA231","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKB1","description":"ICD-GIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVC0","description":"ICD-OKVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for immunofluorescence_ per specimen; initial single antibody stain procedure (List separately in addition to code for primary procedur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0845T","description":"Digitization of glass microscope slides for immunofluorescence_ per specimen; initial single antibody stain procedure (List separately in addition to code for primary procedur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove hip foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27087","description":"Remove hip foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVA0","description":"ICD-NEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJF1","description":"ICD-JHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAD1","description":"ICD-JHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transplant/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26483","description":"Transplant/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYB1","description":"ICD-DBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of liver duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47400","description":"Incision of liver duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE22C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay phosphatidylglycerol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84081","description":"Assay phosphatidylglycerol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lo sag rig pnl stays pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0626","description":"Lo sag rig pnl stays pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUA1","description":"ICD-CBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brain image w/flow 4 + views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78606","description":"Brain image w/flow 4 + views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASF0","description":"ICD-PASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29035","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAE1","description":"ICD-IDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB112","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28I","description":"Special Care High _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTC1","description":"ICD-NBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC212","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWC0","description":"ICD-CEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam pituitary saddle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70240","description":"X-ray exam pituitary saddle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apically positioned flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4245","description":"Apically positioned flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adj chem pres ajcc iii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8927","description":"Adj chem pres ajcc iii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect shoulder tumor < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23077","description":"Resect shoulder tumor < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBD0","description":"ICD-CBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBC1","description":"ICD-OBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Njx platelet plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0232T","description":"Njx platelet plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSF0","description":"ICD-OHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; coronary sinus (List separately in addition to code f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93586","description":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; coronary sinus (List separately in addition to code f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAF0","description":"ICD-ABAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAED0","description":"ICD-FAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGF1","description":"ICD-NFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPF1","description":"ICD-CHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Administration Of Chemotherapy Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0618","description":"Hospital Special Treatment Room Support Component (Hstrsc) Administration Of Chemotherapy Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hfo flexion glove pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3912","description":"Hfo flexion glove pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYD1","description":"ICD-GFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMA0","description":"ICD-MDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCND1","description":"ICD-JCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCA0","description":"ICD-JHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNC0","description":"ICD-NCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1321","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coordinated specialty care_ team-based_ for first episode psychosis_ per encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2041","description":"Coordinated specialty care_ team-based_ for first episode psychosis_ per encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01996","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01996","description":"CPT-01996","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES20D","description":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wig any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9282","description":"Wig any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNF0","description":"ICD-OGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01274","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01274","description":"CPT-01274","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rep perf anoper/vestib fistu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46716","description":"Rep perf anoper/vestib fistu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice in hospice facility","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5006","description":"Hospice in hospice facility","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esrd srv 2-3 vsts p mo 2-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90955","description":"Esrd srv 2-3 vsts p mo 2-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDC0","description":"ICD-MIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bx breast percut w/o image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19100","description":"Bx breast percut w/o image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCD1","description":"ICD-FHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Not pres antibiotic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8712","description":"Not pres antibiotic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHB1","description":"ICD-MAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBB1","description":"ICD-FGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEB1","description":"ICD-ODEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX3D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUF1","description":"ICD-JFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open tx dprsd front sinus fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21343","description":"Open tx dprsd front sinus fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXA0","description":"ICD-NDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE250","description":"Special Care Low _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx prostate mets no cast","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9132","description":"Onc dx prostate mets no cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSE0","description":"ICD-PLSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Csf leakage imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78650","description":"Csf leakage imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ peramivir","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2547","description":"Injection_ peramivir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX35","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00904","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00904","description":"CPT-00904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE25B","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJB1","description":"ICD-BGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLF1","description":"ICD-CDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL12","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWE0","description":"ICD-CAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCF0","description":"ICD-EHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRA1","description":"ICD-KFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBC1","description":"ICD-NEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJID0","description":"ICD-OJID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDC0","description":"ICD-ABDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1140","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBD0","description":"ICD-IDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYB0","description":"ICD-GEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA45","description":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDF0","description":"ICD-CIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITD1","description":"ICD-EITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43121","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ost skn barr extnd >4 sq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4410","description":"Ost skn barr extnd >4 sq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMB1","description":"ICD-OGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUD1","description":"ICD-OEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mnpj of tmj w/anesth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21073","description":"Mnpj of tmj w/anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0594U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","description":"CPT-0594U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQC0","description":"ICD-HGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAB0","description":"ICD-BCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBB0","description":"ICD-AFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDA0","description":"ICD-GBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy rem totl cortex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32652","description":"Thoracoscopy rem totl cortex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPB1","description":"ICD-KHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of hip prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27091","description":"Removal of hip prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOE0","description":"ICD-GIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Trichomonas vaginalis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87808","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Trichomonas vaginalis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPA0","description":"ICD-FFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor viii ahg 1 stage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85240","description":"Clot factor viii ahg 1 stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leflunomide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80193","description":"Leflunomide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx gastric recurrent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9103","description":"Onc dx gastric recurrent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUA0","description":"ICD-KDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOD1","description":"ICD-KFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWE1","description":"ICD-GEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tcranial magn stim tx deli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90868","description":"Tcranial magn stim tx deli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYC1","description":"ICD-CHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lang comp d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9161","description":"Lang comp d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Routine Home Care - A flat per diem before area wage adjustment for intermittent services furnished.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0602","description":"Routine Home Care - A flat per diem before area wage adjustment for intermittent services furnished.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60271","description":"Removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWD1","description":"ICD-CFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Functional status measurement with score was not obtained utilizing the Oxford Knee Score (OKS) patient reported outcome tool w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1046","description":"Functional status measurement with score was not obtained utilizing the Oxford Knee Score (OKS) patient reported outcome tool w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC2C","description":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fixation of shoulder blade","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23400","description":"Fixation of shoulder blade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKD1","description":"ICD-NLKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx pancreatc p r0 res no","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9105","description":"Onc dx pancreatc p r0 res no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove by ligat int hem grp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46945","description":"Remove by ligat int hem grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARA0","description":"ICD-DARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGC1","description":"ICD-JHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iodine i-125 sodium iodide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9527","description":"Iodine i-125 sodium iodide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAB0","description":"ICD-BDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx prostate t3b-t4noprog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9079","description":"Onc dx prostate t3b-t4noprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE14C","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTB1","description":"ICD-EDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSD1","description":"ICD-DGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICID0","description":"ICD-ICID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.25-7/ov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2210","description":"Lens sphcy bifocal 4.25-7/ov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX15","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rigid plastic custom fa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0480","description":"Tlso rigid plastic custom fa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITE1","description":"ICD-FITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transplant hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26480","description":"Transplant hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CO GNOTYP AQP1 EXON 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0181U","description":"CO GNOTYP AQP1 EXON 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCA0","description":"ICD-NHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm_ false aneurysm_ dissection_ endoleak_ or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34710","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm_ false aneurysm_ dissection_ endoleak_ or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of haptoglobins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83012","description":"Assay of haptoglobins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2050","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2050","description":"HCPCS-A2050","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cabg art-vein six or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33523","description":"Cabg art-vein six or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray for pancreas endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74329","description":"X-ray for pancreas endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Preventive counseling indiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99401","description":"Preventive counseling indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biphos thxpy vein ord/recvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4100F","description":"Biphos thxpy vein ord/recvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hhc rn e&m plan svs_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0162","description":"Hhc rn e&m plan svs_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFA0","description":"ICD-JBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect foot/toe tumor 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28047","description":"Resect foot/toe tumor 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOC0","description":"ICD-PFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE12D","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVA1","description":"ICD-OCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKF1","description":"ICD-NDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXF0","description":"ICD-OLXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ic lbw inf 1500-2500 g subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99479","description":"Ic lbw inf 1500-2500 g subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHME0","description":"ICD-MHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASF0","description":"ICD-KASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTA1","description":"ICD-AFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"PLCG2 (phospholipase C gamma 2) (eg_ chronic lymphocytic leukemia) gene analysis_ common variants (eg_ R665W_ S707F_ L845F)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81320","description":"PLCG2 (phospholipase C gamma 2) (eg_ chronic lymphocytic leukemia) gene analysis_ common variants (eg_ R665W_ S707F_ L845F)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKE1","description":"ICD-KHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heredtry nurondcrn tum dsrdr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81437","description":"Heredtry nurondcrn tum dsrdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIA0","description":"ICD-ABIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECD0","description":"ICD-BECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ talquetamab-tgvs_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3055","description":"Injection_ talquetamab-tgvs_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHED0","description":"ICD-JHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANE0","description":"ICD-JANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Arthroscopy_ shoulder_ surgical; with implantation of subacromial spacer (e.g._ balloon)_ includes debridement (e.g._ limited or extensive)_ subacromial decompression_ acromio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9781","description":"Arthroscopy_ shoulder_ surgical; with implantation of subacromial spacer (e.g._ balloon)_ includes debridement (e.g._ limited or extensive)_ subacromial decompression_ acromio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orchiopexy (fowler-stephens)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54650","description":"Orchiopexy (fowler-stephens)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bone for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20902","description":"Removal of bone for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1042T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1042T","description":"CPT-1042T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDA0","description":"ICD-KIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lipoprotein bld hr fraction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83701","description":"Lipoprotein bld hr fraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIB0","description":"ICD-CCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cetirizine hydrochloride_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1201","description":"Injection_ cetirizine hydrochloride_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA12","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunization counseling by a physician or other qualified health care professional for COVID-19_ ages under 21_ 5-15 minutes time (This code is used for the Medicaid EPSDT)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0315","description":"Immunization counseling by a physician or other qualified health care professional for COVID-19_ ages under 21_ 5-15 minutes time (This code is used for the Medicaid EPSDT)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUC0","description":"ICD-KBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Position seat spec orth need","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T5001","description":"Position seat spec orth need","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2CB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CB21","description":"ICD-2CB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWE1","description":"ICD-CDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chylmd trach dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87490","description":"Chylmd trach dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLA1","description":"ICD-EBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home visit fecal/enema mgmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99511","description":"Home visit fecal/enema mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8G","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJF0","description":"ICD-OGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC205","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDC0","description":"ICD-GFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATC1","description":"ICD-EATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Relocation pocket pacemaker","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33222","description":"Relocation pocket pacemaker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUF0","description":"ICD-EBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abduct rotation bar w/o shoe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3150","description":"Abduct rotation bar w/o shoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUB1","description":"ICD-EGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC112","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDB0","description":"ICD-MGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contour cranial bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21181","description":"Contour cranial bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJB0","description":"ICD-BAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDA1","description":"ICD-ECDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHA1","description":"ICD-IAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (von Willebrand disease [VWD])_ von Willebrand factor (VWF) and collagen IV binding by enzyme-linked immunosorbent assays (ELISA)_ plasma_ report of collagen IV bin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0280U","description":"Hematology (von Willebrand disease [VWD])_ von Willebrand factor (VWF) and collagen IV binding by enzyme-linked immunosorbent assays (ELISA)_ plasma_ report of collagen IV bin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADF1","description":"ICD-JADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neg press ventilation cnp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94662","description":"Neg press ventilation cnp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQA1","description":"ICD-OHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","description":"HCPCS-E1804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair anorectal fist w/plug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46707","description":"Repair anorectal fist w/plug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stance phase only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5858","description":"Stance phase only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMD1","description":"ICD-NHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nonrandomized_ nonblinded procedure for NYHA Class II_ III_ IV heart failure; transcatheter implantation of interatrial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9760","description":"Nonrandomized_ nonblinded procedure for NYHA Class II_ III_ IV heart failure; transcatheter implantation of interatrial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSD0","description":"ICD-PKSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay tumor ca 125","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86304","description":"Immunoassay tumor ca 125","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB25C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYE1","description":"ICD-HBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ luspatercept-aamt_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0896","description":"Injection_ luspatercept-aamt_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1CB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CB11","description":"ICD-1CB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIC0","description":"ICD-BFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Saliva test_ hormone level;","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3650","description":"Saliva test_ hormone level;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ reslizumab_ 1 mg (Cinqair)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9481","description":"Injection_ reslizumab_ 1 mg (Cinqair)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWD0","description":"ICD-OAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37284","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","description":"CPT-37284","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap esoph lengthening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43283","description":"Lap esoph lengthening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc abd tum over 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49204","description":"Exc abd tum over 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bumetanide 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0171","description":"Bumetanide 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWC1","description":"ICD-GGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore neck vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35800","description":"Explore neck vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI chest spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72157","description":"MRI chest spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMC1","description":"ICD-GCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKE0","description":"ICD-BHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gi tract capsule endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91110","description":"Gi tract capsule endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of gum flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41821","description":"Excision of gum flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPC1","description":"ICD-FDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFD1","description":"ICD-GEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00522","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00522","description":"CPT-00522","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTE1","description":"ICD-OKTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLD1","description":"ICD-AFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Above elbow switch control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6950","description":"Above elbow switch control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPA0","description":"ICD-CAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES310","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Administration of caregiver-focused health risk assessment instrument (eg_ depression inventory) for the benefit of the patient_ with scoring and documentation_ per standardiz","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96161","description":"Administration of caregiver-focused health risk assessment instrument (eg_ depression inventory) for the benefit of the patient_ with scoring and documentation_ per standardiz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAB1","description":"ICD-EAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18F","description":"Special Care Low _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anticoagulant mgmt subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99364","description":"Anticoagulant mgmt subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGF0","description":"ICD-FGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSD1","description":"ICD-PKSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 3 hd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0851","description":"Pwc gp 3 hd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEF0","description":"ICD-FGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUF0","description":"ICD-IHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00216","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00216","description":"CPT-00216","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOA1","description":"ICD-HCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee control full kneecap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2795","description":"Knee control full kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWF1","description":"ICD-HEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBB0","description":"ICD-MHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOC1","description":"ICD-OGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemotherapy injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96542","description":"Chemotherapy injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFB1","description":"ICD-CCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARA1","description":"ICD-GARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCE0","description":"ICD-JCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA1C","description":"High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC156","description":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKE0","description":"ICD-KEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Moderate (45 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiaryā€™s home_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2003","description":"Moderate (45 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiaryā€™s home_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auto test panel pricing code_ 23+ tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP23","description":"Auto test panel pricing code_ 23+ tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVD1","description":"ICD-NLVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUF0","description":"ICD-FDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/dxa no results doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8400","description":"Pt w/dxa no results doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2789","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2789","description":"HCPCS-J2789","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAB1","description":"ICD-FBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ bal tis dis_ non-vas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1727","description":"Cath_ bal tis dis_ non-vas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intens cardiac rehab w/exerc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0422","description":"Intens cardiac rehab w/exerc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair art intramural","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33507","description":"Repair art intramural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of upper nose/throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42806","description":"Biopsy of upper nose/throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DA31","description":"ICD-3DA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJC1","description":"ICD-JGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPF1","description":"ICD-NEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct lumbar spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72132","description":"Ct lumbar spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA3A","description":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4EA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EA11","description":"ICD-4EA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immune globulin_ powder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1566","description":"Immune globulin_ powder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMD0","description":"ICD-MHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES14A","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00670","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00670","description":"CPT-00670","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dipropylacetic acid free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80165","description":"Dipropylacetic acid free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSA1","description":"ICD-OFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWD1","description":"ICD-DCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTD1","description":"ICD-CCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSA0","description":"ICD-CFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic retrograde cholangiopancreatography (ercp) with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s) and endoscopic cannulation of papilla with di","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7560","description":"Endoscopic retrograde cholangiopancreatography (ercp) with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s) and endoscopic cannulation of papilla with di","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXC1","description":"ICD-CDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D2101","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2101","description":"CDT-D2101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8E","description":"High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPC0","description":"ICD-NJPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open aortoiliac prosth repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34831","description":"Open aortoiliac prosth repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC3B","description":"High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of upper nose/throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42804","description":"Biopsy of upper nose/throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perc d-e cor revasc chro sin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9607","description":"Perc d-e cor revasc chro sin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18A","description":"Special Care High _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB15A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX41","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clin tx mdd not comm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8960","description":"Clin tx mdd not comm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVD0","description":"ICD-FAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATE0","description":"ICD-EATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAE1","description":"ICD-BFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNC0","description":"ICD-NHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHE1","description":"ICD-CAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUA1","description":"ICD-JEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Phenotype infect agent drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87900","description":"Phenotype infect agent drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1213","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28I","description":"Special Care Low _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD250","description":"Special Care Low _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDD1","description":"ICD-AHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVD0","description":"ICD-NKVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYA1","description":"ICD-HHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destroy nerve of eye muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67345","description":"Destroy nerve of eye muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eeg during surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95955","description":"Eeg during surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No sent lymph node biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8882","description":"No sent lymph node biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1603","description":"HCPCS-B1603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28D","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBB1","description":"ICD-AGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUE1","description":"ICD-CFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDF1","description":"ICD-JHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMC0","description":"ICD-KDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDF0","description":"ICD-EEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient admitted to a SPU or an ASC for monitoring and observation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0597","description":"Patient admitted to a SPU or an ASC for monitoring and observation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDD1","description":"ICD-KGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUE1","description":"ICD-ICUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE11B","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQD0","description":"ICD-GDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transtracheal oxygen cath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4608","description":"Transtracheal oxygen cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHF0","description":"ICD-KIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73590","description":"X-ray exam of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLF0","description":"ICD-BDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMF0","description":"ICD-MHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma plan of care documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1223","description":"Glaucoma plan of care documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUE0","description":"ICD-MFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEA0","description":"ICD-IAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB11B","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMF0","description":"ICD-IDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKF0","description":"ICD-CAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOE1","description":"ICD-HEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUE1","description":"ICD-BEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEED1","description":"ICD-KEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB216","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy_ flexible_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter fo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0886T","description":"Sigmoidoscopy_ flexible_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWA1","description":"ICD-KBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laps impltj nstim vagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0312T","description":"Laps impltj nstim vagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Genotype dna hepatitis b","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87912","description":"Genotype dna hepatitis b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat kneecap fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27524","description":"Treat kneecap fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVC0","description":"ICD-NDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVC0","description":"ICD-OJVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ova and parasites smears","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87177","description":"Ova and parasites smears","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALA0","description":"ICD-JALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQA1","description":"ICD-GDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNA0","description":"ICD-BFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDE1","description":"ICD-AIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGD1","description":"ICD-NGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Straight knee joint heavy du","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2385","description":"Straight knee joint heavy du","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ped size pull-on sm/med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4531","description":"Ped size pull-on sm/med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMF0","description":"ICD-BAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exome sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81416","description":"Exome sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHE0","description":"ICD-KAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECA1","description":"ICD-MECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft arm/leg =22","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2625","description":"Adj skin pro/pos wc cus>=22","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hematocrit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85014","description":"Hematocrit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIF0","description":"ICD-NAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLE1","description":"ICD-IFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBE1","description":"ICD-JGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28A","description":"Clinically Complex _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMB0","description":"ICD-NBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHE0","description":"ICD-MBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score le not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8658","description":"Fun stat score le not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m pyrophosphate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9538","description":"Tc99m pyrophosphate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE210","description":"Special Care High _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Construction of absent anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46730","description":"Construction of absent anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient was referred to another provider or specialist during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9968","description":"Patient was referred to another provider or specialist during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prosthetic sock multi ply ak","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8430","description":"Prosthetic sock multi ply ak","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWD0","description":"ICD-CGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDE0","description":"ICD-OEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD245","description":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHC0","description":"ICD-GDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOC1","description":"ICD-KGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trismus appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5937","description":"Trismus appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No follow up pulm nod norsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9347","description":"No follow up pulm nod norsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01922","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01922","description":"CPT-01922","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intake Activities_ Including Initial Medical Examination That Is A Complete_ Fully Documented Physical Evaluation And Initial Assessment By A Program Physician Or A Primary Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2076","description":"Intake Activities_ Including Initial Medical Examination That Is A Complete_ Fully Documented Physical Evaluation And Initial Assessment By A Program Physician Or A Primary Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90593","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","description":"CPT-90593","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIC0","description":"ICD-NFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYD1","description":"ICD-DHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01650","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01650","description":"CPT-01650","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Review patient spirometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94016","description":"Review patient spirometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMC0","description":"ICD-FHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","description":"HCPCS-E0201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAD0","description":"ICD-OKAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytogenomic (Genome-Wide) Analysis For Constitutional Chromosomal Abnormalities; Interrogation Of Genomic Regions For Copy Number And Loss-Of-Heterozygosity Variants_ Low-Pass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81349","description":"Cytogenomic (Genome-Wide) Analysis For Constitutional Chromosomal Abnormalities; Interrogation Of Genomic Regions For Copy Number And Loss-Of-Heterozygosity Variants_ Low-Pass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABD1","description":"ICD-NABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28X","description":"Clinically Complex _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUE0","description":"ICD-FCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTC0","description":"ICD-OGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAD1","description":"ICD-KCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTB1","description":"ICD-BDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA0C","description":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDF0","description":"ICD-FGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUE1","description":"ICD-GCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted maaa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81599","description":"Unlisted maaa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Xm archive tissue molec anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88363","description":"Xm archive tissue molec anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICE1","description":"ICD-FICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIC1","description":"ICD-FBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQD0","description":"ICD-ODQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr f/e/e/n/l/m 2.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12011","description":"Rpr f/e/e/n/l/m 2.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLF0","description":"ICD-BBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVF1","description":"ICD-JCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFB1","description":"ICD-OCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSB1","description":"ICD-OHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX36","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCD0","description":"ICD-AGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nos quant sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0110T","description":"Nos quant sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIE1","description":"ICD-GGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment social skills group_ administered by physician or other qualified health care professional face-to-face with multiple patients","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0372T","description":"Adaptive behavior treatment social skills group_ administered by physician or other qualified health care professional face-to-face with multiple patients","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAC0","description":"ICD-NJAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay 17- ketosteroids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83586","description":"Assay 17- ketosteroids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient is undergoing palliative dialysis with a catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9749","description":"Patient is undergoing palliative dialysis with a catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAA1","description":"ICD-BDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFA1","description":"ICD-FEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTC0","description":"ICD-EDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHD1","description":"ICD-IBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Habilitation_ prevocational_ waiver; per 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2047","description":"Habilitation_ prevocational_ waiver; per 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of mercury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83825","description":"Assay of mercury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMF1","description":"ICD-CDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA214","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Services provided as part of","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9991","description":"Services provided as part of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 81 Years Of Age And Older With A Evidence Of Frailty During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2118","description":"Patients 81 Years Of Age And Older With A Evidence Of Frailty During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWC1","description":"ICD-KIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percussor elect/pneum home m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0480","description":"Percussor elect/pneum home m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELC1","description":"ICD-IELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGC0","description":"ICD-BGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCD0","description":"ICD-FCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLC0","description":"ICD-KGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1704","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1704","description":"CDT-D1704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27700","description":"Revision of ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1034T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1034T","description":"CPT-1034T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Advanced brain imaging (CTA_ CT_ MRA or MRI) was not ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9534","description":"Advanced brain imaging (CTA_ CT_ MRA or MRI) was not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hyperbaric oxygen therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99183","description":"Hyperbaric oxygen therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKA0","description":"ICD-GHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKB0","description":"ICD-FGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAA0","description":"ICD-GFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBB0","description":"ICD-JCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foam caster tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2389","description":"Foam caster tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYB1","description":"ICD-KDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAD0","description":"ICD-EEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPF0","description":"ICD-JIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAD1","description":"ICD-OKAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBF0","description":"ICD-CCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKD0","description":"ICD-NGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC53","description":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEE1","description":"ICD-FFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVE1","description":"ICD-CIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rep dev_ urinary_ w/o sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2631","description":"Rep dev_ urinary_ w/o sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHC0","description":"ICD-JCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 1 std seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0815","description":"Pwc gp 1 std seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKE0","description":"ICD-NCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX60","description":"High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ONC THYR MRNA XPRSN ALYS 593","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0204U","description":"ONC THYR MRNA XPRSN ALYS 593","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fracture frame attachmnts ce","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0948","description":"Fracture frame attachmnts ce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUE1","description":"ICD-IGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blastomyces antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86612","description":"Blastomyces antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0110","description":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES12B","description":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26545","description":"Reconstruct finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bile tract surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47999","description":"Bile tract surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Appendectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44950","description":"Appendectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCB1","description":"ICD-FHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCA1","description":"ICD-OKCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repl zinc air battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8621","description":"Repl zinc air battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Occult blood test strips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4773","description":"Occult blood test strips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLC1","description":"ICD-ADLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Imm admin by intramusc injection of (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimp adenovirus Oxford 1 preserv free_ 0.5 ml dose_ 2nd dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0022A","description":"Imm admin by intramusc injection of (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimp adenovirus Oxford 1 preserv free_ 0.5 ml dose_ 2nd dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLF1","description":"ICD-MGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0544U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0544U","description":"CPT-0544U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVE0","description":"ICD-CAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch w bar/bltinconv/fltr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4417","description":"Ost pch w bar/bltinconv/fltr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTB0","description":"ICD-KBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA21","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ waist length_ 30-40 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6563","description":"Gradient compression stocking_ waist length_ 30-40 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUB1","description":"ICD-GEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIC0","description":"ICD-OKIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRC1","description":"ICD-GBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBA0","description":"ICD-BEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE201","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHC0","description":"ICD-FGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLE0","description":"ICD-CDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVD1","description":"ICD-KFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83251","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETF1","description":"ICD-EETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stress tte only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93350","description":"Stress tte only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSF1","description":"ICD-PBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRA1","description":"ICD-PKRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0404","description":"HCPCS-C0404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lyme dis dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87475","description":"Lyme dis dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQA1","description":"ICD-LAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFC0","description":"ICD-JCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQF0","description":"ICD-CBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMD1","description":"ICD-KIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWD0","description":"ICD-LGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMF1","description":"ICD-BBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUE1","description":"ICD-OFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCF1","description":"ICD-IDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILF0","description":"ICD-KILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Evasc rpr iliac art bifr s&i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0255T","description":"Evasc rpr iliac art bifr s&i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD121","description":"Special Care High _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0013","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUE0","description":"ICD-AAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTF1","description":"ICD-AFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASB0","description":"ICD-HASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRC1","description":"ICD-HFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dentures adjust cmplt mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5411","description":"Dentures adjust cmplt mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHB1","description":"ICD-NEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cryoablate renal mass open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50250","description":"Cryoablate renal mass open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUA1","description":"ICD-ABUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX44","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABB0","description":"ICD-JABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTA1","description":"ICD-BGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC251","description":"Clinically Complex _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rh ig iv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90386","description":"Rh ig iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYE0","description":"ICD-DHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1221","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECA0","description":"ICD-KECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVE0","description":"ICD-FCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test cran nerv unilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95867","description":"Muscle test cran nerv unilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLC0","description":"ICD-MFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMB1","description":"ICD-EAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit tpn over 3l diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9368","description":"Hit tpn over 3l diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hyperthermia treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77605","description":"Hyperthermia treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGA0","description":"ICD-ODGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient /caregiver dyad has been referred to appropriate resources and connection to those resources is confirmed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2186","description":"Patient /caregiver dyad has been referred to appropriate resources and connection to those resources is confirmed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB21C","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth abdominal wall surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82077","description":"Anesth abdominal wall surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA154","description":"Clinically Complex _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWC1","description":"ICD-DEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE155","description":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy pouch solid deodorant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4395","description":"Ostomy pouch solid deodorant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Self care mngment training","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97535","description":"Self care mngment training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Deoxycortisol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82634","description":"Deoxycortisol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Postop ren fail","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8575","description":"Postop ren fail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHB0","description":"ICD-OGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWB0","description":"ICD-OIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adenosine inj 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0153","description":"Adenosine inj 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA212","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bitolterol mesylate comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7628","description":"Bitolterol mesylate comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove ankle joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27626","description":"Remove ankle joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTD0","description":"ICD-GDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJF1","description":"ICD-OLJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISE1","description":"ICD-DISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAB0","description":"ICD-AEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLC1","description":"ICD-FBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma scrn hgh risk direc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0118","description":"Glaucoma scrn hgh risk direc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair tongue laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41252","description":"Repair tongue laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE251","description":"Special Care High _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27824","description":"Treat lower leg fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tail bone ulcer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15920","description":"Removal of tail bone ulcer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Njx px nfrosgrm &/urtrgrm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50431","description":"Njx px nfrosgrm &/urtrgrm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFE1","description":"ICD-JDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCE1","description":"ICD-AHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVE1","description":"ICD-JDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE150","description":"Special Care High _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLB1","description":"ICD-MBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKD0","description":"ICD-ODKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Maxilla or mandible resectio","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7490","description":"Maxilla or mandible resectio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBA0","description":"ICD-JEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFD0","description":"ICD-CHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUD0","description":"ICD-GBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Calcitonin stimul panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80410","description":"Calcitonin stimul panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTD0","description":"ICD-ADTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAA1","description":"ICD-FDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDF0","description":"ICD-GCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEID1","description":"ICD-FEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscp rig trnso inject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43192","description":"Esophagoscp rig trnso inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insrt pulse gen w/singl lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33240","description":"Insrt pulse gen w/singl lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEC1","description":"ICD-GAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31400","description":"Revision of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ olanzapine_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2359","description":"Injection_ olanzapine_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUB0","description":"ICD-JFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYA0","description":"ICD-HHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAB1","description":"ICD-BBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMD0","description":"ICD-IBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAE0","description":"ICD-IAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Emergency surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9752","description":"Emergency surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTE1","description":"ICD-KHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ureter endoscopy & biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50974","description":"Ureter endoscopy & biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee jnt ratchet lock ea jnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2430","description":"Knee jnt ratchet lock ea jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pjp proph ordered low cd4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9222","description":"Pjp proph ordered low cd4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAC0","description":"ICD-BCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aortic anrysm5.5-5.9cm diam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9003F","description":"Aortic anrysm5.5-5.9cm diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00906","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00906","description":"CPT-00906","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXB0","description":"ICD-NEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMD0","description":"ICD-NGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVE0","description":"ICD-FIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJB0","description":"ICD-KBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDD1","description":"ICD-JGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treponema pallidum ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87285","description":"Treponema pallidum ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBE0","description":"ICD-EDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBA0","description":"ICD-FCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient Had History Of At Least One Of The Following Contraindications Any Time During Or Before The Measurement Period: Anaphylaxis Due To Tdap Vaccine_ Anaphylaxis Due To Td","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2155","description":"Patient Had History Of At Least One Of The Following Contraindications Any Time During Or Before The Measurement Period: Anaphylaxis Due To Tdap Vaccine_ Anaphylaxis Due To Td","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy finger joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26105","description":"Biopsy finger joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt recvd aspirin w/in 24 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4563F","description":"Pt recvd aspirin w/in 24 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clsd red comp malar/zygma fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7760","description":"Clsd red comp malar/zygma fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGB0","description":"ICD-NFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDC1","description":"ICD-GBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA226","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No dxa no med hx no rv sx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9472","description":"No dxa no med hx no rv sx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHB1","description":"ICD-JHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection of sclerosant; multiple incompetent veins (other than telangiectasia)_ same leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36471","description":"Injection of sclerosant; multiple incompetent veins (other than telangiectasia)_ same leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Body-worn bilat hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5100","description":"Body-worn bilat hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ voretigene neparvovec-rzyl_ 1 billion vector genomes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3398","description":"Injection_ voretigene neparvovec-rzyl_ 1 billion vector genomes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA116","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKF1","description":"ICD-FEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIE1","description":"ICD-JDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTF0","description":"ICD-MKTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sedative hypnotics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80368","description":"Sedative hypnotics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJC0","description":"ICD-FEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUB0","description":"ICD-NEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls repos perph cnula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33959","description":"Ecmo/ecls repos perph cnula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFA1","description":"ICD-OGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHF0","description":"ICD-JCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDA0","description":"ICD-IGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUC1","description":"ICD-OHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDE0","description":"ICD-OIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVC1","description":"ICD-BBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl nstim apnea sen ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0429T","description":"Rmvl nstim apnea sen ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental bitewings four films","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0274","description":"Dental bitewings four films","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB15A","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCF1","description":"ICD-JDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTF0","description":"ICD-MDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKB1","description":"ICD-CEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTD1","description":"ICD-IDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2108","description":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antinomyces antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86602","description":"Antinomyces antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABE1","description":"ICD-FABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCD1","description":"ICD-CHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAC1","description":"ICD-ECAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt queried prkns complic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4324F","description":"Pt queried prkns complic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elbow adolescent myoelectron","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7190","description":"Elbow adolescent myoelectron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVF0","description":"ICD-FEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6068","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRE1","description":"ICD-DDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8B","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKE1","description":"ICD-CHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECB0","description":"ICD-NECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elbow inter loc elbow forarm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6250","description":"Elbow inter loc elbow forarm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOB1","description":"ICD-CGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKF1","description":"ICD-CBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foam drive wheel tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2388","description":"Foam drive wheel tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01926","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01926","description":"CPT-01926","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUB0","description":"ICD-OCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ex for speech device rx addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92608","description":"Ex for speech device rx addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoe wedge sach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3340","description":"Shoe wedge sach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUF0","description":"ICD-OBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAME0","description":"ICD-NAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26433","description":"Repair finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKD0","description":"ICD-NHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental bitewing single film","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0270","description":"Dental bitewing single film","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBF0","description":"ICD-JDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychiatry (eg_ depression_ anxiety)_ genomic sequence analysis panel_ variant analysis of 13 genes_ saliva or buccal swab_ report of each gene phenotype","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0419U","description":"Neuropsychiatry (eg_ depression_ anxiety)_ genomic sequence analysis panel_ variant analysis of 13 genes_ saliva or buccal swab_ report of each gene phenotype","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLD0","description":"ICD-BBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE145","description":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ostectomy_ partial_ exostectomy or condylectomy_ metatarsal head_ each meta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3052F","description":"Ostectomy_ partial_ exostectomy or condylectomy_ metatarsal head_ each meta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fosaprepitant (focinvez)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1434","description":"Injection_ fosaprepitant (focinvez)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDF0","description":"ICD-OJDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJF1","description":"ICD-KCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITC0","description":"ICD-BITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cetirizine hydrochloride_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9057","description":"Injection_ cetirizine hydrochloride_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACE1","description":"ICD-AACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of halo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20664","description":"Application of halo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open ablate liver tumor cryo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47381","description":"Open ablate liver tumor cryo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTB1","description":"ICD-EGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHC1","description":"ICD-EIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMD0","description":"ICD-AIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doxorubicin inj 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2050","description":"Doxorubicin inj 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5136","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","description":"HCPCS-Q5136","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEA1","description":"ICD-OCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELC0","description":"ICD-MELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42405","description":"Biopsy of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE104","description":"Clinically Complex _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEB1","description":"ICD-AFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIF1","description":"ICD-ADIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXC1","description":"ICD-FDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEB1","description":"ICD-CGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTA1","description":"ICD-JBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implantation of anterior segment intraocular nonbiodegradable drug-eluting system_ internal approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0660T","description":"Implantation of anterior segment intraocular nonbiodegradable drug-eluting system_ internal approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"40-75y w/type 1/2 w/ldl-c rs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9676","description":"40-75y w/type 1/2 w/ldl-c rs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient died at any time during the 24-month measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9751","description":"Patient died at any time during the 24-month measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81406","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTF1","description":"ICD-KGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC12D","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWE1","description":"ICD-CGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILA1","description":"ICD-AILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMD1","description":"ICD-OGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap resect s/intestine addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44203","description":"Lap resect s/intestine addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behav hlth day treat_ per hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2012","description":"Behav hlth day treat_ per hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26548","description":"Reconstruct finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50580","description":"Kidney endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUC1","description":"ICD-NJUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Initiation of medication for the treatment of opioid use disorder in the emergency department setting_ including assessment_ referral to ongoing care_ and arranging access to","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2213","description":"Initiation of medication for the treatment of opioid use disorder in the emergency department setting_ including assessment_ referral to ongoing care_ and arranging access to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01432","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01432","description":"CPT-01432","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87471","description":"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35216","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTA0","description":"ICD-ODTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIF0","description":"ICD-OGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKC1","description":"ICD-GAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ transbronchial ablation of lesion(s) by microwave energy_ including fluoroscopic guidance_ whe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9751","description":"Bronchoscopy_ rigid or flexible_ transbronchial ablation of lesion(s) by microwave energy_ including fluoroscopic guidance_ whe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of windpipe injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31805","description":"Repair of windpipe injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOA1","description":"ICD-PLOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC201","description":"Special Care Low _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVB0","description":"ICD-OLVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt inr measurement performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3555F","description":"Pt inr measurement performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACB1","description":"ICD-OACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD21C","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary arterial angiography_ bilateral (List sep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93573","description":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary arterial angiography_ bilateral (List sep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDE1","description":"ICD-MJDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJE0","description":"ICD-JBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDC1","description":"ICD-MKDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGA0","description":"ICD-CBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBF1","description":"ICD-JFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE234","description":"Special Care Low _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJA1","description":"ICD-OBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fem urinary collect pouch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4328","description":"Fem urinary collect pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pancreas lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48120","description":"Removal of pancreas lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0503U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","description":"CPT-0503U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB10C","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIC1","description":"ICD-CFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHA0","description":"ICD-IBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nonfamily homecare train/15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5115","description":"Nonfamily homecare train/15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transposition ovary(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58825","description":"Transposition ovary(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prep bk ptb thermopls molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5530","description":"Prep bk ptb thermopls molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ neck/head_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6567","description":"Gradient compression garment_ neck/head_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Initial (index visit) numeric rating scale (nrs)_ visual rating scale (vrs)_ or itchyquant assessment score of greater than or equal to 4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1196","description":"Initial (index visit) numeric rating scale (nrs)_ visual rating scale (vrs)_ or itchyquant assessment score of greater than or equal to 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic ring fracture uni/bil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0413","description":"Pelvic ring fracture uni/bil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epiandrosterone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6049","description":"Epiandrosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSF1","description":"ICD-DGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronch ebus samplng 3/> node","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31653","description":"Bronch ebus samplng 3/> node","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVB1","description":"ICD-OAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Jaw arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29800","description":"Jaw arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg 0.5/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11420","description":"Exc h-f-nk-sp b9+marg 0.5/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug-Induced Sleep Endoscopy_ With Dynamic Evaluation Of Velum_ Pharynx_ Tongue Base_ And Larynx For Evaluation Of Sleep-Disordered Breathing_ Flexible_ Diagnostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42975","description":"Drug-Induced Sleep Endoscopy_ With Dynamic Evaluation Of Velum_ Pharynx_ Tongue Base_ And Larynx For Evaluation Of Sleep-Disordered Breathing_ Flexible_ Diagnostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ko derot ant cruciate custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1840","description":"Ko derot ant cruciate custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBF0","description":"ICD-NBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOA0","description":"ICD-HFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation tx delivery imrt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6015","description":"Radiation tx delivery imrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression glove_ custom_ medium weight_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6579","description":"Gradient compression glove_ custom_ medium weight_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYF0","description":"ICD-PKYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFC0","description":"ICD-NFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Genesis Amniotic Membrane_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4198","description":"Genesis Amniotic Membrane_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18E","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64610","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHB0","description":"ICD-EAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSF1","description":"ICD-DCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Environmental manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90882","description":"Environmental manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQF1","description":"ICD-HDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tongue to lip surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41510","description":"Tongue to lip surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAE1","description":"ICD-FBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAD0","description":"ICD-JEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD10B","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ delafloxacin_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9462","description":"Injection_ delafloxacin_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCB1","description":"ICD-ICCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75705","description":"Artery x-rays spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stomach surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43999","description":"Stomach surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bitolterol mesylate comp unt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7629","description":"Bitolterol mesylate comp unt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of dibucaine number","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82638","description":"Assay of dibucaine number","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPE0","description":"ICD-NHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPA1","description":"ICD-BDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LA31","description":"ICD-4LA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elec osteogen stim implanted","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0749","description":"Elec osteogen stim implanted","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGF0","description":"ICD-OGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interv hlth/behav fam no pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96155","description":"Interv hlth/behav fam no pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Forearm/arm cuffs ext/flex a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3730","description":"Forearm/arm cuffs ext/flex a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC206","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMD0","description":"ICD-FFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB12","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBB0","description":"ICD-AGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUC1","description":"ICD-MEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAD0","description":"ICD-BBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGC1","description":"ICD-NHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDB0","description":"ICD-OLDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPF0","description":"ICD-KCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERB0","description":"ICD-PERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01670","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01670","description":"CPT-01670","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special teletx port plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77321","description":"Special teletx port plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Combined Perfusion With Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ W","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78433","description":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Combined Perfusion With Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ W","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ valoctocogene roxaparvovec-rvox_ per ml_ containing nominal 2 x 10^13 vector genomes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1412","description":"Injection_ valoctocogene roxaparvovec-rvox_ per ml_ containing nominal 2 x 10^13 vector genomes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKD0","description":"ICD-OGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ 5 DNA regulatory markers by quantitative PCR_ whole blood_ algorithm_ including prostate-specific antigen_ reported as likelihood of cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0433U","description":"Oncology (prostate)_ 5 DNA regulatory markers by quantitative PCR_ whole blood_ algorithm_ including prostate-specific antigen_ reported as likelihood of cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBD1","description":"ICD-FFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cftr gene intron poly t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81224","description":"Cftr gene intron poly t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC114","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt recvng antivir txmnt hepc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4150F","description":"Pt recvng antivir txmnt hepc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAD0","description":"ICD-EHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRC0","description":"ICD-CIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPF0","description":"ICD-OAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA2A","description":"Default_ /PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDF1","description":"ICD-BCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBD0","description":"ICD-EFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26742","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foot plate molded stirrup at","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2250","description":"Foot plate molded stirrup at","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOE0","description":"ICD-GAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55801","description":"Removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hhc pt maint ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0159","description":"Hhc pt maint ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chest shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0457","description":"Chest shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBB0","description":"ICD-FCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYA1","description":"ICD-GHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAC1","description":"ICD-MKAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIF0","description":"ICD-KDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy br/wa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44380","description":"Small bowel endoscopy br/wa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXB1","description":"ICD-BAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64792","description":"Removal of nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB244","description":"Special Care High _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUC1","description":"ICD-GDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD22D","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg 1.1-2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11602","description":"Exc tr-ext mal+marg 1.1-2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTA1","description":"ICD-OKTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE146","description":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRA1","description":"ICD-GDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wrist disarticul switch ctrl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6920","description":"Wrist disarticul switch ctrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCE1","description":"ICD-NGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exhaled air analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94690","description":"Exhaled air analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No bld inj at surg/1mos post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9627","description":"No bld inj at surg/1mos post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC215","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARF0","description":"ICD-KARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTC1","description":"ICD-IHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMB1","description":"ICD-AHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXD0","description":"ICD-JBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTC1","description":"ICD-BGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE23B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGA1","description":"ICD-OJGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen quant tiagabine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80199","description":"Drug screen quant tiagabine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLF0","description":"ICD-NLLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDD1","description":"ICD-EFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj heparin sodium per 1000u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1644","description":"Inj heparin sodium per 1000u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Syst antimicrobial thx rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4131F","description":"Syst antimicrobial thx rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esoph imped funct test > 1hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91038","description":"Esoph imped funct test > 1hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9814","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9814","description":"HCPCS-C9814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct interp both jaw","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0367","description":"Cone beam ct interp both jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection torsemide 10 mg/ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3265","description":"Injection torsemide 10 mg/ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of sex hormone globul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84270","description":"Assay of sex hormone globul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSB1","description":"ICD-KDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA44","description":"Very High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADC1","description":"ICD-FADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92930","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","description":"CPT-92930","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXC1","description":"ICD-JAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTF1","description":"ICD-OBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHF1","description":"ICD-AEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reposition vad diff session","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33993","description":"Reposition vad diff session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCA0","description":"ICD-KCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBF1","description":"ICD-NFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immed man part denture resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5222","description":"Immed man part denture resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANE1","description":"ICD-KANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kit gene targeted seq analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81272","description":"Kit gene targeted seq analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Methsuximide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6054","description":"Methsuximide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUA1","description":"ICD-NEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25119","description":"Partial removal of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGF0","description":"ICD-JAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay for infectious agent antibody(ies)_ qualitative or semiquantitative_ single-step method (eg_ reagent strip);","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86318","description":"Immunoassay for infectious agent antibody(ies)_ qualitative or semiquantitative_ single-step method (eg_ reagent strip);","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert idrl body thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63305","description":"Remove vert idrl body thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLE0","description":"ICD-BFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove knee joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27334","description":"Remove knee joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC236","description":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWD0","description":"ICD-PAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"RARE DS XOM DNA ALYS EA COMP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0215U","description":"RARE DS XOM DNA ALYS EA COMP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ fluids_ washings_ or brushings_ except cervical or vaginal; simple filter method with interpretation (List separatel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0828T","description":"Digitization of glass microscope slides for cytopathology_ fluids_ washings_ or brushings_ except cervical or vaginal; simple filter method with interpretation (List separatel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocolld drg > 48 in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6239","description":"Hydrocolld drg > 48 in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Centerbased day care perdiem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5105","description":"Centerbased day care perdiem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1032","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","description":"HCPCS-E1032","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Red cell survival study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78130","description":"Red cell survival study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Services provided in urgent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9088","description":"Services provided in urgent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD15B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Platelet deplete of harvest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38213","description":"Platelet deplete of harvest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Emer rspns sys serv permonth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5161","description":"Emer rspns sys serv permonth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Additional spinal fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22585","description":"Additional spinal fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDB0","description":"ICD-ACDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOA1","description":"ICD-DBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9362","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9362","description":"HCPCS-J9362","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of salivary gland","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7981","description":"Excision of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adenoma(s) or colorectal cancer detected during screening colonoscopy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9933","description":"Adenoma(s) or colorectal cancer detected during screening colonoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLD0","description":"ICD-IFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILA0","description":"ICD-FILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial amputation of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28825","description":"Partial amputation of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fx growth plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27519","description":"Treat thigh fx growth plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGC0","description":"ICD-NAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sympathectomy digital artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64820","description":"Sympathectomy digital artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGC1","description":"ICD-NFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTF0","description":"ICD-JCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMF1","description":"ICD-NAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUF0","description":"ICD-OCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pathology Clinical Consultation; Prolonged Service_ Each Additional 30 Minutes (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80506","description":"Pathology Clinical Consultation; Prolonged Service_ Each Additional 30 Minutes (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ppps_ initial visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0438","description":"Ppps_ initial visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA CLOSTRIDIUM DIFFICILE TOXIN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87324","description":"IAAD IA CLOSTRIDIUM DIFFICILE TOXIN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUB0","description":"ICD-JGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDE1","description":"ICD-JIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal smear for eosinophils","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89190","description":"Nasal smear for eosinophils","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esrd srv 4 vsts p mo 12-19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90957","description":"Esrd srv 4 vsts p mo 12-19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Legg perthes orthosis trilat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1720","description":"Legg perthes orthosis trilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIF1","description":"ICD-NEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD25C","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tenofovir_ by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ urine_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0025U","description":"Tenofovir_ by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ urine_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release of lower leg tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27680","description":"Release of lower leg tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat elbow fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24587","description":"Treat elbow fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB50","description":"Low Rehab_ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUE1","description":"ICD-EFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRE0","description":"ICD-LGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHA1","description":"ICD-FHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sebelipase alfa_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2840","description":"Injection_ sebelipase alfa_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rad w/backup non inv intrfc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0471","description":"Rad w/backup non inv intrfc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0403","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0403","description":"CDT-D0403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADE0","description":"ICD-IADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTF0","description":"ICD-NLTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 VAC AD26 .5ML B","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0034A","description":"ADM SARSCOV2 VAC AD26 .5ML B","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJND1","description":"ICD-NJND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHB0","description":"ICD-NLHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rho d immune globulin 50 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2788","description":"Rho d immune globulin 50 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18C","description":"Clinically Complex _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.25-7d/.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2207","description":"Lens sphcy bifocal 4.25-7d/.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit chelation diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9355","description":"Hit chelation diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATD0","description":"ICD-IATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrst x-ray urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74415","description":"Contrst x-ray urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9128","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9128","description":"CDT-D9128","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc med reas no pt cat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9429","description":"Doc med reas no pt cat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18G","description":"Special Care Low _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQD1","description":"ICD-KAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0624U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","description":"CPT-0624U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27822","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18A","description":"Special Care Low _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRD1","description":"ICD-HDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCD1","description":"ICD-BCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Peristomal hernia supprt blt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4396","description":"Peristomal hernia supprt blt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair paravag defect open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57284","description":"Repair paravag defect open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFE1","description":"ICD-CIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYE1","description":"ICD-PBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHB0","description":"ICD-IGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADA0","description":"ICD-GADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair elbow perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24357","description":"Repair elbow perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHD1","description":"ICD-IIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27510","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKB0","description":"ICD-CAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METD1","description":"ICD-METD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCC0","description":"ICD-OGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXD1","description":"ICD-FHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc med rsn scope pt >85y","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9660","description":"Doc med rsn scope pt >85y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOB0","description":"ICD-LBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKA1","description":"ICD-NGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDD1","description":"ICD-IFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRD1","description":"ICD-HCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAC1","description":"ICD-CEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat radius fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24655","description":"Treat radius fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFA1","description":"ICD-OFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIID1","description":"ICD-NIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAE0","description":"ICD-BDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOB1","description":"ICD-OCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUE0","description":"ICD-NJUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1446","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","description":"HCPCS-M1446","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Soft tissue graft addl tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4278","description":"Soft tissue graft addl tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy/lung bx each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31628","description":"Bronchoscopy/lung bx each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAB1","description":"ICD-EIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPC1","description":"ICD-CIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD213","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat ankle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27848","description":"Treat ankle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Correct inverted nipple(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19355","description":"Correct inverted nipple(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Create tear sac drain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68720","description":"Create tear sac drain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUD0","description":"ICD-CBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft contral carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35509","description":"Art byp grft contral carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESC1","description":"ICD-PESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITC0","description":"ICD-JITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ank-foot sys dors-plant flex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5973","description":"Ank-foot sys dors-plant flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKD1","description":"ICD-BHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSF1","description":"ICD-LBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBE0","description":"ICD-GFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Bone Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1076","description":"Radiation Therapy For Bone Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELF0","description":"ICD-OELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Back Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 3.0 And Back Pain Measured By The Visual Analog Scale (Vas)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2137","description":"Back Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 3.0 And Back Pain Measured By The Visual Analog Scale (Vas)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Telescopic intraocular lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1840","description":"Telescopic intraocular lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEE1","description":"ICD-NLEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICF0","description":"ICD-FICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy lymph node exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32674","description":"Thoracoscopy lymph node exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTB1","description":"ICD-JHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDF0","description":"ICD-NEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray of hip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73525","description":"Contrast x-ray of hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLB0","description":"ICD-JDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBF0","description":"ICD-KFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALD1","description":"ICD-EALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65210","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPF1","description":"ICD-BAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIB0","description":"ICD-FGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPE1","description":"ICD-JIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ligate esophagus veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43400","description":"Ligate esophagus veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEB1","description":"ICD-OIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIA0","description":"ICD-JEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMB1","description":"ICD-AFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINF1","description":"ICD-KINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB117","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BA31","description":"ICD-2BA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1011","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0804","description":"HCPCS-B0804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVF0","description":"ICD-KFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLE1","description":"ICD-MGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol > 100gm prote","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4199","description":"Parenteral sol > 100gm prote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITE1","description":"ICD-EITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKD0","description":"ICD-NIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBC1","description":"ICD-MBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive prostate cancer estimation map_ derived from augmentative analysis of image-guided fusion biopsy and pathology_ including visualization of margin volume and locati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0898T","description":"Noninvasive prostate cancer estimation map_ derived from augmentative analysis of image-guided fusion biopsy and pathology_ including visualization of margin volume and locati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAE0","description":"ICD-KFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMF1","description":"ICD-GDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHE1","description":"ICD-NKHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Collagen crosslinks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82523","description":"Collagen crosslinks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Peritoneal dialysis clamp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1634","description":"Peritoneal dialysis clamp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUB0","description":"ICD-JDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDE1","description":"ICD-KBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sio rig pnl pelv/sac pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0623","description":"Sio rig pnl pelv/sac pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC224","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cryopreservation oocyte(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89337","description":"Cryopreservation oocyte(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fulvestrant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9395","description":"Injection_ fulvestrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMC1","description":"ICD-OAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYA1","description":"ICD-OFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation thru metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28805","description":"Amputation thru metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test cran nerve bilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95868","description":"Muscle test cran nerve bilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66500","description":"Incision of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINA0","description":"ICD-NINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKE0","description":"ICD-FAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMD0","description":"ICD-GCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96933","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPE1","description":"ICD-KAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATA0","description":"ICD-CATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQD1","description":"ICD-ODQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDC1","description":"ICD-CGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNC0","description":"ICD-CBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRE0","description":"ICD-PCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Periodic orthodontc tx visit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8670","description":"Periodic orthodontc tx visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amalgam three surfaces perma","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2160","description":"Amalgam three surfaces perma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including ultrasound guidance; each additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10006","description":"Fine needle aspiration biopsy_ including ultrasound guidance; each additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pov group 2 vhd 451-600 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0808","description":"Pov group 2 vhd 451-600 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOB0","description":"ICD-PFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial)_ quantitative antimicrobial susceptibility reported as phenotypic minimum inhibitory concentration (MIC)ā€“based antimicrobial susceptibility for","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0311U","description":"Infectious disease (bacterial)_ quantitative antimicrobial susceptibility reported as phenotypic minimum inhibitory concentration (MIC)ā€“based antimicrobial susceptibility for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLC1","description":"ICD-KGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17284","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYD1","description":"ICD-OCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFF0","description":"ICD-KDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1002T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","description":"CPT-1002T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Restore/remodel ventricle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33548","description":"Restore/remodel ventricle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGF0","description":"ICD-GGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUB0","description":"ICD-OLUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQF0","description":"ICD-CGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOA0","description":"ICD-CGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKD0","description":"ICD-KIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ferric derisomaltose_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1437","description":"Injection_ ferric derisomaltose_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFD1","description":"ICD-JFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ped compr care pkg_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1025","description":"Ped compr care pkg_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCA0","description":"ICD-MDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQB1","description":"ICD-PLQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSB1","description":"ICD-PGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLA0","description":"ICD-FGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSC1","description":"ICD-OFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Vedolizumab_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9026","description":"Injection_ Vedolizumab_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVD0","description":"ICD-CEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLE0","description":"ICD-JBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOE0","description":"ICD-OBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alloskin ac_ 1 cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4141","description":"Alloskin ac_ 1 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHC0","description":"ICD-FDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology hrt trnspl mrna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81595","description":"Cardiology hrt trnspl mrna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36578","description":"Replace tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEB0","description":"ICD-OAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTE1","description":"ICD-EHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDA1","description":"ICD-BIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB05","description":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYB1","description":"ICD-GEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Most recent tobacco status is tobacco free","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9791","description":"Most recent tobacco status is tobacco free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKE0","description":"ICD-JBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRF1","description":"ICD-HFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFD0","description":"ICD-NDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSD0","description":"ICD-CHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYD1","description":"ICD-PBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVC1","description":"ICD-FIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise/graft eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68326","description":"Revise/graft eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCF1","description":"ICD-GBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMC0","description":"ICD-MBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFF0","description":"ICD-FDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL2B","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous arteriovenous fistula creation_ upper extremity_ single access of both the peripheral artery and peripheral vein_ including fistula maturation procedures (eg_ tra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36836","description":"Percutaneous arteriovenous fistula creation_ upper extremity_ single access of both the peripheral artery and peripheral vein_ including fistula maturation procedures (eg_ tra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transvaginal us obstetric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76817","description":"Transvaginal us obstetric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enema tube_ with or without adapter_ any type_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4457","description":"Enema tube_ with or without adapter_ any type_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAF0","description":"ICD-NFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Appendectomy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44955","description":"Appendectomy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Photochemotherapy with uv-b","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96910","description":"Photochemotherapy with uv-b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWB1","description":"ICD-PHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDA0","description":"ICD-JDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEE1","description":"ICD-GIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL56","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAD0","description":"ICD-MKAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Functional status was measured by the Oswestry Disability Index (ODI version 2.1a) patient reported outcome tool within three m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1050","description":"Functional status was measured by the Oswestry Disability Index (ODI version 2.1a) patient reported outcome tool within three m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Advnc care plan in rcrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1157F","description":"Advnc care plan in rcrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUD1","description":"ICD-MLUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mirikizumab-mrkz_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2267","description":"Injection_ mirikizumab-mrkz_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring Treatment Management Services_ Physician Or Other Qualified Health Care Professional Time In A Calendar Month Requiring At Least One Interactive","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98981","description":"Remote Therapeutic Monitoring Treatment Management Services_ Physician Or Other Qualified Health Care Professional Time In A Calendar Month Requiring At Least One Interactive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infect control supplies nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8301","description":"Infect control supplies nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVB0","description":"ICD-BEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCD1","description":"ICD-GDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAC0","description":"ICD-MJAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraventricular pacing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93612","description":"Intraventricular pacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVD1","description":"ICD-GIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDE1","description":"ICD-NBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAD1","description":"ICD-MAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ferritin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82728","description":"Assay of ferritin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bk/ak locking mechanism","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5671","description":"Bk/ak locking mechanism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBD1","description":"ICD-ADBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLB0","description":"ICD-IGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB112","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Current cig smoker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9642","description":"Current cig smoker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXB0","description":"ICD-KBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXA1","description":"ICD-FEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC210","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE124","description":"Clinically Complex _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mechanical traction therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97012","description":"Mechanical traction therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVB1","description":"ICD-BAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCB1","description":"ICD-JBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMF0","description":"ICD-KCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBB1","description":"ICD-FHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (autosomal dominant congenital thrombocytopenia)_ genomic sequence analysis of 14 genes_ blood_ buccal swab_ or amniotic fluid (Versitiā„¢ Autosomal Dominant Thromboc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0269U","description":"Hematology (autosomal dominant congenital thrombocytopenia)_ genomic sequence analysis of 14 genes_ blood_ buccal swab_ or amniotic fluid (Versitiā„¢ Autosomal Dominant Thromboc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWB0","description":"ICD-GEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBD1","description":"ICD-FCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQF1","description":"ICD-HBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYD1","description":"ICD-PFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4341","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","description":"HCPCS-Q4341","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB23C","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYE0","description":"ICD-OCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of toe(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73660","description":"X-ray exam of toe(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHF1","description":"ICD-EFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mental/Behavioral Health Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4013","description":"Mental/Behavioral Health Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ eravacycline_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0122","description":"Injection_ eravacycline_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vent mgmt nf per day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94004","description":"Vent mgmt nf per day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of toe joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28054","description":"Biopsy of toe joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mrs disc pain acquisj data","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0609T","description":"Mrs disc pain acquisj data","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Long qt syn gene dup/dlt var","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81282","description":"Long qt syn gene dup/dlt var","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVE0","description":"ICD-NDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUF1","description":"ICD-MKUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBA0","description":"ICD-KGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD20A","description":"Special Care Low _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOD1","description":"ICD-PGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4CC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CC21","description":"ICD-4CC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSA1","description":"ICD-LBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spacer without mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8100","description":"Spacer without mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSF1","description":"ICD-KBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJE1","description":"ICD-OFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNE0","description":"ICD-NJNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31375","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDD0","description":"ICD-BGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt not recvng antiv hep c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4151F","description":"Pt not recvng antiv hep c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAF0","description":"ICD-EHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ ITE/ITC","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5212","description":"Hearing aid_ contralateral routing system_ binaural_ ITE/ITC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal) screening_ cell enumeration of circulating tumor cells_ utilizing whole blood_ algorithm_ for the presence of adenoma or cancer_ reported as a positive o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0091U","description":"Oncology (colorectal) screening_ cell enumeration of circulating tumor cells_ utilizing whole blood_ algorithm_ for the presence of adenoma or cancer_ reported as a positive o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37266","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","description":"CPT-37266","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDF1","description":"ICD-CFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73630","description":"X-ray exam of foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGB1","description":"ICD-FIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interrog device eval heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93289","description":"Interrog device eval heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRD0","description":"ICD-KIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx nasomax fx multple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21347","description":"Opn tx nasomax fx multple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBA1","description":"ICD-KIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRD0","description":"ICD-GBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50553","description":"Kidney endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDA1","description":"ICD-AHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNB0","description":"ICD-ODNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 5MCG/.5ML AS03B","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0104A","description":"ADM SARSCOV2 5MCG/.5ML AS03B","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJA1","description":"ICD-JGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoplasty congenital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43313","description":"Esophagoplasty congenital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAC1","description":"ICD-ACAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVA1","description":"ICD-BHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hep b surface antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86706","description":"Hep b surface antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-53866","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","description":"CPT-53866","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nerve repair; with nerve allograft_ each additional strand (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64913","description":"Nerve repair; with nerve allograft_ each additional strand (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD225","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRA1","description":"ICD-LDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLE1","description":"ICD-FCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transport chair pt wt<=300lb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1038","description":"Transport chair pt wt<=300lb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBC0","description":"ICD-OEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMF1","description":"ICD-GHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiopha dx beta amyloid pet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9599","description":"Radiopha dx beta amyloid pet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDE1","description":"ICD-BGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDE0","description":"ICD-MKDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXB1","description":"ICD-NCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNB0","description":"ICD-JDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADA1","description":"ICD-MADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pp eval/edu not perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9358","description":"Pp eval/edu not perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWA0","description":"ICD-CFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD234","description":"Special Care Low _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB55","description":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDD0","description":"ICD-EHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGB0","description":"ICD-OIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIB1","description":"ICD-JIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tint_ any color/solid/grad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2745","description":"Tint_ any color/solid/grad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64561","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVD0","description":"ICD-CDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18D","description":"Clinically Complex _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJF0","description":"ICD-BAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAD1","description":"ICD-CFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFA1","description":"ICD-BGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRE0","description":"ICD-KIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLF0","description":"ICD-OGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXF1","description":"ICD-GHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXE0","description":"ICD-KHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electronic elbow sequential","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7180","description":"Electronic elbow sequential","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAD0","description":"ICD-MAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTE0","description":"ICD-BCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVC0","description":"ICD-BDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28308","description":"Incision of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXF1","description":"ICD-NCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUD1","description":"ICD-MGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUA0","description":"ICD-OFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSF0","description":"ICD-OCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXB1","description":"ICD-CIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA23","description":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUF1","description":"ICD-KAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEC1","description":"ICD-OBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPB1","description":"ICD-NGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental retainr cast metl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6545","description":"Dental retainr cast metl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUF1","description":"ICD-IGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB0B","description":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVE1","description":"ICD-NIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGB0","description":"ICD-FCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHD0","description":"ICD-CCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMF1","description":"ICD-MAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26765","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q9999","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","description":"HCPCS-Q9999","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0703","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0703","description":"CDT-D0703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen therapy rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4030F","description":"Oxygen therapy rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAF1","description":"ICD-BCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBC1","description":"ICD-MLBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"SurFactor or NuDyn_ per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4233","description":"SurFactor or NuDyn_ per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBA0","description":"ICD-IGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99213","description":"Office/outpatient visit est","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC135","description":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No doc share dec prior proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9297","description":"No doc share dec prior proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Device handling phys/qhp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99002","description":"Device handling phys/qhp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psych diagnostic evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90791","description":"Psych diagnostic evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18X","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUF0","description":"ICD-IIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE15C","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Site no lung or lung cx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9424","description":"Site no lung or lung cx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHC1","description":"ICD-EHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBD1","description":"ICD-EDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOB0","description":"ICD-GHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ romosozumab-aqqg_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3111","description":"Injection_ romosozumab-aqqg_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect/excise lesion skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61616","description":"Resect/excise lesion skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Central dexa ordered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3096F","description":"Central dexa ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEE0","description":"ICD-BIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye socket implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67560","description":"Revise eye socket implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colistimethate inh sol mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0142","description":"Colistimethate inh sol mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rn telephone calls to dmp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0320","description":"Rn telephone calls to dmp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB1C","description":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACF1","description":"ICD-GACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTA1","description":"ICD-MLTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBD0","description":"ICD-JIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGC0","description":"ICD-BAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0804","description":"HCPCS-A0804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"B cells total count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86355","description":"B cells total count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTC0","description":"ICD-NJTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII (antihemophiliac factor_ recombinant) (Nuwiq)_ 1 I.U.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9138","description":"Injection_ Factor VIII (antihemophiliac factor_ recombinant) (Nuwiq)_ 1 I.U.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCE1","description":"ICD-MDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWF1","description":"ICD-OGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Delay flap eye/nos/ear/lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15630","description":"Delay flap eye/nos/ear/lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMA0","description":"ICD-MIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic retrograde cholangiopancreatography (ercp) with sphincterotomy/papillotomy_ with endoscopic cannulation of papilla with direct visualization of pancreatic/common bi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7543","description":"Endoscopic retrograde cholangiopancreatography (ercp) with sphincterotomy/papillotomy_ with endoscopic cannulation of papilla with direct visualization of pancreatic/common bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMC1","description":"ICD-EIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB50","description":"Ultra High Rehab _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18G","description":"Special Care High _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPF0","description":"ICD-FBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breath recording infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94772","description":"Breath recording infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pmp22 gene dup/delet","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81324","description":"Pmp22 gene dup/delet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXA1","description":"ICD-NHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCC1","description":"ICD-KDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0504U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","description":"CPT-0504U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUB0","description":"ICD-JHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp axill-fem-femoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35654","description":"Art byp axill-fem-femoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"PuraPly AM_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4196","description":"PuraPly AM_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLF1","description":"ICD-OFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWA1","description":"ICD-DEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLB0","description":"ICD-GGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRF1","description":"ICD-KBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29819","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4426","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","description":"HCPCS-Q4426","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apply spine prosth device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22851","description":"Apply spine prosth device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA4B","description":"High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHE0","description":"ICD-AIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUD0","description":"ICD-EFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCD0","description":"ICD-MDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28H","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEID1","description":"ICD-OEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVE0","description":"ICD-CCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXC1","description":"ICD-BAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism (adverse drug reactions and drug response)_ targeted sequence analysis (ie_ CYP1A2_ CYP2C19_ CYP2C9_ CYP2D6_ CYP3A4_ CYP3A5_ CYP4F2_ SLCO1B1_ VKORC1 and rs1277","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0029U","description":"Drug metabolism (adverse drug reactions and drug response)_ targeted sequence analysis (ie_ CYP1A2_ CYP2C19_ CYP2C9_ CYP2D6_ CYP3A4_ CYP3A5_ CYP4F2_ SLCO1B1_ VKORC1 and rs1277","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIB0","description":"ICD-GCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVE0","description":"ICD-GGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01710","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01710","description":"CPT-01710","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"External patient-activated_ physician- or other qualified health care professional-prescribed_ electrocardiographic rhythm derived event recording without 24 hour attended mon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0498T","description":"External patient-activated_ physician- or other qualified health care professional-prescribed_ electrocardiographic rhythm derived event recording without 24 hour attended mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA230","description":"Clinically Complex _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ belantamab mafodontin-blmf_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9037","description":"Injection_ belantamab mafodontin-blmf_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES20A","description":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYB1","description":"ICD-DEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEB0","description":"ICD-OJEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJED1","description":"ICD-OJED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"I131 iodide cap_ rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9517","description":"I131 iodide cap_ rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Powered w/c cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2610","description":"Powered w/c cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Polishing artifical eye","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2624","description":"Polishing artifical eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Als routine disposble suppls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0398","description":"Als routine disposble suppls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOA1","description":"ICD-CCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDE0","description":"ICD-MDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-cov surg proc_clin trial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0293","description":"Non-cov surg proc_clin trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infrared ht sys replcmnt pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4639","description":"Infrared ht sys replcmnt pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDME0","description":"ICD-MDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCC0","description":"ICD-IHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC240","description":"Special Care High _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFF0","description":"ICD-GHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCB0","description":"ICD-IHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA07","description":"Ultra High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUA1","description":"ICD-OFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYD1","description":"ICD-LIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA146","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0626U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","description":"CPT-0626U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBD0","description":"ICD-NLBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAA1","description":"ICD-OAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26499","description":"Revision of finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNE0","description":"ICD-NLNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOF0","description":"ICD-LEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"History cd4+ cell count <350","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3492F","description":"History cd4+ cell count <350","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHA1","description":"ICD-OKHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUB1","description":"ICD-ICUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4416","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","description":"HCPCS-Q4416","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES155","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHD0","description":"ICD-AEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMC1","description":"ICD-NAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPF0","description":"ICD-OHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADC0","description":"ICD-GADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMA1","description":"ICD-FEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSA1","description":"ICD-PBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA126","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism curbside clinical augmented workflow_ as defined by the medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1020","description":"Clinical decision support mechanism curbside clinical augmented workflow_ as defined by the medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hysteroscopy sterilization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58565","description":"Hysteroscopy sterilization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99157","description":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOC0","description":"ICD-OIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hla typing dr/dq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86816","description":"Hla typing dr/dq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYF1","description":"ICD-CGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTC1","description":"ICD-CFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Seat width 24-27 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2202","description":"Seat width 24-27 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRB1","description":"ICD-GDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18G","description":"Special Care Low _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVF0","description":"ICD-NGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPD0","description":"ICD-CAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE254","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9304","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9304","description":"HCPCS-C9304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGF0","description":"ICD-GCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27235","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eo w/o joints cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3702","description":"Eo w/o joints cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQA1","description":"ICD-LHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"AFF2 (AF4/FMR2 family_ member 2 [FMR2]) (eg_ fragile X mental retardation 2 [FRAXE]) gene analysis; characterization of alleles (eg_ expanded size and methylation status)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81172","description":"AFF2 (AF4/FMR2 family_ member 2 [FMR2]) (eg_ fragile X mental retardation 2 [FRAXE]) gene analysis; characterization of alleles (eg_ expanded size and methylation status)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8C","description":"High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPC0","description":"ICD-GDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHB0","description":"ICD-MDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPF0","description":"ICD-GAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVA1","description":"ICD-GHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXC0","description":"ICD-CHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy for bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44391","description":"Colonoscopy for bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE124","description":"Special Care High _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00865","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00865","description":"CPT-00865","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCA0","description":"ICD-GFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artificial larynx_ accessory","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8505","description":"Artificial larynx_ accessory","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPC0","description":"ICD-OGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRF1","description":"ICD-PHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOB1","description":"ICD-CBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUB0","description":"ICD-CFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent observation care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99224","description":"Subsequent observation care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRE0","description":"ICD-GDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDF1","description":"ICD-AFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"FUT2 GNOTYP FUT2 EXON 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0186U","description":"FUT2 GNOTYP FUT2 EXON 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPC1","description":"ICD-KDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLF1","description":"ICD-JBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of chromium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82495","description":"Assay of chromium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWA1","description":"ICD-DIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVC0","description":"ICD-GFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC23C","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQF1","description":"ICD-KFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE14C","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair Of Fixed Retainer_ Includes Reattachment - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8702","description":"Repair Of Fixed Retainer_ Includes Reattachment - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIF1","description":"ICD-FGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTC1","description":"ICD-KCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2GC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GC31","description":"ICD-2GC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHC1","description":"ICD-NAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Syringe w/needle insulin 3cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4232","description":"Syringe w/needle insulin 3cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIA0","description":"ICD-OHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACE0","description":"ICD-OACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWE0","description":"ICD-LHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSE0","description":"ICD-HCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extended steel shank","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2360","description":"Extended steel shank","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis_ first evalua","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0835T","description":"Digitization of glass microscope slides for cytopathology_ evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis_ first evalua","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRA1","description":"ICD-PFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic analysis_ programming_ and verification of an auditory osseointegrated sound processor_ any type; first 60 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92622","description":"Diagnostic analysis_ programming_ and verification of an auditory osseointegrated sound processor_ any type; first 60 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0542","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","description":"HCPCS-G0542","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLF0","description":"ICD-EFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWA0","description":"ICD-LHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0486U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","description":"CPT-0486U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct thorax w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71270","description":"Ct thorax w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES121","description":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVB0","description":"ICD-FIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hdr elctrnc skn surf brchytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0394T","description":"Hdr elctrnc skn surf brchytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXE0","description":"ICD-OGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Whirlpool Tub_ Walk-In_ Portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1003","description":"Whirlpool Tub_ Walk-In_ Portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic appliance full arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0665","description":"Pneumatic appliance full arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXE0","description":"ICD-KGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepatobil syst image w/drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78227","description":"Hepatobil syst image w/drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCID0","description":"ICD-MCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPD1","description":"ICD-BAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPC1","description":"ICD-GGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ bin_ ite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5252","description":"Hearing aid_ prog_ bin_ ite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Most favored nation (mfn) model drug add-on amount_ per dose_ (do not bill with line items that have the jw modifier)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1145","description":"Most favored nation (mfn) model drug add-on amount_ per dose_ (do not bill with line items that have the jw modifier)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHC1","description":"ICD-OHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD216","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Test for urine cystines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82615","description":"Test for urine cystines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJB1","description":"ICD-JDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAD1","description":"ICD-NKAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystourethroscopy_ with biopsy(ies) with adjuctive blue light cystoscopy with fluorescent imaging agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7550","description":"Cystourethroscopy_ with biopsy(ies) with adjuctive blue light cystoscopy with fluorescent imaging agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAE1","description":"ICD-NGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laser surg penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54057","description":"Laser surg penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tendon for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20924","description":"Removal of tendon for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore/drain eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67405","description":"Explore/drain eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD104","description":"Reduced Physical Function _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILA1","description":"ICD-GILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mr angio spine w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72159","description":"Mr angio spine w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with transluminal stent placement(s)_ includes angioplasty within the same v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7535","description":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with transluminal stent placement(s)_ includes angioplasty within the same v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABB1","description":"ICD-EABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESA0","description":"ICD-OESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01444","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01444","description":"CPT-01444","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIA1","description":"ICD-EHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBF1","description":"ICD-KBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJA1","description":"ICD-NGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELA0","description":"ICD-AELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKE1","description":"ICD-NCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision/removal of kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27424","description":"Revision/removal of kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open/perq place stent ea add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37237","description":"Open/perq place stent ea add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of donor liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47133","description":"Removal of donor liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXB1","description":"ICD-FCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N block inj common digit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64632","description":"N block inj common digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKC0","description":"ICD-BAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVC0","description":"ICD-CGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCE1","description":"ICD-MLCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC216","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAC0","description":"ICD-JFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inpt/tele follow up 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0406","description":"Inpt/tele follow up 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ntsty modul rad tx dlvr smpl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77385","description":"Ntsty modul rad tx dlvr smpl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"TOTAL_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4330","description":"TOTAL_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nudge control elbow lock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6637","description":"Nudge control elbow lock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOF0","description":"ICD-PFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4FA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FA21","description":"ICD-4FA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHD0","description":"ICD-JFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking full lngth 30-40","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6537","description":"Gc stocking full lngth 30-40","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBC0","description":"ICD-FGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQE0","description":"ICD-HCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL20","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXA1","description":"ICD-GHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOE1","description":"ICD-KCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ carfilzomib_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9047","description":"Injection_ carfilzomib_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNB1","description":"ICD-OFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Freeing of bowel adhesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44005","description":"Freeing of bowel adhesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTE1","description":"ICD-NLTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp femoral-femoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35661","description":"Art byp femoral-femoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTB0","description":"ICD-IBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8625","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Power operated vehicle noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0812","description":"Power operated vehicle noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGME1","description":"ICD-CGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clearance of airways","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31720","description":"Clearance of airways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4394","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","description":"HCPCS-Q4394","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSA0","description":"ICD-OCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hla i & ii typing hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81378","description":"Hla i & ii typing hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Athletic training evaluation_ low complexity_ requiring these components: A history and physical activity profile with no comorbidities that affect physical activity; An exami","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97169","description":"Athletic training evaluation_ low complexity_ requiring these components: A history and physical activity profile with no comorbidities that affect physical activity; An exami","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99233","description":"Subsequent hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHB1","description":"ICD-CHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEB0","description":"ICD-GDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Correction of astigmatism","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65775","description":"Correction of astigmatism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC07","description":"Ultra High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHB0","description":"ICD-GBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATF1","description":"ICD-BATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acth stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80402","description":"Acth stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMD0","description":"ICD-FEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUF1","description":"ICD-NLUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay caffeine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80155","description":"Drug assay caffeine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BB31","description":"ICD-2BB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35246","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0585T","description":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBC0","description":"ICD-OGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGF0","description":"ICD-NDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged service inpatient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99357","description":"Prolonged service inpatient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cyclophosphamide_ (AuroMedics)_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9071","description":"Injection_ cyclophosphamide_ (AuroMedics)_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Papaverin hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2440","description":"Papaverin hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ talimogene laherparepvec_ 1 million plaque forming units (PFU) (Imlygic)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9472","description":"Injection_ talimogene laherparepvec_ 1 million plaque forming units (PFU) (Imlygic)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1957","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1957","description":"HCPCS-J1957","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOB0","description":"ICD-PIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagus motility study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91010","description":"Esophagus motility study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA43","description":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXC1","description":"ICD-JBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFF1","description":"ICD-OLFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lab pathology consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80500","description":"Lab pathology consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHD1","description":"ICD-JIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Correct rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45540","description":"Correct rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCID1","description":"ICD-JCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQE1","description":"ICD-OEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Microsatellite instability","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81301","description":"Microsatellite instability","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOC0","description":"ICD-LAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ without imaging guidance; each additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10004","description":"Fine needle aspiration biopsy_ without imaging guidance; each additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0107","description":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Using Dual X-Ray Absorptiometry (Dxa) Or Other Imaging Data On Gray-Scale Variogram_ Calculati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77089","description":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Using Dual X-Ray Absorptiometry (Dxa) Or Other Imaging Data On Gray-Scale Variogram_ Calculati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8F","description":"High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove unilat space maintain","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1520","description":"Remove unilat space maintain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FB31","description":"ICD-1FB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMF1","description":"ICD-EHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEC1","description":"ICD-CIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Scoliosis dna alys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0004M","description":"Scoliosis dna alys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of wrist bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25210","description":"Removal of wrist bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKF0","description":"ICD-FBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0640U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0640U","description":"CPT-0640U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transport chair pt wt >300lb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1039","description":"Transport chair pt wt >300lb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise hand/finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26460","description":"Incise hand/finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKE1","description":"ICD-FHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITB0","description":"ICD-AITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC20C","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQF0","description":"ICD-PHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"AJCC breast cancer stage I: T1 mic or T1a documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9704","description":"AJCC breast cancer stage I: T1 mic or T1a documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAF1","description":"ICD-IDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA130","description":"Clinically Complex _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgery to stop leg growth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27475","description":"Surgery to stop leg growth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Initial exam involved joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2004F","description":"Initial exam involved joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUD0","description":"ICD-IEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRD0","description":"ICD-DCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9948","description":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQE1","description":"ICD-CHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lengthening of palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42226","description":"Lengthening of palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inject/aspirate liver cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47015","description":"Inject/aspirate liver cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection glatiramer acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1595","description":"Injection glatiramer acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYE0","description":"ICD-GIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB13","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18E","description":"Special Care High _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elder maltreatment screen documented as positive_ follow-up plan not documented_ documentation the patient is not eligible for follow-up plan at the time of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8941","description":"Elder maltreatment screen documented as positive_ follow-up plan not documented_ documentation the patient is not eligible for follow-up plan at the time of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infusion supplies w/o pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4223","description":"Infusion supplies w/o pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHD1","description":"ICD-MCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNC1","description":"ICD-OHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16375","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16375","description":"CPT-16375","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYD1","description":"ICD-CFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCE0","description":"ICD-BCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art trnsposj carotid subclav","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35695","description":"Art trnsposj carotid subclav","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Beta not given no reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9188","description":"Beta not given no reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEA1","description":"ICD-OBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coroners autopsy (necropsy)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88045","description":"Coroners autopsy (necropsy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Close nephrovisceral fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50525","description":"Close nephrovisceral fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lacer molded to patient mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2330","description":"Lacer molded to patient mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQD0","description":"ICD-PKQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAB1","description":"ICD-ICAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVE1","description":"ICD-JFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI chest w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71550","description":"MRI chest w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain lower leg lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27603","description":"Drain lower leg lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Monthly supplies for use of device coded at K1016","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1017","description":"Monthly supplies for use of device coded at K1016","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA224","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of c-peptide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84681","description":"Assay of c-peptide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACD1","description":"ICD-IACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ levothyroxine sodium_ not otherwise specified_ 10 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0650","description":"Injection_ levothyroxine sodium_ not otherwise specified_ 10 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJA0","description":"ICD-NCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJB1","description":"ICD-OGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of finger lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26210","description":"Removal of finger lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1473","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","description":"HCPCS-M1473","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ft prosth multiaxial ankl/ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5978","description":"Ft prosth multiaxial ankl/ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37269","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","description":"CPT-37269","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cnslng epi spec sfty issues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4330F","description":"Cnslng epi spec sfty issues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBD1","description":"ICD-JDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUA0","description":"ICD-NLUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIC1","description":"ICD-CDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXE1","description":"ICD-BBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology Care Model (OCM) Monthly Enhanced Oncology Oncology Services (MEOS) payment for enhanced care management services for OCM beneficiaries.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9678","description":"Oncology Care Model (OCM) Monthly Enhanced Oncology Oncology Services (MEOS) payment for enhanced care management services for OCM beneficiaries.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIA1","description":"ICD-IEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFD0","description":"ICD-KFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leg surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27599","description":"Leg surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apply short leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29425","description":"Apply short leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA and RNA)_ central nervous system pathogen_ metagenomic next-generation sequencing_ cerebrospinal fluid (CSF)_ identification of","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0323U","description":"Infectious agent detection by nucleic acid (DNA and RNA)_ central nervous system pathogen_ metagenomic next-generation sequencing_ cerebrospinal fluid (CSF)_ identification of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dmd dup/delet analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81161","description":"Dmd dup/delet analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJD1","description":"ICD-KFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWF0","description":"ICD-GAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFF0","description":"ICD-JHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNB0","description":"ICD-OFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGC0","description":"ICD-JGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAF0","description":"ICD-MEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01486","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01486","description":"CPT-01486","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37299","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","description":"CPT-37299","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shingrix vaccine not documented as administered_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1066","description":"Shingrix vaccine not documented as administered_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nebulizer dome & mouthpiece","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7016","description":"Nebulizer dome & mouthpiece","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; each additional single probe stain procedure (List separately in addition to code f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0849T","description":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; each additional single probe stain procedure (List separately in addition to code f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Routine venipuncture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36415","description":"Routine venipuncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBC1","description":"ICD-IBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBID1","description":"ICD-JBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBB1","description":"ICD-JBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dentures immediat mandible","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5140","description":"Dentures immediat mandible","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLA1","description":"ICD-MDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assessment of aphasia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96105","description":"Assessment of aphasia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXA0","description":"ICD-NIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tendon excision palm/finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26145","description":"Tendon excision palm/finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33771","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC15","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACC0","description":"ICD-OACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"One-way allow prorated trip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9604","description":"One-way allow prorated trip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0922T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","description":"CPT-0922T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXB0","description":"ICD-KGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46753","description":"Reconstruction of anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc harness_ expand control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2313","description":"Pwc harness_ expand control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88150","description":"Cytopath c/v manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAB1","description":"ICD-AFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITA0","description":"ICD-BITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64655","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","description":"CPT-64655","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36563","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIF0","description":"ICD-AEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCE1","description":"ICD-OHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4KB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KB11","description":"ICD-4KB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of sinus tarsi implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0510T","description":"Removal of sinus tarsi implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLF1","description":"ICD-CFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01756","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01756","description":"CPT-01756","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOF0","description":"ICD-PKOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUB1","description":"ICD-JFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Negative pressure ventilator; portable or stationary","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0460","description":"Negative pressure ventilator; portable or stationary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOF0","description":"ICD-DGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rsa upper extr exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0349T","description":"Rsa upper extr exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27442","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nerve pedicle transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64905","description":"Nerve pedicle transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDC0","description":"ICD-GHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUC1","description":"ICD-ICUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLF1","description":"ICD-GBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUE0","description":"ICD-ADUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPF0","description":"ICD-OLPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00170","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00170","description":"CPT-00170","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAB0","description":"ICD-EFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cultured chondrocytes implnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7330","description":"Cultured chondrocytes implnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Distal transcutaneous electrical nerve stimulator_ stimulates peripheral nerves of the upper arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1023","description":"Distal transcutaneous electrical nerve stimulator_ stimulates peripheral nerves of the upper arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCF1","description":"ICD-ADCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDME0","description":"ICD-NDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray of elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73085","description":"Contrast x-ray of elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient enrolled in hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9858","description":"Patient enrolled in hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVA0","description":"ICD-KIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNF1","description":"ICD-FGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITE1","description":"ICD-BITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9809","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9809","description":"HCPCS-C9809","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reprogram cochlear implt 7/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92604","description":"Reprogram cochlear implt 7/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDA0","description":"ICD-EEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrst x-ray uppr gi tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74246","description":"Contrst x-ray uppr gi tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHD1","description":"ICD-GIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD211","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDD0","description":"ICD-EDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35184","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Seizure type& frequ docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1200F","description":"Seizure type& frequ docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNE0","description":"ICD-NFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42830","description":"Removal of adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUF0","description":"ICD-FBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reusable underpad chair size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4540","description":"Reusable underpad chair size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFC0","description":"ICD-GBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD236","description":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA13","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autochondrocyte implant knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27412","description":"Autochondrocyte implant knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB26","description":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHE0","description":"ICD-KDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCF0","description":"ICD-GFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychosis_ Depression_ Anxiety_ Apathy_ And Impulse Control Disorder Assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2121","description":"Psychosis_ Depression_ Anxiety_ Apathy_ And Impulse Control Disorder Assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYF1","description":"ICD-DAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQB0","description":"ICD-OLQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDB1","description":"ICD-GDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKB0","description":"ICD-OLKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXE0","description":"ICD-GGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kafo w/o joint multi-axis an","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2038","description":"Kafo w/o joint multi-axis an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Professional services for the administration of antiinfective_ pain management_ chelation_ pulmonary hypertension_ and/or inotr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0068","description":"Professional services for the administration of antiinfective_ pain management_ chelation_ pulmonary hypertension_ and/or inotr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBA1","description":"ICD-JEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXD1","description":"ICD-ODXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETE0","description":"ICD-OETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXD1","description":"ICD-OFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21088","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBA0","description":"ICD-GFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Supplies for external insulin infusion pump_ syringe type cartridge_ sterile_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4225","description":"Supplies for external insulin infusion pump_ syringe type cartridge_ sterile_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Str markers spec anal addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81266","description":"Str markers spec anal addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDE0","description":"ICD-KDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEB0","description":"ICD-FIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKB0","description":"ICD-CGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Segmental pneumatic trunk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0656","description":"Segmental pneumatic trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair umbilical lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49610","description":"Repair umbilical lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ko supracondylar socket mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1860","description":"Ko supracondylar socket mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGE1","description":"ICD-FIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX3D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCA1","description":"ICD-EDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARC1","description":"ICD-KARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of tibia fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27750","description":"Treatment of tibia fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD201","description":"Special Care Low _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJC0","description":"ICD-KBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95723","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC220","description":"Reduced Physical Function _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sinus augmentation vertical","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7952","description":"Sinus augmentation vertical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASD0","description":"ICD-DASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy remove segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32669","description":"Thoracoscopy remove segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERA0","description":"ICD-PERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Deoxyribonucleic acid (DNA) antibody_ double stranded_ high avidity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0039U","description":"Deoxyribonucleic acid (DNA) antibody_ double stranded_ high avidity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEC0","description":"ICD-MEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKD1","description":"ICD-ODKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEB1","description":"ICD-MAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPD0","description":"ICD-GGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCB0","description":"ICD-NKCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35141","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYC0","description":"ICD-PBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunotherapy injections","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95117","description":"Immunotherapy injections","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Folding ped wc tilt-in-space","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1232","description":"Folding ped wc tilt-in-space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD255","description":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGA0","description":"ICD-BCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWB0","description":"ICD-CAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJB0","description":"ICD-FGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGF1","description":"ICD-NAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESC0","description":"ICD-LESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instrumenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97551","description":"Caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instrumenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWD0","description":"ICD-HFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBC0","description":"ICD-KHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55707","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","description":"CPT-55707","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYD0","description":"ICD-GBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELC0","description":"ICD-AELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"D&c of cervical stump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57558","description":"D&c of cervical stump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spkt/v less than 1. 2 (single-pool clearance of urea [kt] / volume [v])_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8717","description":"Spkt/v less than 1. 2 (single-pool clearance of urea [kt] / volume [v])_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMD0","description":"ICD-KCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMD1","description":"ICD-GCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITA0","description":"ICD-NITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFB0","description":"ICD-JBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Walker folding wheeled w/o s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0143","description":"Walker folding wheeled w/o s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect radius/ulnar tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25170","description":"Resect radius/ulnar tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQF1","description":"ICD-KCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home sleep test/type 2 porta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0398","description":"Home sleep test/type 2 porta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICA1","description":"ICD-OICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace quadlat socket brim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4020","description":"Replace quadlat socket brim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINB1","description":"ICD-GINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert major vessel graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33335","description":"Insert major vessel graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE22C","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient received bone marrow transplant any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1157","description":"Patient received bone marrow transplant any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE113","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0220","description":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA116","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBB0","description":"ICD-BDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Body muscle testing manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95833","description":"Body muscle testing manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA22A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLE0","description":"ICD-NHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFB1","description":"ICD-BAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Splint elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8452","description":"Splint elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACE1","description":"ICD-NACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electron microscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88348","description":"Electron microscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neg press wound tx segmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35683","description":"Composite byp grft 3/> segmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair lightwt fixed arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1089","description":"Wheelchair lightwt fixed arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNA1","description":"ICD-OLNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJD1","description":"ICD-CIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Safety counseling dem order","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6102F","description":"Safety counseling dem order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18F","description":"Clinically Complex _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHF0","description":"ICD-MHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endocervical curettage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57505","description":"Endocervical curettage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEE1","description":"ICD-CAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cochlear implt f/up exam 7/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92603","description":"Cochlear implt f/up exam 7/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTC0","description":"ICD-GFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21248","description":"Reconstruction of jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA3A","description":"Default_ /PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fqhc visit_ estab pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0467","description":"Fqhc visit_ estab pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adrenal tissue transplant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2103","description":"Adrenal tissue transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Appropos mthd offloading rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4269F","description":"Appropos mthd offloading rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD21A","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFB1","description":"ICD-FEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGME0","description":"ICD-MGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair esophagus wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43410","description":"Repair esophagus wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAB1","description":"ICD-OHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11305","description":"Shave skin lesion 0.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDID0","description":"ICD-NDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx orbit fx w/bone grft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21408","description":"Opn tx orbit fx w/bone grft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clear outer ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69200","description":"Clear outer ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOC0","description":"ICD-CBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBC0","description":"ICD-EHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATA1","description":"ICD-AATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICC1","description":"ICD-MICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"R&l hrt art/ventricle angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93461","description":"R&l hrt art/ventricle angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Platelets_ each unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9019","description":"Platelets_ each unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDA1","description":"ICD-OBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOB0","description":"ICD-PGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8D","description":"Medium Rehab _ ADL Index 0-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOB1","description":"ICD-PJOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Test urine for porphyrins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84119","description":"Test urine for porphyrins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTC0","description":"ICD-JCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55110","description":"Explore scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.6-1.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11306","description":"Shave skin lesion 0.6-1.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-pneum walk boot pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4387","description":"Non-pneum walk boot pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MECP2 (methyl CpG binding protein 2) (eg_ Rett syndrome)_ full gene analysis_ including small sequence changes in exonic and intronic regions_ deletions_ duplications_ mobile","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0234U","description":"MECP2 (methyl CpG binding protein 2) (eg_ Rett syndrome)_ full gene analysis_ including small sequence changes in exonic and intronic regions_ deletions_ duplications_ mobile","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKB1","description":"ICD-GFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVF1","description":"ICD-CFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lumasiran_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0224","description":"Injection_ lumasiran_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Control throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42961","description":"Control throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXB1","description":"ICD-JFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 BIVALENT 30 MCG/0.3 ML ADDL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0124A","description":"IMM ADMN SARSCOV2 BIVALENT 30 MCG/0.3 ML ADDL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBD0","description":"ICD-BDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastric restrictive procedure_ endoscopic sleeve gastroplasty_ with esophagogastroduodenoscopy and intraluminal tube insertion_ if performed_ including all system and tissue a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9784","description":"Gastric restrictive procedure_ endoscopic sleeve gastroplasty_ with esophagogastroduodenoscopy and intraluminal tube insertion_ if performed_ including all system and tissue a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Influenza dna amp prob addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87503","description":"Influenza dna amp prob addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTD1","description":"ICD-NKTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAB0","description":"ICD-CCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEA0","description":"ICD-MBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87638","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87638","description":"CPT-87638","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low rsk thromboembolism","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3550F","description":"Low rsk thromboembolism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comp geriatr assmt team","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0250","description":"Comp geriatr assmt team","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAB1","description":"ICD-IBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIA1","description":"ICD-AAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAD1","description":"ICD-EFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL05","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMD1","description":"ICD-FCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00792","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00792","description":"CPT-00792","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD240","description":"Clinically Complex _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA225","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWF0","description":"ICD-DCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGF1","description":"ICD-OBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pin knuckle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26706","description":"Pin knuckle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUA0","description":"ICD-CFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ CYP2D6-2D7 hybrid gene) (List separately in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0072U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ CYP2D6-2D7 hybrid gene) (List separately in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0549U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","description":"CPT-0549U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANF1","description":"ICD-FANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Retainer For Fpd - Porcelain Fused To Noble Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6099","description":"Implant Supported Retainer For Fpd - Porcelain Fused To Noble Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGED0","description":"ICD-BGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01482","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01482","description":"CPT-01482","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1553","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1553","description":"HCPCS-J1553","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQF0","description":"ICD-OCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of thigh brace","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20663","description":"Application of thigh brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBF0","description":"ICD-IFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"4vhpv vaccine 3 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90649","description":"4vhpv vaccine 3 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24575","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastric suction pump hme mdl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2000","description":"Gastric suction pump hme mdl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Redo endovas vena cava filtr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37192","description":"Redo endovas vena cava filtr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMD1","description":"ICD-GFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate) gene expression profile by real-time RT-PCR of 3 genes (ERG_ PCA3_ and SPDEF)_ urine_ algorithm reported as risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0005U","description":"Oncology (prostate) gene expression profile by real-time RT-PCR of 3 genes (ERG_ PCA3_ and SPDEF)_ urine_ algorithm reported as risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDE1","description":"ICD-NHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Lymphoma Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1097","description":"Radiation Therapy For Lymphoma Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp3 vhd mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0863","description":"Pwc gp3 vhd mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX46","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Milwaukee type superstructur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1230","description":"Milwaukee type superstructur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17286","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hand restoration multiple fi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6905","description":"Hand restoration multiple fi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJA0","description":"ICD-FAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert ant segment drain int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0191T","description":"Insert ant segment drain int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"O2/water vapor enrich w/heat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1405","description":"O2/water vapor enrich w/heat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEB1","description":"ICD-JDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastric mucosa imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78261","description":"Gastric mucosa imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0502","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0502","description":"CDT-D0502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00406","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00406","description":"CPT-00406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARA1","description":"ICD-DARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pne not given norsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9280","description":"Pne not given norsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prosthetic sock multi ply bk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8420","description":"Prosthetic sock multi ply bk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBC0","description":"ICD-BHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic bone marrow; biopsy(ies)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38221","description":"Diagnostic bone marrow; biopsy(ies)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cannabinoid synthetic 7/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80352","description":"Cannabinoid synthetic 7/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBE0","description":"ICD-MDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRE1","description":"ICD-KGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD150","description":"Clinically Complex _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFF1","description":"ICD-NLFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMF1","description":"ICD-IFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abscess drainage under x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75989","description":"Abscess drainage under x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMF0","description":"ICD-EBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBB1","description":"ICD-IFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX01","description":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHD1","description":"ICD-NCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPD0","description":"ICD-BAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73600","description":"X-ray exam of ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBF1","description":"ICD-IDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Part removal of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28113","description":"Part removal of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSB1","description":"ICD-PBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of carotene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82380","description":"Assay of carotene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAA1","description":"ICD-GGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEB0","description":"ICD-EFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcvng warf thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4300F","description":"Pt rcvng warf thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEC0","description":"ICD-MFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial_ fungal_ or viral infection)_ semiquantitative biomechanical assessment (via deformability cytometry)_ whole blood_ with algorithmic analysis and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0441U","description":"Infectious disease (bacterial_ fungal_ or viral infection)_ semiquantitative biomechanical assessment (via deformability cytometry)_ whole blood_ with algorithmic analysis and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMD1","description":"ICD-GIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJF1","description":"ICD-OKJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0797T","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasopharyngoscopy_ Surgical_ With Dilation Of Eustachian Tube (Ie_ Balloon Dilation); Unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69705","description":"Nasopharyngoscopy_ Surgical_ With Dilation Of Eustachian Tube (Ie_ Balloon Dilation); Unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incisional biopsy of skin (eg_ wedge) (including simple closure_ when performed); each separate/additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11107","description":"Incisional biopsy of skin (eg_ wedge) (including simple closure_ when performed); each separate/additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIB1","description":"ICD-NKIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Streptomycin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3000","description":"Streptomycin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNE1","description":"ICD-FCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD15B","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had a transplant prior to initiation of dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1262","description":"Patients who had a transplant prior to initiation of dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of bioprosthetic valve_ open_ femoral vein_ including duplex ultrasound imaging guidance_ when performed_ including autogenous or nonautogenous patch graft (eg_ poly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0744T","description":"Insertion of bioprosthetic valve_ open_ femoral vein_ including duplex ultrasound imaging guidance_ when performed_ including autogenous or nonautogenous patch graft (eg_ poly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASA0","description":"ICD-OASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cmprs burngarment foot-knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6507","description":"Cmprs burngarment foot-knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB14D","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise diaphragm nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64746","description":"Incise diaphragm nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ abdominal_ with contrast","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9744","description":"Ultrasound_ abdominal_ with contrast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of nasal bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70160","description":"X-ray exam of nasal bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQC1","description":"ICD-HEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXB0","description":"ICD-NBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01500","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01500","description":"CPT-01500","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYF1","description":"ICD-DBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIE0","description":"ICD-BBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopy swallow tst (fees)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92612","description":"Endoscopy swallow tst (fees)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAME1","description":"ICD-OAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1111T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1111T","description":"CPT-1111T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ paclitaxel protein-bound particles (american regent) not therapeutically equivalent to j9264_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9259","description":"Injection_ paclitaxel protein-bound particles (american regent) not therapeutically equivalent to j9264_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIB0","description":"ICD-ODIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFF1","description":"ICD-JHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28D","description":"Special Care High _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAC0","description":"ICD-GDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAA1","description":"ICD-OKAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVE1","description":"ICD-KCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"PSYC GEN ALYS PANEL 15 GENES","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0175U","description":"PSYC GEN ALYS PANEL 15 GENES","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOA1","description":"ICD-PHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ moxetumomab pasudotox-tdfx_ 0.01mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9045","description":"Injection_ moxetumomab pasudotox-tdfx_ 0.01mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCD1","description":"ICD-JGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKC0","description":"ICD-JCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of erythropoietin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82668","description":"Assay of erythropoietin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOE1","description":"ICD-OEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHB1","description":"ICD-IIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of bowel lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44111","description":"Excision of bowel lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision gastroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43848","description":"Revision gastroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXD0","description":"ICD-NEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prep ak ischial thermo mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5580","description":"Prep ak ischial thermo mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOA1","description":"ICD-LAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDB1","description":"ICD-AHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kafo fem fx cast thermoplas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2126","description":"Kafo fem fx cast thermoplas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXF0","description":"ICD-ODXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQB1","description":"ICD-CDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ammonia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82140","description":"Assay of ammonia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laser surgery of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52648","description":"Laser surgery of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMF0","description":"ICD-IIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29821","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA255","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBC0","description":"ICD-ODBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKB0","description":"ICD-JFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ost sknbar w/o conv<=4 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4414","description":"Ost sknbar w/o conv<=4 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Normal saline solution infus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7030","description":"Normal saline solution infus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23530","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUA0","description":"ICD-AGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cognit assessed and reviewed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1494F","description":"Cognit assessed and reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nutrition/Dietician Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4017","description":"Nutrition/Dietician Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARD1","description":"ICD-CARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Singl visn sphere 7.12-20.00","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2102","description":"Singl visn sphere 7.12-20.00","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEC1","description":"ICD-AFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB156","description":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brain canal shunt procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61070","description":"Brain canal shunt procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sp bone agrft struct add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20938","description":"Sp bone agrft struct add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUA1","description":"ICD-OLUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB21B","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental inlay metallic 2 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2520","description":"Dental inlay metallic 2 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJB0","description":"ICD-KCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dx bipol_ death_ nhres_ hosp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9394","description":"Dx bipol_ death_ nhres_ hosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEB0","description":"ICD-JEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKF0","description":"ICD-OCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANE1","description":"ICD-OANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEF1","description":"ICD-EHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sgd accessory noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2599","description":"Sgd accessory noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWB0","description":"ICD-LBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQD0","description":"ICD-CFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKD0","description":"ICD-OLKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17260","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Scintimammography","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8080","description":"Scintimammography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Merkel cell carcinoma)_ detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1)_ serum_ reported as positive or negative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0059U","description":"Oncology (Merkel cell carcinoma)_ detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1)_ serum_ reported as positive or negative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYE0","description":"ICD-PGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFD0","description":"ICD-GGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elec alys vagus nrv pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0317T","description":"Elec alys vagus nrv pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mibm but no dx of breast ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8946","description":"Mibm but no dx of breast ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKD0","description":"ICD-BAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOA1","description":"ICD-OIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXD0","description":"ICD-ODXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt dchg home post op day 7","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9601","description":"Pt dchg home post op day 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0489U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","description":"CPT-0489U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQB1","description":"ICD-LGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDF1","description":"ICD-JDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUC1","description":"ICD-NLUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKF1","description":"ICD-CIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEME1","description":"ICD-EEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDC0","description":"ICD-IFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pappa serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84163","description":"Pappa serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8H","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHF1","description":"ICD-EDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIA0","description":"ICD-ICIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ceruloplasmin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82390","description":"Assay of ceruloplasmin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMB1","description":"ICD-FEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33476","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJB1","description":"ICD-FDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLED0","description":"ICD-MLED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHF0","description":"ICD-AAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling_ ph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1310","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling_ ph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBB0","description":"ICD-IHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMB1","description":"ICD-MGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Arthroscopy_ shoulder_ surgi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2300","description":"Arthroscopy_ shoulder_ surgi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0568","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","description":"HCPCS-G0568","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dermatological procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96999","description":"Dermatological procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASB1","description":"ICD-PASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHF1","description":"ICD-NAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00926","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00926","description":"CPT-00926","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEC1","description":"ICD-AHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLC0","description":"ICD-KFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"BMI is documented as being outside of normal limits_ follow-up plan is not completed for documented reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9716","description":"BMI is documented as being outside of normal limits_ follow-up plan is not completed for documented reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDA1","description":"ICD-FCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Retrograde ejaculation anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89331","description":"Retrograde ejaculation anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDD1","description":"ICD-CEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQC1","description":"ICD-KDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAB0","description":"ICD-FCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEB1","description":"ICD-BCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBB1","description":"ICD-CIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endo_ colon_ retro imaging","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1749","description":"Endo_ colon_ retro imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"BRCA1_ BRCA2 (breast cancer 1 and 2) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants in BRCA1 (ie_ ex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81211","description":"BRCA1_ BRCA2 (breast cancer 1 and 2) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants in BRCA1 (ie_ ex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQA1","description":"ICD-KCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18X","description":"Special Care Low _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft aor/carot/innom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35526","description":"Art byp grft aor/carot/innom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1295","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUC1","description":"ICD-BBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEF1","description":"ICD-MGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEB1","description":"ICD-KFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracostomy w/rib resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32035","description":"Thoracostomy w/rib resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27331","description":"Explore/treat knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lvef <40%","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8694","description":"Lvef <40%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQD0","description":"ICD-PIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNB0","description":"ICD-GHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE206","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSC1","description":"ICD-KFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ear mold/insert_ disp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5265","description":"Ear mold/insert_ disp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFF0","description":"ICD-FHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair rotator cuff chronic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23412","description":"Repair rotator cuff chronic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDED1","description":"ICD-JDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMC0","description":"ICD-FEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stationary compressed gas 02","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0424","description":"Stationary compressed gas 02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx brst stg1-2b hr_nopro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9071","description":"Onc dx brst stg1-2b hr_nopro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOB0","description":"ICD-OFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Albumin; other source_ quantitative_ each specimen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82042","description":"Albumin; other source_ quantitative_ each specimen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adjust elbow ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1800","description":"Adjust elbow ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Temp fml iu vlv-pmp 1st insj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0596T","description":"Temp fml iu vlv-pmp 1st insj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTB0","description":"ICD-IGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPF0","description":"ICD-FAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL15","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFA0","description":"ICD-NAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIA0","description":"ICD-FDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cine/video x-rays add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76125","description":"Cine/video x-rays add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adj skin pro wc cus wd>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2623","description":"Adj skin pro wc cus wd>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Quant nonher2 ihc brst cx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3395F","description":"Quant nonher2 ihc brst cx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWD1","description":"ICD-HCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDED0","description":"ICD-NDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKE1","description":"ICD-OIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHE1","description":"ICD-CIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMC1","description":"ICD-MHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVD1","description":"ICD-NEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alginate dressing > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6198","description":"Alginate dressing > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alatrofloxacin mesylate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0200","description":"Alatrofloxacin mesylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDA1","description":"ICD-CDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQE0","description":"ICD-CCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPB1","description":"ICD-CIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUD0","description":"ICD-JFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","description":"HCPCS-M1406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt no tx sys bio rx 6 mths","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9653","description":"Pt no tx sys bio rx 6 mths","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKE1","description":"ICD-KBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colorectal scrn; hi risk ind","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0105","description":"Colorectal scrn; hi risk ind","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laser surgery of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52647","description":"Laser surgery of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Female patients unable to bear children","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1016","description":"Female patients unable to bear children","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contour of face bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21029","description":"Contour of face bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc prac guide differs nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9062","description":"Onc prac guide differs nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Restrata minimatrix_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2026","description":"Restrata minimatrix_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEC0","description":"ICD-JDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNF1","description":"ICD-BGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIA1","description":"ICD-FBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWB0","description":"ICD-OEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onsite Ac C Tx Nsg Fac Res W/Chf Billd Sid-Benef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9680","description":"Onsite Ac C Tx Nsg Fac Res W/Chf Billd Sid-Benef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITA1","description":"ICD-CITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJC1","description":"ICD-CHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD14B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITD0","description":"ICD-IITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEC0","description":"ICD-OKEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC11A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28B","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNC1","description":"ICD-GHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADB0","description":"ICD-FADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB230","description":"Clinically Complex _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQD1","description":"ICD-KDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-pneumatic compression controller with sequential calibrated gradient pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0680","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43108","description":"Removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation therapy planning","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77262","description":"Radiation therapy planning","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOB0","description":"ICD-HHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCC0","description":"ICD-KDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home infusion/visit 2 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99601","description":"Home infusion/visit 2 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Legion pneumo dna amp prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87541","description":"Legion pneumo dna amp prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGB0","description":"ICD-BCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Culture of specimen by kit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87084","description":"Culture of specimen by kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pierce earlobes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69090","description":"Pierce earlobes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHA0","description":"ICD-IAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA3D","description":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQD0","description":"ICD-KGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise inner ear nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69915","description":"Incise inner ear nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMC0","description":"ICD-CHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with the power source and control electronics unit_ controlled by phon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1029","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with the power source and control electronics unit_ controlled by phon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC113","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28E","description":"Special Care High _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTB1","description":"ICD-CCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYE1","description":"ICD-LFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXC1","description":"ICD-OKXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thermal Destruction Of Intraosseous Basivertebral Nerve_ Including All Imaging Guidance; First 2 Vertebral Bodies_ Lumbar Or Sacral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64628","description":"Thermal Destruction Of Intraosseous Basivertebral Nerve_ Including All Imaging Guidance; First 2 Vertebral Bodies_ Lumbar Or Sacral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA13A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq dev soft tiss 1st imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10035","description":"Perq dev soft tiss 1st imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revis reconst shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23474","description":"Revis reconst shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAA0","description":"ICD-MHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skilled services of a licensed practical nurse (LPN) for the observation and assessment of the patient_s condition_ each 15 minutes (the change in the patient_s condition requ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0494","description":"Skilled services of a licensed practical nurse (LPN) for the observation and assessment of the patient_s condition_ each 15 minutes (the change in the patient_s condition requ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radial keratotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65771","description":"Radial keratotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJF0","description":"ICD-JFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFF0","description":"ICD-GDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ash fibrosure (tm)_ labcorp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0002M","description":"Ash fibrosure (tm)_ labcorp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Private duty/independent nsg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1000","description":"Private duty/independent nsg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYF0","description":"ICD-CAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKF0","description":"ICD-CGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRB0","description":"ICD-LHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFA0","description":"ICD-OJFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reagent strip/blood glucose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82948","description":"Reagent strip/blood glucose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENF1","description":"ICD-GENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Microbe susceptible diffuse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87181","description":"Microbe susceptible diffuse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trabeculostomy Ab Interno By Laser; With Use Of Ophthalmic Endoscope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0622T","description":"Trabeculostomy Ab Interno By Laser; With Use Of Ophthalmic Endoscope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRA0","description":"ICD-DDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB20","description":"Ultra High Rehab _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVF0","description":"ICD-JIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj iron dextran","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1750","description":"Inj iron dextran","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28I","description":"Clinically Complex _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKF0","description":"ICD-CDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DC11","description":"ICD-3DC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYF0","description":"ICD-PAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTC1","description":"ICD-OCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disease activity not assessed_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1006","description":"Disease activity not assessed_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0948T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","description":"CPT-0948T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tmj unspecified therapy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7899","description":"Tmj unspecified therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAA1","description":"ICD-FAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6059","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHE1","description":"ICD-KCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chimerism anal w/cell select","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81268","description":"Chimerism anal w/cell select","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQB1","description":"ICD-CEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGND0","description":"ICD-NGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVF0","description":"ICD-BIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pet img wholbod melano nonco","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0219","description":"Pet img wholbod melano nonco","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUB0","description":"ICD-FIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx nhl stg unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9138","description":"Onc dx nhl stg unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA13A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDC1","description":"ICD-MBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA0B","description":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPA1","description":"ICD-GEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRC1","description":"ICD-PKRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Occ orthotic device adjust","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7881","description":"Occ orthotic device adjust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Visual audiometry (vra)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92579","description":"Visual audiometry (vra)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKF1","description":"ICD-CHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJA0","description":"ICD-OBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVA0","description":"ICD-FFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8B","description":"Medium Rehab _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise lumbar artif disc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22862","description":"Revise lumbar artif disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDF0","description":"ICD-NLDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pne scrn done doc not ind","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9281","description":"Pne scrn done doc not ind","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARA1","description":"ICD-HARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas on statin or contra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9507","description":"Doc reas on statin or contra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNC0","description":"ICD-FFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA2B","description":"Ultra High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNB0","description":"ICD-BFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICC0","description":"ICD-GICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Needle biopsy pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48102","description":"Needle biopsy pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cabg vein four","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33513","description":"Cabg vein four","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPF0","description":"ICD-GDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQD1","description":"ICD-GAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aprepitant_ (aponvie)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9145","description":"Injection_ aprepitant_ (aponvie)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ergonovine maleate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1330","description":"Ergonovine maleate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKC0","description":"ICD-CAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28A","description":"Special Care High _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHB1","description":"ICD-GEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE131","description":"Special Care High _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAC1","description":"ICD-ODAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Herpes simplex type 2 test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86696","description":"Herpes simplex type 2 test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE11C","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removable unilateral partial denture - one piece cast metal_ mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5283","description":"Removable unilateral partial denture - one piece cast metal_ mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bk fork strap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5684","description":"Bk fork strap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood/lymph nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78199","description":"Blood/lymph nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of breast capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19371","description":"Removal of breast capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylinder 4.25d/over 6d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2110","description":"Spherocylinder 4.25d/over 6d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHF1","description":"ICD-ODHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0804","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0804","description":"CDT-D0804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99214","description":"Office/outpatient visit est","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVF0","description":"ICD-BBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct orbit/forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21172","description":"Reconstruct orbit/forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8X","description":"Medium Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDD1","description":"ICD-GBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68110","description":"Remove eyelid lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWD1","description":"ICD-LFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXB1","description":"ICD-NLXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEE1","description":"ICD-GAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc rect tum transanal part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45171","description":"Exc rect tum transanal part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECB0","description":"ICD-JECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHB0","description":"ICD-EFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adjust knee ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1810","description":"Adjust knee ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTE1","description":"ICD-ICTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wrst mld sck flx hng tri pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6050","description":"Wrst mld sck flx hng tri pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28H","description":"Special Care High _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urethrlys transvag w/ scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53500","description":"Urethrlys transvag w/ scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOD1","description":"ICD-DEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB141","description":"Clinically Complex _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBE1","description":"ICD-IEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBA0","description":"ICD-JDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41008","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKE1","description":"ICD-BAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMB0","description":"ICD-EEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILE1","description":"ICD-IILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDF1","description":"ICD-OLDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy bronch stents","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31636","description":"Bronchoscopy bronch stents","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXF1","description":"ICD-BGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (minimal residual disease [MRD])_ next-generation targeted sequencing analysis of a patient-specific panel_ cell-free DNA_ subsequent assessment with comparison to pr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0307U","description":"Oncology (minimal residual disease [MRD])_ next-generation targeted sequencing analysis of a patient-specific panel_ cell-free DNA_ subsequent assessment with comparison to pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASB1","description":"ICD-KASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAC1","description":"ICD-ABAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNA1","description":"ICD-NCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJB1","description":"ICD-FHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTC0","description":"ICD-CGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemiluminescent assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82397","description":"Chemiluminescent assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breast prosthesis w adhesive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8031","description":"Breast prosthesis w adhesive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPB1","description":"ICD-CGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54318","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rad resect hand tumor < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26117","description":"Rad resect hand tumor < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBE1","description":"ICD-FFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35256","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy & biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50574","description":"Kidney endoscopy & biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXE1","description":"ICD-GAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE214","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prednisone ir or dr oral 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7512","description":"Prednisone ir or dr oral 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No doc type nsm lung ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9290","description":"No doc type nsm lung ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thorabd diaphr hern repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43336","description":"Thorabd diaphr hern repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIA1","description":"ICD-NEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy contrl bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32654","description":"Thoracoscopy contrl bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEE1","description":"ICD-CGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93313","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRE1","description":"ICD-OBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES341","description":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUB1","description":"ICD-OIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urinary leg bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5112","description":"Urinary leg bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDB0","description":"ICD-KHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAC1","description":"ICD-NDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urinal female jug-type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0326","description":"Urinal female jug-type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEE1","description":"ICD-OJEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUF1","description":"ICD-ACUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQF1","description":"ICD-GIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIA1","description":"ICD-EEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00102","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00102","description":"CPT-00102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWE0","description":"ICD-KFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX23","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOD0","description":"ICD-KFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRC1","description":"ICD-CFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVB0","description":"ICD-KCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy rigid trnso dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43191","description":"Esophagoscopy rigid trnso dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo proc abdm/per/oment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49329","description":"Laparo proc abdm/per/oment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRB0","description":"ICD-KCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove lamina/facets lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63012","description":"Remove lamina/facets lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBB1","description":"ICD-IBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRE0","description":"ICD-DFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVF1","description":"ICD-NBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ref for oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8856","description":"Ref for oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0803T","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVD1","description":"ICD-BGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLB0","description":"ICD-BFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRB0","description":"ICD-ODRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perp bk ptb thermopls direct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5520","description":"Perp bk ptb thermopls direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXE0","description":"ICD-NBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHF1","description":"ICD-MAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKD0","description":"ICD-CEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Normal blood pressure reading documented_ follow-up not required","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1294","description":"Normal blood pressure reading documented_ follow-up not required","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDB0","description":"ICD-BGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01999","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01999","description":"CPT-01999","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Egd diagnostic brush wash","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43235","description":"Egd diagnostic brush wash","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKD0","description":"ICD-FHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCC1","description":"ICD-GHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home ventilator_ multi-function respiratory device_ also performs any or all of the additional functions of oxygen concentratio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0467","description":"Home ventilator_ multi-function respiratory device_ also performs any or all of the additional functions of oxygen concentratio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADC0","description":"ICD-AADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospitalized patients with newly diagnosed CVA considered for endovascular stroke treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9767","description":"Hospitalized patients with newly diagnosed CVA considered for endovascular stroke treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repeat drainage of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33011","description":"Repeat drainage of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hdr rdncl ntrstl/icav brchtx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77770","description":"Hdr rdncl ntrstl/icav brchtx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBF1","description":"ICD-BGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score ue < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8668","description":"Fun stat score ue < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spirmtry w/brnchdil inf-2 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94012","description":"Spirmtry w/brnchdil inf-2 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36216","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sps ankle device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1816","description":"Sps ankle device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap colectomy w/proctectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44211","description":"Lap colectomy w/proctectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOE0","description":"ICD-DFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove ankle joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27625","description":"Remove ankle joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSC1","description":"ICD-PJSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMF1","description":"ICD-FGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBF1","description":"ICD-MEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNB1","description":"ICD-CDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDE1","description":"ICD-JHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61567","description":"Incision of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8011","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8011","description":"HCPCS-C8011","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPB1","description":"ICD-KIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37268","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","description":"CPT-37268","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mr angiography head w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70545","description":"Mr angiography head w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAA1","description":"ICD-NFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score knee pt noelg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8649","description":"Fun stat score knee pt noelg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2JA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JA21","description":"ICD-2JA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTE0","description":"ICD-NBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove knee cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27347","description":"Remove knee cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEF1","description":"ICD-NDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esw wound healing addl wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0300T","description":"Esw wound healing addl wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD113","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay resin 2 surface","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2662","description":"Dental onlay resin 2 surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFA1","description":"ICD-FDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWD1","description":"ICD-OJWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64555","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOC1","description":"ICD-CHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUB1","description":"ICD-FHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQD1","description":"ICD-OLQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESA0","description":"ICD-DESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ arm_ padded_ for nighttime use_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6522","description":"Gradient compression garment_ arm_ padded_ for nighttime use_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIC1","description":"ICD-IFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove cerv artif disc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22864","description":"Remove cerv artif disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intravasc us heart add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92979","description":"Intravasc us heart add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJC0","description":"ICD-JIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection_ all nonsele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34703","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection_ all nonsele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stoma absorptive cover","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5083","description":"Stoma absorptive cover","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (oropharyngeal)_ evaluation of 17 DNA biomarkers using droplet digital PCR (ddPCR)_ cell-free DNA_ algorithm reported as a prognostic risk score for cancer recurrence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0356U","description":"Oncology (oropharyngeal)_ evaluation of 17 DNA biomarkers using droplet digital PCR (ddPCR)_ cell-free DNA_ algorithm reported as a prognostic risk score for cancer recurrence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTF0","description":"ICD-CGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHE1","description":"ICD-JHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Omalizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2357","description":"Omalizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQC0","description":"ICD-DCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHME1","description":"ICD-CHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eye mvmt alys w/o calbrj i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0615T","description":"Eye mvmt alys w/o calbrj i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prq card revasc chronic addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92944","description":"Prq card revasc chronic addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc visc aorta 2 graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34842","description":"Endovasc visc aorta 2 graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKB0","description":"ICD-KAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","description":"HCPCS-Q4401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of procainamide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80192","description":"Assay of procainamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp3 hd mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0862","description":"Pwc gp3 hd mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Egd remove lesion snare","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43251","description":"Egd remove lesion snare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Realignment of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25335","description":"Realignment of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRA1","description":"ICD-HBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4358","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","description":"HCPCS-Q4358","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace chst cmprss sys hose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7026","description":"Replace chst cmprss sys hose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Group caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97552","description":"Group caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rhythm ecg with report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93040","description":"Rhythm ecg with report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC125","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28I","description":"Clinically Complex _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSE1","description":"ICD-LFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB24A","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"DPYD (dihydropyrimidine dehydrogenase) (eg_ 5-fluorouracil/5-FU and capecitabine drug metabolism)_ gene analysis_ common variant(s) (eg_ *2A_ *4_ *5_ *6)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81232","description":"DPYD (dihydropyrimidine dehydrogenase) (eg_ 5-fluorouracil/5-FU and capecitabine drug metabolism)_ gene analysis_ common variant(s) (eg_ *2A_ *4_ *5_ *6)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKE1","description":"ICD-JAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDE1","description":"ICD-MHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB1B","description":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Ct Guidance_ Lumbar; First Level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0629T","description":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Ct Guidance_ Lumbar; First Level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMF0","description":"ICD-GHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYC0","description":"ICD-HGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRC0","description":"ICD-DFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKC1","description":"ICD-GBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYF0","description":"ICD-OFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQF0","description":"ICD-HFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy orchiectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54690","description":"Laparoscopy orchiectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB34","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30999","description":"Nasal surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCE0","description":"ICD-MCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mw therapy for breast tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0301T","description":"Mw therapy for breast tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No off assis eol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9382","description":"No off assis eol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Legg perthes patten bottom t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1755","description":"Legg perthes patten bottom t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45400","description":"Laparoscopic proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAND1","description":"ICD-FAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ pmkr_ other than trans","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1898","description":"Lead_ pmkr_ other than trans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA44","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUA1","description":"ICD-JBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVD1","description":"ICD-FAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMC0","description":"ICD-JDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUC1","description":"ICD-CAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC24B","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLB1","description":"ICD-ECLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99152","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interferon beta-1b / .25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1830","description":"Interferon beta-1b / .25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nonpneumatic sequential compression garment_ full leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1032","description":"Nonpneumatic sequential compression garment_ full leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB225","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVF0","description":"ICD-KAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITB1","description":"ICD-AITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMA1","description":"ICD-NDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHF1","description":"ICD-IGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA140","description":"Reduced Physical Function _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct chest spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72130","description":"Ct chest spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"5% dextrose/water","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7060","description":"5% dextrose/water","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardioassist internal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92970","description":"Cardioassist internal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of knee 1 or 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73560","description":"X-ray exam of knee 1 or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDB1","description":"ICD-IDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Evoked auditory tst complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92588","description":"Evoked auditory tst complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCD0","description":"ICD-GHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gemtuzumab ozogamicin inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9300","description":"Gemtuzumab ozogamicin inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDB1","description":"ICD-AFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSA0","description":"ICD-HDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCC0","description":"ICD-EDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHD1","description":"ICD-FFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAA0","description":"ICD-JEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"carePATCH_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4236","description":"carePATCH_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphc trifocal 4.25-7/2.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2308","description":"Lens sphc trifocal 4.25-7/2.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of fetal fibronectin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82731","description":"Assay of fetal fibronectin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWD1","description":"ICD-HBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBE0","description":"ICD-NJBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection for wrist x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25246","description":"Injection for wrist x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18A","description":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair anal fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46288","description":"Repair anal fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAD1","description":"ICD-IGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUF0","description":"ICD-KCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL43","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLD1","description":"ICD-NGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIE0","description":"ICD-MEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay resin 4/mre sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2664","description":"Dental onlay resin 4/mre sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home visit new pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99328","description":"Domicil/r-home visit new pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVC0","description":"ICD-FHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISF1","description":"ICD-OISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgery for vulva lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56440","description":"Surgery for vulva lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL0D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQC1","description":"ICD-OHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNA0","description":"ICD-NCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPB0","description":"ICD-GGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELB1","description":"ICD-CELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPA0","description":"ICD-BIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intrafraction track motion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6017","description":"Intrafraction track motion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1090T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1090T","description":"CPT-1090T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elec knee-shin swing/stance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5856","description":"Elec knee-shin swing/stance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Functional outcome assessment documented_ care plan not documented_ documentation the patient is not eligible for a care plan at the time of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9227","description":"Functional outcome assessment documented_ care plan not documented_ documentation the patient is not eligible for a care plan at the time of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28C","description":"Clinically Complex _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59120","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE245","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism persivia clinical decision support_ as defined by the medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1023","description":"Clinical decision support mechanism persivia clinical decision support_ as defined by the medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ext h rate epi sz 14 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0381T","description":"Ext h rate epi sz 14 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSA1","description":"ICD-GCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace aortic valve open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33362","description":"Replace aortic valve open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Legionella micdadei ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87277","description":"Legionella micdadei ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol amino acid >","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4178","description":"Parenteral sol amino acid >","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion of cipaglucosidase alfa-atga_ including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of recei","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0138","description":"Intravenous infusion of cipaglucosidase alfa-atga_ including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of recei","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACB0","description":"ICD-AACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXC0","description":"ICD-FBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVA1","description":"ICD-NIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin barrier liquid per oz","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4369","description":"Skin barrier liquid per oz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA52","description":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCC0","description":"ICD-NHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fxnl status assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1170F","description":"Fxnl status assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intracranial complete study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93886","description":"Intracranial complete study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL2D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown full cast high noble m","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2790","description":"Crown full cast high noble m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKD0","description":"ICD-BGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Zenith Amniotic Membrane_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4253","description":"Zenith Amniotic Membrane_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and radiotracer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52250","description":"Cystoscopy and radiotracer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ gadopiclenol_ 1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9573","description":"Injection_ gadopiclenol_ 1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Irrigation supply sleeve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4397","description":"Irrigation supply sleeve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove in/ex hem groups 2+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46260","description":"Remove in/ex hem groups 2+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Incomplete Abortion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X2060","description":"Hospital Special Treatment Room Support Component (Hstrsc) Incomplete Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair narrowing device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0969","description":"Wheelchair narrowing device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC241","description":"Clinically Complex _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chronic pain management and treatment_ monthly bundle including_ diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G3002","description":"Chronic pain management and treatment_ monthly bundle including_ diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWA0","description":"ICD-LCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC125","description":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB134","description":"Special Care High _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLE1","description":"ICD-EFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX33","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYE0","description":"ICD-OAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bendamustine HCl (Bendeka)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9034","description":"Injection_ bendamustine HCl (Bendeka)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of androstenedione","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82157","description":"Assay of androstenedione","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRC0","description":"ICD-HFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin sub graft t/a/l add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15272","description":"Skin sub graft t/a/l add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVE1","description":"ICD-BCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIB0","description":"ICD-ECIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35001","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC215","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ca tx e-stim electr/transduc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4555","description":"Ca tx e-stim electr/transduc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93314","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGE0","description":"ICD-JBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEC0","description":"ICD-FCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWE0","description":"ICD-HHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIC1","description":"ICD-CAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETF1","description":"ICD-KETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQC0","description":"ICD-GGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Giardia lamblia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86674","description":"Giardia lamblia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Most recent assess vol mgmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8955","description":"Most recent assess vol mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"FlowerAmnioPatch_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4178","description":"FlowerAmnioPatch_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTC1","description":"ICD-FFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDE0","description":"ICD-OJDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAD0","description":"ICD-MEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interfyl_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4171","description":"Interfyl_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIC1","description":"ICD-MGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQA1","description":"ICD-KHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKF1","description":"ICD-OGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gen_ neuro_ hf_ rechg bat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1822","description":"Gen_ neuro_ hf_ rechg bat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mycophenolate mofetil oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7517","description":"Mycophenolate mofetil oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKD0","description":"ICD-GBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYD0","description":"ICD-DEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens spher bifoc plano 4.00d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2200","description":"Lens spher bifoc plano 4.00d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSF0","description":"ICD-HHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYC1","description":"ICD-ODYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Supplies and accessories (e.g._ transducer) for low frequency ultrasonic diathermy treatment device_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1036","description":"Supplies and accessories (e.g._ transducer) for low frequency ultrasonic diathermy treatment device_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEID0","description":"ICD-FEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of vasopressin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84588","description":"Assay of vasopressin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYB1","description":"ICD-LHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXF0","description":"ICD-FBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXB1","description":"ICD-KIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1DC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DC11","description":"ICD-1DC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAE0","description":"ICD-BAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove eye implant material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67120","description":"Remove eye implant material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICE1","description":"ICD-BICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMB1","description":"ICD-NHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psori tool doc w/benchmk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9649","description":"Psori tool doc w/benchmk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDB0","description":"ICD-OJDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC130","description":"Clinically Complex _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp iliorenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35634","description":"Art byp iliorenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytomeg dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87496","description":"Cytomeg dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES212","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHE0","description":"ICD-EGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ levoleucovorin (khapzory)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0642","description":"Injection_ levoleucovorin (khapzory)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKD1","description":"ICD-GBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRC0","description":"ICD-PKRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPF0","description":"ICD-BAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown resin-based indirect","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2710","description":"Crown resin-based indirect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLA0","description":"ICD-EDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ melphalan (Evomela)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9246","description":"Injection_ melphalan (Evomela)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVB0","description":"ICD-NHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAF1","description":"ICD-NAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prepare fecal microbiota","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44705","description":"Prepare fecal microbiota","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pacemaker_ leadless_ dual chamber (right atrial and right ventricular implantable components)_ rate-responsive_ including all necessary components for implantation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1605","description":"Pacemaker_ leadless_ dual chamber (right atrial and right ventricular implantable components)_ rate-responsive_ including all necessary components for implantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Maxillary part denture flex","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5225","description":"Maxillary part denture flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mycobacteria dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87550","description":"Mycobacteria dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiofrequency spectroscopy_ real time_ intraoperative margin assessment_ at the time of partial mastectomy_ with report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0546T","description":"Radiofrequency spectroscopy_ real time_ intraoperative margin assessment_ at the time of partial mastectomy_ with report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4370","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","description":"HCPCS-Q4370","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sent lymph node biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8878","description":"Sent lymph node biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBA1","description":"ICD-EBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0603","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0603","description":"CDT-D0603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC117","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTE1","description":"ICD-CHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Imatinib 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0088","description":"Imatinib 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKB0","description":"ICD-BGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLE0","description":"ICD-AHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCE1","description":"ICD-BDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXE0","description":"ICD-JCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMB1","description":"ICD-BCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33778","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reeva FT_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4314","description":"Reeva FT_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Masters two step","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3904","description":"Masters two step","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABID0","description":"ICD-ABID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fee covid-19 vac 2 res","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0014A","description":"Fee covid-19 vac 2 res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAD0","description":"ICD-GEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIA0","description":"ICD-CDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGB0","description":"ICD-KDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: temporal headaches in patients over 55 years of age","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2192","description":"Patients with clinical indications for imaging of the head: temporal headaches in patients over 55 years of age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDE0","description":"ICD-EHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC14D","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDED0","description":"ICD-EDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23540","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEE1","description":"ICD-JBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCB0","description":"ICD-NDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMD0","description":"ICD-CGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intervene hlth/behave indiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96152","description":"Intervene hlth/behave indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3D) mammography results documented and reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9899","description":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3D) mammography results documented and reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWE0","description":"ICD-GAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHD1","description":"ICD-GAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUC1","description":"ICD-ADUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGB1","description":"ICD-BHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYB1","description":"ICD-OCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18B","description":"Clinically Complex _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28A","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sitz bath chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0162","description":"Sitz bath chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRA1","description":"ICD-CFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCB0","description":"ICD-IGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-15011","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","description":"CPT-15011","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKC1","description":"ICD-KGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBE0","description":"ICD-GDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFF1","description":"ICD-FBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB22C","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cd4+ cell count >= 500 cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3496F","description":"Cd4+ cell count >= 500 cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ko swedish type pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1850","description":"Ko swedish type pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELC1","description":"ICD-KELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHB0","description":"ICD-GAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIC1","description":"ICD-KCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion 2 or more 3d images","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0395","description":"Fusion 2 or more 3d images","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64795","description":"Biopsy of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD244","description":"Clinically Complex _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Truss double w/ standard pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8310","description":"Truss double w/ standard pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis - bitewing radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0388","description":"intraoral tomosynthesis - bitewing radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair detachable foot r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1070","description":"Wheelchair detachable foot r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove inner ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69910","description":"Remove inner ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBC1","description":"ICD-JEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDA0","description":"ICD-JGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOD1","description":"ICD-LDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQB1","description":"ICD-HIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITD0","description":"ICD-AITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSF0","description":"ICD-DHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home visit sing/m/fam couns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99510","description":"Home visit sing/m/fam couns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXB0","description":"ICD-CBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ugt1a1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81350","description":"Ugt1a1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHD0","description":"ICD-NBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sodium thiosulfate (hope)_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0209","description":"Injection_ sodium thiosulfate (hope)_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMB0","description":"ICD-IAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28D","description":"Special Care High _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by dna-based testing status_ or both","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1193","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by dna-based testing status_ or both","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBD1","description":"ICD-CCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJE0","description":"ICD-BFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression arm sleeve and glove combination_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6574","description":"Gradient compression arm sleeve and glove combination_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFA0","description":"ICD-JDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPB0","description":"ICD-FAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYD1","description":"ICD-HAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAC0","description":"ICD-GIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lefort i-1 piece w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21141","description":"Lefort i-1 piece w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAE1","description":"ICD-ABAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBND0","description":"ICD-BBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ infliximab-axxq_ biosimilar_ (AVSOLA)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5121","description":"Injection_ infliximab-axxq_ biosimilar_ (AVSOLA)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCE0","description":"ICD-CGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUA1","description":"ICD-MHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDF0","description":"ICD-MCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Culture type immunofluoresc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87140","description":"Culture type immunofluoresc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPA0","description":"ICD-FHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of diaphragm hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39541","description":"Repair of diaphragm hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATE1","description":"ICD-KATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKF1","description":"ICD-KIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of vitamin b-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84425","description":"Assay of vitamin b-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKF1","description":"ICD-GBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGD1","description":"ICD-KFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA05","description":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUA0","description":"ICD-ICUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC22A","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rem odontogen cyst > 1.25 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7451","description":"Rem odontogen cyst > 1.25 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKD0","description":"ICD-JFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWA0","description":"ICD-CIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJA1","description":"ICD-KBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMB0","description":"ICD-FAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrodiag polyneuro 6 mn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3751F","description":"Electrodiag polyneuro 6 mn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWD1","description":"ICD-PEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTD0","description":"ICD-MKTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Segmental pneumatic chest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0657","description":"Segmental pneumatic chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMA0","description":"ICD-AIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28730","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLA1","description":"ICD-NJLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lutetium lu 177_ dotatate_ therapeutic_ 1 millicure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9513","description":"Lutetium lu 177_ dotatate_ therapeutic_ 1 millicure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTF0","description":"ICD-NJTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFA1","description":"ICD-NGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ neurostim test kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1897","description":"Lead_ neurostim test kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXA1","description":"ICD-CCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Prostate)_ Mrna_ Microarray Gene Expression Profiling Of 22 Content Genes_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_ Algorithm Reported As Metastasis Risk S","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81542","description":"Oncology (Prostate)_ Mrna_ Microarray Gene Expression Profiling Of 22 Content Genes_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_ Algorithm Reported As Metastasis Risk S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aspirin/clopidogrel rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4086F","description":"Aspirin/clopidogrel rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interv req for leak","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9306","description":"Interv req for leak","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBE0","description":"ICD-ICBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMD1","description":"ICD-NLMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPF0","description":"ICD-FFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-49188","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","description":"CPT-49188","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGE1","description":"ICD-KHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISE0","description":"ICD-DISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ rimabotulinumtoxinb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0587","description":"Inj_ rimabotulinumtoxinb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKC0","description":"ICD-NEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat elbow dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24615","description":"Treat elbow dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOB0","description":"ICD-LHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHB1","description":"ICD-KDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ost pouch absorbent material","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4422","description":"Ost pouch absorbent material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent observation care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99226","description":"Subsequent observation care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atria","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0825T","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atria","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTD0","description":"ICD-CGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAE1","description":"ICD-BAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCC0","description":"ICD-FGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVD0","description":"ICD-ODVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC13C","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAA0","description":"ICD-GBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect tibia tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27645","description":"Resect tibia tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQF1","description":"ICD-PAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB4C","description":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx colon t1-4 no dx prog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9086","description":"Onc dx colon t1-4 no dx prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inpnt stay radiolabeled item","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9898","description":"Inpnt stay radiolabeled item","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat shoulder blade fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23575","description":"Treat shoulder blade fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANB1","description":"ICD-CANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam neck spine 2-3 vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72040","description":"X-ray exam neck spine 2-3 vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUE1","description":"ICD-BDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFE0","description":"ICD-OIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTD1","description":"ICD-FCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAB0","description":"ICD-NLAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Follow-Up And Mrs Score Assessed At 90 Days Following Endovascular Stroke Intervention","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0045","description":"Clinical Follow-Up And Mrs Score Assessed At 90 Days Following Endovascular Stroke Intervention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIB0","description":"ICD-GAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq lumbosacral injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22511","description":"Perq lumbosacral injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cefotaxime sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0698","description":"Cefotaxime sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUB1","description":"ICD-OAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0403","description":"HCPCS-B0403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELF0","description":"ICD-BELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision and repair of eyelid_ involving lid margin_ tarsus_ conjunctiva_ canthus_ or full thickness_ may include preparation for skin graft or pedicle flap with adjacent tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67961","description":"Excision and repair of eyelid_ involving lid margin_ tarsus_ conjunctiva_ canthus_ or full thickness_ may include preparation for skin graft or pedicle flap with adjacent tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNA0","description":"ICD-FFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gene test beta-thalassemia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3846","description":"Gene test beta-thalassemia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18F","description":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRA1","description":"ICD-PCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prepare donor intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44715","description":"Prepare donor intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAE0","description":"ICD-GEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8D","description":"Medium Rehab _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Connection of liver allograft to normothermic machine perfusion device_ hemostasis control; initial 4 hours of monitoring time_ including hourly physiological and laboratory a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0895T","description":"Connection of liver allograft to normothermic machine perfusion device_ hemostasis control; initial 4 hours of monitoring time_ including hourly physiological and laboratory a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBB1","description":"ICD-MFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELA1","description":"ICD-OELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFB0","description":"ICD-KGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Valrubicin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9357","description":"Valrubicin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N block stellate ganglion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64510","description":"N block stellate ganglion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis for chromosomal abnormalities_ copy number variants_ duplications/deletions_ inversions_ unb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0469U","description":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis for chromosomal abnormalities_ copy number variants_ duplications/deletions_ inversions_ unb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXC0","description":"ICD-OKXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPC0","description":"ICD-GGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct uppr extremity w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73202","description":"Ct uppr extremity w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brief emotional/behav assmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96127","description":"Brief emotional/behav assmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGA0","description":"ICD-OEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng leg cylinder pl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4033","description":"Cast sup lng leg cylinder pl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Weekly Bundle Not Including The Drug_ Including Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Testing If Performed (Pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2074","description":"Medication Assisted Treatment_ Weekly Bundle Not Including The Drug_ Including Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Testing If Performed (Pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore/biopsy eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67400","description":"Explore/biopsy eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vaginal hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58260","description":"Vaginal hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWD0","description":"ICD-GHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTD1","description":"ICD-KGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Measure blood oxygen level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94760","description":"Measure blood oxygen level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVB0","description":"ICD-NGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVB0","description":"ICD-BIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eval aud rehab status","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92626","description":"Eval aud rehab status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIB0","description":"ICD-NHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQC0","description":"ICD-OIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPD0","description":"ICD-JHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTF1","description":"ICD-MFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cabg artery-vein four","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33521","description":"Cabg artery-vein four","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAE1","description":"ICD-NCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise & repair chest wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32906","description":"Revise & repair chest wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth skin ext/per/atrunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40051","description":"Anesth skin ext/per/atrunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES11B","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEB0","description":"ICD-EIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not performing a dilated macular examination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9975","description":"Documentation of medical reason(s) for not performing a dilated macular examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1078T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1078T","description":"CPT-1078T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQD0","description":"ICD-KEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXD1","description":"ICD-KGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urinalysis nonauto w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81000","description":"Urinalysis nonauto w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOB0","description":"ICD-DCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amniply_ for topical use only_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4249","description":"Amniply_ for topical use only_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNC0","description":"ICD-KCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEC1","description":"ICD-IEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERE1","description":"ICD-DERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coronary artery angio s&i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93454","description":"Coronary artery angio s&i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wrmng 4 surg normothermia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4250F","description":"Wrmng 4 surg normothermia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMC1","description":"ICD-FHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare shor","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB06","description":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare shor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No documentation of a chlamydia screening test with proper follow-up","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9821","description":"No documentation of a chlamydia screening test with proper follow-up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXA1","description":"ICD-BBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIF0","description":"ICD-AHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALC0","description":"ICD-AALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of eye water bath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76513","description":"Echo exam of eye water bath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for level IV_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0753T","description":"Digitization of glass microscope slides for level IV_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMB0","description":"ICD-BDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYF0","description":"ICD-CCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUE0","description":"ICD-OIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of tibiofibular joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27871","description":"Fusion of tibiofibular joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0950T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","description":"CPT-0950T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJED0","description":"ICD-MJED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEE1","description":"ICD-FBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAC0","description":"ICD-CBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAA0","description":"ICD-GEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ labetalol hydrochloride (hikma) not therapeutically equivalent to j1820_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1921","description":"Injection_ labetalol hydrochloride (hikma) not therapeutically equivalent to j1820_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27530","description":"Treat knee fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ neurostimulator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1778","description":"Lead_ neurostimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPA1","description":"ICD-CAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup hip spica fiberglas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4026","description":"Cast sup hip spica fiberglas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1002","description":"HCPCS-C1002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open tx nose fx uncomplicatd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21325","description":"Open tx nose fx uncomplicatd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23921","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQE1","description":"ICD-PAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGC0","description":"ICD-GHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sinus aug w bone/bone sup","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7951","description":"Sinus aug w bone/bone sup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking thighlngth 30-40","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6534","description":"Gc stocking thighlngth 30-40","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGC0","description":"ICD-FCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDE1","description":"ICD-IIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHE0","description":"ICD-IHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLD1","description":"ICD-GHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWA1","description":"ICD-LHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUC0","description":"ICD-NCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nursing fac care subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99309","description":"Nursing fac care subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17274","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECB1","description":"ICD-KECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUB0","description":"ICD-NHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADA0","description":"ICD-FADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIA1","description":"ICD-EFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oropharyngeal suction catheter_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4628","description":"Oropharyngeal suction catheter_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Xray endovasc thor ao repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75956","description":"Xray endovasc thor ao repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGE1","description":"ICD-OLGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJC0","description":"ICD-BAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0585U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","description":"CPT-0585U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB224","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLC1","description":"ICD-NFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJA1","description":"ICD-GGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay alkaline phosphatase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84078","description":"Assay alkaline phosphatase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJC0","description":"ICD-NEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove lung pneumonectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32440","description":"Remove lung pneumonectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter w/o bag 2-way latex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4311","description":"Catheter w/o bag 2-way latex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant brain electrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61533","description":"Implant brain electrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1326","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","description":"HCPCS-J1326","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIB1","description":"ICD-EEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMD0","description":"ICD-KBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVE0","description":"ICD-GHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMD1","description":"ICD-OLMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNC0","description":"ICD-JCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQF1","description":"ICD-DHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEB1","description":"ICD-EAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICE1","description":"ICD-IICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAA0","description":"ICD-JHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIA0","description":"ICD-CCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA40","description":"High Rehab _ ADL Index 0-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove gastric port open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43887","description":"Remove gastric port open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAC0","description":"ICD-MHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABD1","description":"ICD-KABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Preventive Medicine Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4029","description":"Preventive Medicine Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24115","description":"Remove/graft bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAD0","description":"ICD-KCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (asceniv)_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1554","description":"Injection_ immune globulin (asceniv)_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Death occurring after discharge from the hospital but within 30 days post procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9816","description":"Death occurring after discharge from the hospital but within 30 days post procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML13","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVB1","description":"ICD-KFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOD1","description":"ICD-KGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fern test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0114","description":"Fern test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL4D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC114","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ stranded_ c-131","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2642","description":"Brachytx_ stranded_ c-131","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of homocystine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83090","description":"Assay of homocystine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0101","description":"HCPCS-C0101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7519","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAD1","description":"ICD-NDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35021","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat midfoot fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28465","description":"Treat midfoot fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMB1","description":"ICD-NIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lice treatment_ topical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9180","description":"Lice treatment_ topical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (hospira) not therapeutically equivalent to j9305_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9294","description":"Injection_ pemetrexed (hospira) not therapeutically equivalent to j9305_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0480U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","description":"CPT-0480U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim-fpgk (stimufend)_ biosimilar_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5127","description":"Injection_ pegfilgrastim-fpgk (stimufend)_ biosimilar_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBC0","description":"ICD-IGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rituximab_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9310","description":"Injection_ rituximab_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Lung)_ Mrna_ Quantitative Pcr Analysis Of 11 Genes (Bag1_ Brca1_ Cdc6_ Cdk2Ap1_ Erbb3_ Fut3_ Il11_ Lck_ Rnd3_ Sh3Bgr_ Wnt3A) And 3 Reference Genes (Esd_ Tbp_ Yap1)_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0288U","description":"Oncology (Lung)_ Mrna_ Quantitative Pcr Analysis Of 11 Genes (Bag1_ Brca1_ Cdc6_ Cdk2Ap1_ Erbb3_ Fut3_ Il11_ Lck_ Rnd3_ Sh3Bgr_ Wnt3A) And 3 Reference Genes (Esd_ Tbp_ Yap1)_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA35","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA10","description":"Default_ /5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILE0","description":"ICD-NILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pov group 1 std up to 300lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0800","description":"Pov group 1 std up to 300lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL4D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYB0","description":"ICD-HIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove/transplant tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23440","description":"Remove/transplant tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAC0","description":"ICD-EEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKC0","description":"ICD-CHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEF1","description":"ICD-IIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKB0","description":"ICD-KDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXA1","description":"ICD-FAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0703","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0703","description":"HCPCS-A0703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLE0","description":"ICD-KBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA06","description":"Default_ /SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Methocarbamol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2800","description":"Methocarbamol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67930","description":"Repair eyelid wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETB1","description":"ICD-BETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Procarbazine_ oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0182","description":"Procarbazine_ oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repl electrode for aed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0609","description":"Repl electrode for aed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dispos cont lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0500","description":"Dispos cont lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHME0","description":"ICD-JHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFED0","description":"ICD-GFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BC11","description":"ICD-2BC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reremove wrist tendon lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25112","description":"Reremove wrist tendon lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES24B","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMF0","description":"ICD-EHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDE1","description":"ICD-AEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQC0","description":"ICD-LEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transferase (ast) (sgot)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84450","description":"Transferase (ast) (sgot)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect leg/ankle tum 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27616","description":"Resect leg/ankle tum 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTC0","description":"ICD-GHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N block inj plantar digit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64455","description":"N block inj plantar digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPA1","description":"ICD-KAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc plan hybrid/stage proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9640","description":"Doc plan hybrid/stage proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Factor ix fc fusion recomb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7201","description":"Factor ix fc fusion recomb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOD1","description":"ICD-DGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLD1","description":"ICD-BCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prefab stainless steel crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2933","description":"Prefab stainless steel crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of achilles tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27654","description":"Repair of achilles tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct bone density axial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77078","description":"Ct bone density axial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBD0","description":"ICD-FEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Salicylate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80179","description":"Salicylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIE0","description":"ICD-IFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perc drug-el cor stent bran","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9601","description":"Perc drug-el cor stent bran","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove lumb artif disc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22865","description":"Remove lumb artif disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transplt autol hct/donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38241","description":"Transplt autol hct/donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Barium swallow test not req","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3200F","description":"Barium swallow test not req","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJD0","description":"ICD-CDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insj/rplc cardiac modulj sys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0408T","description":"Insj/rplc cardiac modulj sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anticoagulant mgmt initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99363","description":"Anticoagulant mgmt initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCA0","description":"ICD-ODCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ taliglucerase alfa_ 10 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3060","description":"Injection_ taliglucerase alfa_ 10 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGB1","description":"ICD-BAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD134","description":"Special Care High _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient screened for tobacco use and identified as a tobacco user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9902","description":"Patient screened for tobacco use and identified as a tobacco user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPF1","description":"ICD-GFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Merkel cell carcinoma)_ detection of antibodies to the Merkel cell polyoma virus oncoprotein (small T antigen)_ serum_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0058U","description":"Oncology (Merkel cell carcinoma)_ detection of antibodies to the Merkel cell polyoma virus oncoprotein (small T antigen)_ serum_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVC0","description":"ICD-GHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCF1","description":"ICD-MLCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23146","description":"Removal of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Standard size footplate each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0042","description":"Standard size footplate each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hg a1c level 7.0-9.0%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3045F","description":"Hg a1c level 7.0-9.0%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX2D","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBID0","description":"ICD-CBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEE1","description":"ICD-FAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJF0","description":"ICD-GFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABB0","description":"ICD-KABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFC1","description":"ICD-NAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lpn home care per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1031","description":"Lpn home care per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXF0","description":"ICD-NCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33694","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHF0","description":"ICD-GGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHD0","description":"ICD-CGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocolld drg > 48 in w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6236","description":"Hydrocolld drg > 48 in w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft subclav-brchial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35512","description":"Art byp grft subclav-brchial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replantation foot complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20838","description":"Replantation foot complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDB1","description":"ICD-IIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOA0","description":"ICD-KDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGF1","description":"ICD-GCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFC1","description":"ICD-BCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEE1","description":"ICD-MAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEF0","description":"ICD-ADEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCB0","description":"ICD-NCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove pilonidal cyst compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11772","description":"Remove pilonidal cyst compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Janssen Covid-19 Vaccine Administration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0031A","description":"Janssen Covid-19 Vaccine Administration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUF1","description":"ICD-FFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC154","description":"Clinically Complex _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/svc oxygen equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0740","description":"Repair/svc oxygen equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orbitocranial approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61585","description":"Orbitocranial approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRE0","description":"ICD-LIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRC1","description":"ICD-GFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWE1","description":"ICD-DEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD212","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOA0","description":"ICD-PHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAE1","description":"ICD-OJAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAD0","description":"ICD-CFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHB0","description":"ICD-NCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIA0","description":"ICD-OKIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOD0","description":"ICD-OGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE215","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0102","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0102","description":"CDT-D0102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITC0","description":"ICD-AITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIB0","description":"ICD-OIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laser tx skin 250-500 sq cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96921","description":"Laser tx skin 250-500 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJD0","description":"ICD-NAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCC0","description":"ICD-NFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Canal prep/fitting of dowel","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3950","description":"Canal prep/fitting of dowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOE1","description":"ICD-LAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Us guidance fetal reduct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8055","description":"Us guidance fetal reduct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA254","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCE1","description":"ICD-GCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear diagnostic exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78999","description":"Nuclear diagnostic exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACB1","description":"ICD-CACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24155","description":"Removal of elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAE0","description":"ICD-MEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transpetrosal approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61598","description":"Transpetrosal approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Metatarsal joint implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8641","description":"Metatarsal joint implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCC1","description":"ICD-BFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMC0","description":"ICD-AGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSB0","description":"ICD-OCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRB1","description":"ICD-OBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cyto/molecular report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88291","description":"Cyto/molecular report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-sterile gloves","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4927","description":"Non-sterile gloves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement Of Lost Or Broken Retainer - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8704","description":"Replacement Of Lost Or Broken Retainer - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPC0","description":"ICD-OCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEB1","description":"ICD-MBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKF1","description":"ICD-KHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC130","description":"Reduced Physical Function _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oprelvekin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2355","description":"Oprelvekin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap revise/remv eltrd antrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43648","description":"Lap revise/remv eltrd antrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pouch drainable w barrier at","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5061","description":"Pouch drainable w barrier at","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Albuterol ipratrop non-comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7620","description":"Albuterol ipratrop non-comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSF0","description":"ICD-OLSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIE1","description":"ICD-OCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocolld drg <=16 in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6237","description":"Hydrocolld drg <=16 in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elec osteogen stim spinal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0748","description":"Elec osteogen stim spinal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Als 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0426","description":"Als 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sumatriptan succinate / 6 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3030","description":"Sumatriptan succinate / 6 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCB0","description":"ICD-KGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAA1","description":"ICD-OLAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIA0","description":"ICD-KIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace duod/jej tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49451","description":"Replace duod/jej tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg 1.1-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11642","description":"Exc f/e/e/n/l mal+mrg 1.1-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Colorectal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1087","description":"Radiation Therapy For Colorectal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHB1","description":"ICD-BBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSE1","description":"ICD-PJSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIF0","description":"ICD-NCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"In ear binaural hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5130","description":"In ear binaural hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHD0","description":"ICD-FCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFF0","description":"ICD-BHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transvaginal us non-ob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76830","description":"Transvaginal us non-ob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onsite Ac C Tx Nsg Fac Res Copd/As Bill Sid-Bnef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9681","description":"Onsite Ac C Tx Nsg Fac Res Copd/As Bill Sid-Bnef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB23D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METD0","description":"ICD-METD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neuromodulation stimulator system_ adjunct to rehabilitation therapy regime_ mouthpiece each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4594","description":"Neuromodulation stimulator system_ adjunct to rehabilitation therapy regime_ mouthpiece each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESC0","description":"ICD-OESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28675","description":"Repair of toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Supplies For Maintenance Of Insulin Infusion Pump With Dosage Rate Adjustment Using Therapeutic Continuous Glucose Sensing_ Per Week","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4226","description":"Supplies For Maintenance Of Insulin Infusion Pump With Dosage Rate Adjustment Using Therapeutic Continuous Glucose Sensing_ Per Week","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin pedicle flap arms/legs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15572","description":"Skin pedicle flap arms/legs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRC0","description":"ICD-HIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTF0","description":"ICD-NHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQF0","description":"ICD-CEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHD1","description":"ICD-EEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXC1","description":"ICD-BEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLF0","description":"ICD-MGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML3C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHA1","description":"ICD-NHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFF0","description":"ICD-CEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBD1","description":"ICD-GGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC250","description":"Special Care High _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECA0","description":"ICD-GECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise breast duct fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19112","description":"Excise breast duct fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epidrm autogrft trnk/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15110","description":"Epidrm autogrft trnk/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJD0","description":"ICD-GBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWA0","description":"ICD-OFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N block inj ilio-ing/hypogi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64425","description":"N block inj ilio-ing/hypogi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prol intubation req","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8569","description":"Prol intubation req","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESD0","description":"ICD-CESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISB0","description":"ICD-HISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUF1","description":"ICD-BFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKB1","description":"ICD-FDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATC0","description":"ICD-OATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFD0","description":"ICD-NCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAD1","description":"ICD-AIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIF1","description":"ICD-NLIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IADNA SARSCOV2& INF A&B MULT AMPLIFIED PROBE TQ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87636","description":"IADNA SARSCOV2& INF A&B MULT AMPLIFIED PROBE TQ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGA1","description":"ICD-JCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETF0","description":"ICD-IETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0534","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","description":"HCPCS-G0534","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25929","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy removal of clots","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52001","description":"Cystoscopy removal of clots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dihydrotestosterone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6047","description":"Dihydrotestosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWD0","description":"ICD-LBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"U/s trtmt_ not leiomyomata","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9734","description":"U/s trtmt_ not leiomyomata","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRA0","description":"ICD-PHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALE1","description":"ICD-CALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDA1","description":"ICD-JCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ped size pull-on lg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4532","description":"Ped size pull-on lg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy splenectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38120","description":"Laparoscopy splenectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFF0","description":"ICD-OCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYE0","description":"ICD-KIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LA11","description":"ICD-3LA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVD0","description":"ICD-JEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followin","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB60","description":"Low Rehab_ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVB0","description":"ICD-ODVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUD1","description":"ICD-KBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2GB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GB21","description":"ICD-2GB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXD1","description":"ICD-OEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE131","description":"Clinically Complex _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eval on foot documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8410","description":"Eval on foot documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unspec maxillofacial prosth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8048","description":"Unspec maxillofacial prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJD1","description":"ICD-ODJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEC0","description":"ICD-JFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWE0","description":"ICD-PDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA54","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pierce skull & explore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61253","description":"Pierce skull & explore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIE0","description":"ICD-NEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo guide for transfusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76941","description":"Echo guide for transfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dx bronchoscope/brush","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31623","description":"Dx bronchoscope/brush","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Egd cautery tumor polyp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43250","description":"Egd cautery tumor polyp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX4B","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rbc deglycerolized","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9039","description":"Rbc deglycerolized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tb scrng done-interpd 6mon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3455F","description":"Tb scrng done-interpd 6mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44141","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL06","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove windpipe lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31786","description":"Remove windpipe lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUA0","description":"ICD-BHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHA0","description":"ICD-IFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAE0","description":"ICD-JCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRC0","description":"ICD-DBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial exchange transfusion_ blood_ plasma or crystalloid necessitating the skill of a physician or other qualified health care professional_ newborn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36456","description":"Partial exchange transfusion_ blood_ plasma or crystalloid necessitating the skill of a physician or other qualified health care professional_ newborn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOC1","description":"ICD-DCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDF0","description":"ICD-MFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWC0","description":"ICD-GAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation stating the patient has received or is currently receiving palliative or hospice care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1307","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0203","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0203","description":"HCPCS-C0203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA36","description":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUE0","description":"ICD-CHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove extra spine segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22116","description":"Remove extra spine segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELB0","description":"ICD-GELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"repair cast partial framework_ maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5622","description":"repair cast partial framework_ maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Automated Analysis Of An Existing Computed Tomography Study For Vertebral Fracture(S)_ Including Assessment Of Bone Density When Performed_ Data Preparation_ Interpretation_ A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0691T","description":"Automated Analysis Of An Existing Computed Tomography Study For Vertebral Fracture(S)_ Including Assessment Of Bone Density When Performed_ Data Preparation_ Interpretation_ A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAF0","description":"ICD-AIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVC1","description":"ICD-BAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHF1","description":"ICD-EIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLA1","description":"ICD-KDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3HA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HA11","description":"ICD-3HA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert palate implants","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9727","description":"Insert palate implants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWD1","description":"ICD-CCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ open or percutaneous_ incl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37246","description":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ open or percutaneous_ incl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCA0","description":"ICD-NCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat spinal cord lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62280","description":"Treat spinal cord lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40816","description":"Excision of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKA0","description":"ICD-BBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRB0","description":"ICD-CFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOD0","description":"ICD-KHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAC1","description":"ICD-KDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prostate laser enucleation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52649","description":"Prostate laser enucleation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ olipudase alfa-rpcp_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0218","description":"Injection_ olipudase alfa-rpcp_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTA0","description":"ICD-CDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement breastpump adpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4282","description":"Replacement breastpump adpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXB1","description":"ICD-OKXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove contraceptive capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11976","description":"Remove contraceptive capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHME1","description":"ICD-BHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27720","description":"Repair of tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUC0","description":"ICD-MHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQF1","description":"ICD-CDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBF0","description":"ICD-BCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUD0","description":"ICD-JGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9726","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKA1","description":"ICD-NLKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect/debride pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48105","description":"Resect/debride pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGA0","description":"ICD-NIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJA1","description":"ICD-GAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEND1","description":"ICD-OEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC22A","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA134","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiopharm rx agent noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9699","description":"Radiopharm rx agent noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFA1","description":"ICD-NKFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPE1","description":"ICD-OAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTA0","description":"ICD-EFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSA1","description":"ICD-DBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTB1","description":"ICD-NFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA14A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBA1","description":"ICD-MIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interphalangeal joint spacer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8658","description":"Interphalangeal joint spacer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNB0","description":"ICD-GBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAF1","description":"ICD-JEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1494","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","description":"HCPCS-M1494","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJA0","description":"ICD-FFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPF1","description":"ICD-OFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRE1","description":"ICD-CIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ef blenderized foods","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4149","description":"Ef blenderized foods","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUB1","description":"ICD-ADUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLE0","description":"ICD-CGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA5B","description":"Default_ /PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC156","description":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBA1","description":"ICD-AEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEB0","description":"ICD-NIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDC0","description":"ICD-MCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWF1","description":"ICD-OCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHB0","description":"ICD-CFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00640","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00640","description":"CPT-00640","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45110","description":"Removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIB0","description":"ICD-FBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELE0","description":"ICD-OELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYA0","description":"ICD-OLYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNF1","description":"ICD-JGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adhesion barrier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1765","description":"Adhesion barrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOC0","description":"ICD-DEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALD0","description":"ICD-IALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acute bronchitis/bronchiolitis episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to or on the episode date","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2177","description":"Acute bronchitis/bronchiolitis episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to or on the episode date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1GA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GA31","description":"ICD-1GA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB2C","description":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXF0","description":"ICD-NFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ue triple control harness","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6677","description":"Ue triple control harness","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELC1","description":"ICD-MELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDF1","description":"ICD-AEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINE1","description":"ICD-OINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Accession of brush biopsy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0486","description":"Accession of brush biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1409","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","description":"HCPCS-M1409","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls repos perph cnula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33962","description":"Ecmo/ecls repos perph cnula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEE1","description":"ICD-EHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEA0","description":"ICD-JAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUD1","description":"ICD-NEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOE0","description":"ICD-PIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elosulfase alfa_ injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1322","description":"Elosulfase alfa_ injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBE1","description":"ICD-MKBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bso omentectomy w/tah","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58956","description":"Bso omentectomy w/tah","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3KA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KA11","description":"ICD-3KA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1-Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66989","description":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1-Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQF1","description":"ICD-DAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcyl bifocal 4.00d/.1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2203","description":"Lens sphcyl bifocal 4.00d/.1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVE1","description":"ICD-GEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQB1","description":"ICD-HDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNF0","description":"ICD-JDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIE1","description":"ICD-KHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMC1","description":"ICD-KGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETA0","description":"ICD-FETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGED1","description":"ICD-MGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKE1","description":"ICD-BBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBME0","description":"ICD-JBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens/es other type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2599","description":"Contact lens/es other type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXC0","description":"ICD-KFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Felbamate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80167","description":"Felbamate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enterectomy cadaver donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44132","description":"Enterectomy cadaver donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYC0","description":"ICD-OFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASA0","description":"ICD-KASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA0B","description":"High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNE1","description":"ICD-FFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (cutaneous melanoma)_ mRNA gene expression profiling by RT-PCR of 35 genes (32 content and 3 housekeeping)_ utilizing formalin-fixed paraffin-embedded (FFPE) tissue_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0314U","description":"Oncology (cutaneous melanoma)_ mRNA gene expression profiling by RT-PCR of 35 genes (32 content and 3 housekeeping)_ utilizing formalin-fixed paraffin-embedded (FFPE) tissue_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transperineal periurethral balloon continence device; unilateral placement_ including cystoscopy and fluoroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0549T","description":"Transperineal periurethral balloon continence device; unilateral placement_ including cystoscopy and fluoroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incontinence treatment systm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0740","description":"Incontinence treatment systm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVD1","description":"ICD-FCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEE0","description":"ICD-MFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEB0","description":"ICD-OKEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBA1","description":"ICD-AFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAE0","description":"ICD-NFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWC0","description":"ICD-LDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g._ inadequate time for follow-up_ patients who received a prior intravitreal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1325","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g._ inadequate time for follow-up_ patients who received a prior intravitreal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Back Pain Measured By The Visual Analog Scale (Vas) Pain At One Year (9 To 15 Months) Postoperatively Was Greater Than 3.0 And Back Pain Measured By The Visual Analog Scale (V","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2139","description":"Back Pain Measured By The Visual Analog Scale (Vas) Pain At One Year (9 To 15 Months) Postoperatively Was Greater Than 3.0 And Back Pain Measured By The Visual Analog Scale (V","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Docrsn no comm comorb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9232","description":"Docrsn no comm comorb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0659","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","description":"HCPCS-E0659","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Screen mammo doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3014F","description":"Screen mammo doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUD0","description":"ICD-BHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERD0","description":"ICD-CERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Community-acquired bacterial pneumonia assessment (includes all of the foll","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0118U","description":"Community-acquired bacterial pneumonia assessment (includes all of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFC0","description":"ICD-JAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBB1","description":"ICD-OJBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIC1","description":"ICD-JEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOB1","description":"ICD-ODOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adjustment of custom sleep apnea appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9948","description":"Adjustment of custom sleep apnea appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed fixed ht w/ mattres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0250","description":"Hosp bed fixed ht w/ mattres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYB1","description":"ICD-LAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTA0","description":"ICD-MCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHA1","description":"ICD-BGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQC0","description":"ICD-CEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of cheek nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64734","description":"Incision of cheek nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHA0","description":"ICD-BIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28090","description":"Removal of foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXC1","description":"ICD-KEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cell enumeration phys interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86153","description":"Cell enumeration phys interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ak/knee disartic silesian ba","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5698","description":"Ak/knee disartic silesian ba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home Delivered Meals-Emergency Pack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1762","description":"Home Delivered Meals-Emergency Pack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit immunotherapy diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9338","description":"Hit immunotherapy diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Carotid intima atheroma eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93895","description":"Carotid intima atheroma eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28G","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB22B","description":"Clinically Complex _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9959","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9959","description":"CDT-D9959","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain open retroperi abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49060","description":"Drain open retroperi abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc rect tum transanal full","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45172","description":"Exc rect tum transanal full","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1CC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CC31","description":"ICD-1CC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHB1","description":"ICD-NJHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace lensshield cartridge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4257","description":"Replace lensshield cartridge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPD0","description":"ICD-GEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Puncture/clear windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31612","description":"Puncture/clear windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRB1","description":"ICD-GBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28140","description":"Removal of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prenatal care atrisk assessm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1000","description":"Prenatal care atrisk assessm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of hand or foot nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64836","description":"Repair of hand or foot nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Habil sup empl waiver 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2019","description":"Habil sup empl waiver 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETE1","description":"ICD-JETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intrvasc us noncoronary 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37252","description":"Intrvasc us noncoronary 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood/lymph system procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38999","description":"Blood/lymph system procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEA0","description":"ICD-CAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pinworm examinations","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0113","description":"Pinworm examinations","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXD0","description":"ICD-BBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8F","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLB1","description":"ICD-KCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mod sed diff phys/qhp<5 yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99148","description":"Mod sed diff phys/qhp<5 yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted procedure colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45399","description":"Unlisted procedure colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Promethazine hcl 12.5mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0169","description":"Promethazine hcl 12.5mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEB0","description":"ICD-NKEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc rsn no adeno/neopl detec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9496","description":"Doc rsn no adeno/neopl detec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUB0","description":"ICD-IHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDE0","description":"ICD-FFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg) Continuous Recording_ With Video When Performed_ Setup_ Patient Education_ And Takedown When Performed_ Administered In Person By Eeg Technologist_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95700","description":"Electroencephalogram (Eeg) Continuous Recording_ With Video When Performed_ Setup_ Patient Education_ And Takedown When Performed_ Administered In Person By Eeg Technologist_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"DermaBind FM_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4313","description":"DermaBind FM_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHE1","description":"ICD-FBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA41","description":"Medium Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orthopedic ftwear ladies oxf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3215","description":"Orthopedic ftwear ladies oxf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ crotalidae immune F(ab_)2 (equine)_ 120 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0841","description":"Injection_ crotalidae immune F(ab_)2 (equine)_ 120 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOE0","description":"ICD-HCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flex foot system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5980","description":"Flex foot system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ciltacabtagene autoleucel_ up to 100 million autologous B-cell maturation antigen (BCMA) directed CAR-positive T cells_ including leukapheresis and dose preparation procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9098","description":"Ciltacabtagene autoleucel_ up to 100 million autologous B-cell maturation antigen (BCMA) directed CAR-positive T cells_ including leukapheresis and dose preparation procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELC0","description":"ICD-OELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tc99 tilmanocept diag 0.5mci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9520","description":"Tc99 tilmanocept diag 0.5mci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01680","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01680","description":"CPT-01680","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of stomach partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43635","description":"Removal of stomach partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRE1","description":"ICD-PGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Postop app non-wgt bear dsg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5450","description":"Postop app non-wgt bear dsg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHC1","description":"ICD-OBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAB0","description":"ICD-OGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOE1","description":"ICD-PHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q0519","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0519","description":"HCPCS-Q0519","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQE1","description":"ICD-PIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNE1","description":"ICD-FHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0495U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","description":"CPT-0495U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0603U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","description":"CPT-0603U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis B virus (HBV) status assessed and results interpreted prior to initiating anti-TNF (tumor necrosis factor) therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9912","description":"Hepatitis B virus (HBV) status assessed and results interpreted prior to initiating anti-TNF (tumor necrosis factor) therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eo elas w/metal jnts pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3710","description":"Eo elas w/metal jnts pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECC0","description":"ICD-OECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1CB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CB31","description":"ICD-1CB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Control unit bowel system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0350","description":"Control unit bowel system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antiepileptics nos 7/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80341","description":"Antiepileptics nos 7/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft fem-femoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35558","description":"Art byp grft fem-femoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHB1","description":"ICD-EDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLE1","description":"ICD-CCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAE0","description":"ICD-JIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ exosome-based analysis of 53 small noncoding RNAs (sncRNAs) by quantitative reverse transcription polymerase chain reaction (RT-qPCR)_ urine_ reported as","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0424U","description":"Oncology (prostate)_ exosome-based analysis of 53 small noncoding RNAs (sncRNAs) by quantitative reverse transcription polymerase chain reaction (RT-qPCR)_ urine_ reported as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat kneecap dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27560","description":"Treat kneecap dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0995T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","description":"CPT-0995T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBF1","description":"ICD-KDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJF0","description":"ICD-KCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transplants of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27397","description":"Transplants of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARD1","description":"ICD-LARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEB0","description":"ICD-GCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB35","description":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRD1","description":"ICD-KFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17270","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENA0","description":"ICD-JENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trluml perip athrc abd aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0236T","description":"Trluml perip athrc abd aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGC1","description":"ICD-KEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair ruptd popliteal art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35152","description":"Repair ruptd popliteal art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar bolster pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1030","description":"Lumbar bolster pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB254","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBA1","description":"ICD-KHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWA1","description":"ICD-OKWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUB1","description":"ICD-OLUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of catheter vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36481","description":"Insertion of catheter vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"SARSCOV2 VAC 25MCG/0.25ML IM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91311","description":"SARSCOV2 VAC 25MCG/0.25ML IM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of arsenic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82175","description":"Assay of arsenic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCF1","description":"ICD-IFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPC0","description":"ICD-OJPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-38226","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","description":"CPT-38226","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHF1","description":"ICD-BHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plmt nephroureteral catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50433","description":"Plmt nephroureteral catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATA1","description":"ICD-GATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20520","description":"Removal of foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16070","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16070","description":"CPT-16070","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with dementia any time during the patient_s history through the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1164","description":"Patients with dementia any time during the patient_s history through the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB214","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHB1","description":"ICD-MEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBA0","description":"ICD-NKBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWF1","description":"ICD-LIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9175","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9175","description":"HCPCS-C9175","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Water circ heat pad w pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0217","description":"Water circ heat pad w pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Potassium hydroxide preps","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0112","description":"Potassium hydroxide preps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTC1","description":"ICD-NDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tongue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41140","description":"Removal of tongue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical revision procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4268","description":"Surgical revision procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAA0","description":"ICD-MFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA SHIGA-LIKE TOXIN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87427","description":"IAAD IA SHIGA-LIKE TOXIN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wrist arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29843","description":"Wrist arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise sperm duct pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55600","description":"Incise sperm duct pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auto test panel pricing code_ 19 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP19","description":"Auto test panel pricing code_ 19 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDE1","description":"ICD-OCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRE0","description":"ICD-OHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disease progn ra good docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3476F","description":"Disease progn ra good docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUC1","description":"ICD-ACUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37294","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","description":"CPT-37294","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0577","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0577","description":"HCPCS-G0577","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKE0","description":"ICD-NGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brow wrinkles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15826","description":"Removal of brow wrinkles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without fusion_ including image guidance when performed_ with open decompression_ lumbar; seco","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22868","description":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without fusion_ including image guidance when performed_ with open decompression_ lumbar; seco","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAB0","description":"ICD-GCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18E","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTB0","description":"ICD-GDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagus endoscopy/ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43205","description":"Esophagus endoscopy/ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQD0","description":"ICD-KBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJE1","description":"ICD-OJJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMF0","description":"ICD-JCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWC1","description":"ICD-PCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOD1","description":"ICD-CGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen system gas portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0430","description":"Oxygen system gas portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical opening of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43500","description":"Surgical opening of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Fetal Monitoring Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0621","description":"Hospital Special Treatment Room Support Component (Hstrsc) Fetal Monitoring Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWA0","description":"ICD-KAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWE0","description":"ICD-ODWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBD1","description":"ICD-IFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD214","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair umbilical lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49600","description":"Repair umbilical lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA)_ vaginal pathogen panel_ identification of 27 organisms_ amplified probe technique_ vaginal swab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0330U","description":"Infectious agent detection by nucleic acid (DNA or RNA)_ vaginal pathogen panel_ identification of 27 organisms_ amplified probe technique_ vaginal swab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDC1","description":"ICD-OFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plmt post facet implt cerv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0219T","description":"Plmt post facet implt cerv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYE1","description":"ICD-HEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Severity angina by actvty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1010F","description":"Severity angina by actvty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC0C","description":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lipid profile perf doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8725","description":"Lipid profile perf doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy tubal cautery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58670","description":"Laparoscopy tubal cautery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dentur repr broken compl bas","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5510","description":"Dentur repr broken compl bas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMA1","description":"ICD-MHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Battery chrgr 12 volt utah/e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7366","description":"Battery chrgr 12 volt utah/e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47130","description":"Partial removal of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDB1","description":"ICD-FGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETC0","description":"ICD-IETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJB1","description":"ICD-NJJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTC1","description":"ICD-EDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ob us >/= 14 wks addl fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76810","description":"Ob us >/= 14 wks addl fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMD0","description":"ICD-NKMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQF1","description":"ICD-GCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDA1","description":"ICD-OJDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMF0","description":"ICD-GIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8003","description":"HCPCS-C8003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD21B","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie_ previously diagnosed) tissue(s) for molecular analysis (eg_ KRAS mutational an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0847T","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie_ previously diagnosed) tissue(s) for molecular analysis (eg_ KRAS mutational an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAC0","description":"ICD-OAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eeg awake and asleep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95819","description":"Eeg awake and asleep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB24D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3IB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IB31","description":"ICD-3IB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revsc opn/prq tib/pero stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37234","description":"Revsc opn/prq tib/pero stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4334","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","description":"HCPCS-Q4334","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWF0","description":"ICD-HCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX20","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42836","description":"Removal of adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"3 cc sterile syringe&needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4208","description":"3 cc sterile syringe&needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEB0","description":"ICD-NLEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0996T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","description":"CPT-0996T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Peginesatide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0890","description":"Peginesatide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig bmi calculation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8422","description":"Pt inelig bmi calculation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAD1","description":"ICD-EDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath therapeutic irrig agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4321","description":"Cath therapeutic irrig agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the pr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99418","description":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX45","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIB0","description":"ICD-JEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFE0","description":"ICD-FGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHA0","description":"ICD-NHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg 0.6-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11641","description":"Exc f/e/e/n/l mal+mrg 0.6-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDE1","description":"ICD-JBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepa vacc ped/adol 2 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90633","description":"Hepa vacc ped/adol 2 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOC0","description":"ICD-HDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJB0","description":"ICD-NCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAA0","description":"ICD-KDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPE1","description":"ICD-BFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVC1","description":"ICD-OJVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGE1","description":"ICD-KCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJF1","description":"ICD-OFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEE0","description":"ICD-IDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice continuous home care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2043","description":"Hospice continuous home care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1404","description":"HCPCS-B1404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAC0","description":"ICD-JHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anal/urinary muscle study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51785","description":"Anal/urinary muscle study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug test def 1-7 classes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0480","description":"Drug test def 1-7 classes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal non-stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59025","description":"Fetal non-stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx cml acceler phase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9124","description":"Onc dx cml acceler phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMC1","description":"ICD-KAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81284","description":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIED0","description":"ICD-AIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBID1","description":"ICD-MBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55711","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","description":"CPT-55711","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fistulization of sclera for glaucoma_ through ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0123T","description":"Fistulization of sclera for glaucoma_ through ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDD1","description":"ICD-EGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB3B","description":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9901","description":"Patient age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis - comprehensive series of radiographic images - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0387","description":"intraoral tomosynthesis - comprehensive series of radiographic images - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gene test retinoblastoma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3841","description":"Gene test retinoblastoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove eye/revise socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65114","description":"Remove eye/revise socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUB0","description":"ICD-ADUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test nonparaspinal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95870","description":"Muscle test nonparaspinal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tissue exam by pathologist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88302","description":"Tissue exam by pathologist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tacrolimus injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7525","description":"Tacrolimus injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vert bitewings-sev to eight","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0277","description":"Vert bitewings-sev to eight","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDD0","description":"ICD-GDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJB1","description":"ICD-JEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Daily cont lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0512","description":"Daily cont lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adults who are deliberately phased out of medication assisted treatment (MAT) prior to 180 days of continuous treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1035","description":"Adults who are deliberately phased out of medication assisted treatment (MAT) prior to 180 days of continuous treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHA0","description":"ICD-NIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting proced","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0135U","description":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting proced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29015","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA1C","description":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCA0","description":"ICD-CGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIC1","description":"ICD-IEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immed mand part dent metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5224","description":"Immed mand part dent metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMB1","description":"ICD-MDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay alkaline phosphatase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84075","description":"Assay alkaline phosphatase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA15","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of neck artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37600","description":"Ligation of neck artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXA1","description":"ICD-NDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vagina tissue compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57111","description":"Remove vagina tissue compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nose lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30125","description":"Removal of nose lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA25A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8B","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWE1","description":"ICD-LBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ below knee_ 40 mmhg or greater_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6555","description":"Gradient compression stocking_ below knee_ 40 mmhg or greater_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neuromuscular junction test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95937","description":"Neuromuscular junction test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDND1","description":"ICD-FDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUA1","description":"ICD-OJUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTC1","description":"ICD-IGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMA0","description":"ICD-FGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUD1","description":"ICD-NAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt doc with wrong event","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8912","description":"Pt doc with wrong event","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOE1","description":"ICD-KHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Risk-adjusted functional status change residual score for the neck impairment not measured because the patient did not complete the neck fs prom at initial evaluation and/or n","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2210","description":"Risk-adjusted functional status change residual score for the neck impairment not measured because the patient did not complete the neck fs prom at initial evaluation and/or n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPF0","description":"ICD-BIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICB1","description":"ICD-CICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For Not Using Multimodal Pain Management (E.G._ Allergy To Multiple Classes Of Analgesics_ Intubated Patient_ Hepatic Failure_ Patient Repor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2149","description":"Documentation Of Medical Reason(S) For Not Using Multimodal Pain Management (E.G._ Allergy To Multiple Classes Of Analgesics_ Intubated Patient_ Hepatic Failure_ Patient Repor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSB1","description":"ICD-OJSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIC1","description":"ICD-MEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLA1","description":"ICD-CBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contour back for ped size wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2293","description":"Contour back for ped size wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ durvalumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9492","description":"Injection_ durvalumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSE0","description":"ICD-GDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lipopro bld electrophoretic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83700","description":"Lipopro bld electrophoretic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chest procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39499","description":"Chest procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol or peroxide per pint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4244","description":"Alcohol or peroxide per pint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHD1","description":"ICD-KDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0694U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694U","description":"CPT-0694U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGA1","description":"ICD-GIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMB0","description":"ICD-EFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3391","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","description":"HCPCS-J3391","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33776","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drill skull for implantation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61107","description":"Drill skull for implantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUE0","description":"ICD-OBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28A","description":"Special Care Low _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Liver allotransplantation; heterotopic_ partial or whole_ from cadaver or living donor_ any age","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47136","description":"Liver allotransplantation; heterotopic_ partial or whole_ from cadaver or living donor_ any age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JB31","description":"ICD-4JB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKD1","description":"ICD-JGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB13","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMD0","description":"ICD-JIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Homecare train pt 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5108","description":"Homecare train pt 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAC0","description":"ICD-ICAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Permanent tear duct plug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4263","description":"Permanent tear duct plug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epsd bk pain for >6 wks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1135F","description":"Epsd bk pain for >6 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBF1","description":"ICD-CGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE121","description":"Special Care Low _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMD1","description":"ICD-MEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oral surgery procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7999","description":"Oral surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFD1","description":"ICD-FCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKME0","description":"ICD-NKME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC10B","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHB0","description":"ICD-GHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTB1","description":"ICD-EBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDE0","description":"ICD-GCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinolytic plasminogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85415","description":"Fibrinolytic plasminogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shrinker below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8440","description":"Shrinker below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hexa gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81255","description":"Hexa gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1432","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","description":"HCPCS-M1432","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECB0","description":"ICD-OECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal endoscopy_ surgical_ ethmoid sinus_ placement of drug eluting implant; with biopsy_ polypectomy or debridement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0407T","description":"Nasal endoscopy_ surgical_ ethmoid sinus_ placement of drug eluting implant; with biopsy_ polypectomy or debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Periodontal medicament carrier with peripheral seal - laboratory processed - maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5995","description":"Periodontal medicament carrier with peripheral seal - laboratory processed - maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Group psychotherapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90853","description":"Group psychotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVE0","description":"ICD-KBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Deluxe lens feature","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2702","description":"Deluxe lens feature","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0737","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0737","description":"HCPCS-E0737","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYD1","description":"ICD-HGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0508U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0508U","description":"CPT-0508U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJD1","description":"ICD-FEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC11C","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWB0","description":"ICD-GBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Icar ischm mntrng sys compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0302T","description":"Icar ischm mntrng sys compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mra_ w/o&w/dye_ spinal canal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8933","description":"Mra_ w/o&w/dye_ spinal canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAA1","description":"ICD-KHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSF1","description":"ICD-PGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDC1","description":"ICD-EGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDD0","description":"ICD-MHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAA0","description":"ICD-JFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rhythm ecg report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93042","description":"Rhythm ecg report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34151","description":"Removal of artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx nose fx w/o manj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21310","description":"Closed tx nose fx w/o manj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AB21","description":"ICD-3AB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJD1","description":"ICD-OJJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA16","description":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEE0","description":"ICD-JDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJE0","description":"ICD-NLJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXF0","description":"ICD-JGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty (except dialysis circuit)_ open or percutaneous_ including all imaging and radiological supervision and interpretation necessary to perform th","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37249","description":"Transluminal balloon angioplasty (except dialysis circuit)_ open or percutaneous_ including all imaging and radiological supervision and interpretation necessary to perform th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAA1","description":"ICD-IIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFA0","description":"ICD-KAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMF0","description":"ICD-CCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBA0","description":"ICD-NCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIA0","description":"ICD-MHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC5D","description":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ calcium gluconate (fresenius kabi)_ per 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0612","description":"Injection_ calcium gluconate (fresenius kabi)_ per 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient was in hospice or receiving palliative care at any time during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1059","description":"Patient was in hospice or receiving palliative care at any time during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"PERIURETHRAL TRANSPERINEAL ADJUSTABLE BALLOON CONTINENCE DEVICE; BILATERAL INSERTION_ INCLUDING CYSTOURETHROSCOPY AND IMAGING GUIDANCE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53451","description":"PERIURETHRAL TRANSPERINEAL ADJUSTABLE BALLOON CONTINENCE DEVICE; BILATERAL INSERTION_ INCLUDING CYSTOURETHROSCOPY AND IMAGING GUIDANCE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4379","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","description":"HCPCS-Q4379","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPD1","description":"ICD-NAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ground mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0425","description":"Ground mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prosthetic device repair rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7510","description":"Prosthetic device repair rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8H","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient Received An Influenza Vaccine On Or Between July 1 Of The Year Prior To The Measurement Period And June 30 Of The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2163","description":"Patient Received An Influenza Vaccine On Or Between July 1 Of The Year Prior To The Measurement Period And June 30 Of The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRF0","description":"ICD-GIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft fem-popliteal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35556","description":"Art byp grft fem-popliteal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1500","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","description":"HCPCS-M1500","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC52","description":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKC1","description":"ICD-BGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKB1","description":"ICD-FHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGD1","description":"ICD-NCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSC1","description":"ICD-PGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKB0","description":"ICD-BDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJA0","description":"ICD-NEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IC21","description":"ICD-1IC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERD1","description":"ICD-HERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Physical therapy treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97039","description":"Physical therapy treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUF0","description":"ICD-CBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQE0","description":"ICD-DAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clean out mastoid cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69220","description":"Clean out mastoid cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGA0","description":"ICD-FFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc foot/toe tum sc < 1.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28043","description":"Exc foot/toe tum sc < 1.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52240","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAF1","description":"ICD-BFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc active inj drug use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9518","description":"Doc active inj drug use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLD0","description":"ICD-OHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTC1","description":"ICD-JGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin full grft face/genit/hf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15240","description":"Skin full grft face/genit/hf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOA1","description":"ICD-CBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLF0","description":"ICD-NCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKF0","description":"ICD-KGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oasis wound matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4102","description":"Oasis wound matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLD0","description":"ICD-BCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNE1","description":"ICD-NGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4342","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","description":"HCPCS-Q4342","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVF0","description":"ICD-KCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEF1","description":"ICD-BDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCD1","description":"ICD-IBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hla class ii phenotype qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86831","description":"Hla class ii phenotype qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAD1","description":"ICD-BEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBD0","description":"ICD-NEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic propulsion tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2211","description":"Pneumatic propulsion tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVA1","description":"ICD-OKVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERE1","description":"ICD-PERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELD0","description":"ICD-FELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJB1","description":"ICD-OKJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES140","description":"Extensive Services _ ADL Index 2-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWD0","description":"ICD-DGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPF0","description":"ICD-NLPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBE0","description":"ICD-IGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Glycine receptor alpha1 IgG_ serum or cerebrospinal fluid (CSF)_ live cell-binding assay (LCBA)_ qualitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0431U","description":"Glycine receptor alpha1 IgG_ serum or cerebrospinal fluid (CSF)_ live cell-binding assay (LCBA)_ qualitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Below knee wood socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5639","description":"Below knee wood socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLA0","description":"ICD-FBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB140","description":"Reduced Physical Function _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hysteroscopy biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58558","description":"Hysteroscopy biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADE1","description":"ICD-CADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLA1","description":"ICD-KGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise spine nrv half segmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63185","description":"Incise spine nrv half segmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without open decompression or fusion_ including image guidance when performed_ lumbar; second","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22870","description":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without open decompression or fusion_ including image guidance when performed_ lumbar; second","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0602","description":"HCPCS-C0602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8I","description":"Low Rehab_ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHD0","description":"ICD-ABHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ready gradient gauntlet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8428","description":"Ready gradient gauntlet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ esmolol hydrochloride (wg critical care) not therapeutically equivalent to j1805_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1806","description":"Injection_ esmolol hydrochloride (wg critical care) not therapeutically equivalent to j1805_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCB0","description":"ICD-IDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFED0","description":"ICD-IFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx gastric p r1-r2noprog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9101","description":"Onc dx gastric p r1-r2noprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAD0","description":"ICD-KFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOF0","description":"ICD-DBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytogenetics 3-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88272","description":"Cytogenetics 3-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQE0","description":"ICD-ODQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acute gi blood loss imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78278","description":"Acute gi blood loss imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYE0","description":"ICD-PBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEF1","description":"ICD-BCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUE0","description":"ICD-JCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPF1","description":"ICD-OLPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of foot joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28022","description":"Exploration of foot joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFC0","description":"ICD-JFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUB1","description":"ICD-OGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove inner ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69905","description":"Remove inner ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTB0","description":"ICD-NBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDA1","description":"ICD-OHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pathogen reduced platelets","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9072","description":"Pathogen reduced platelets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove part lumbar vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22102","description":"Remove part lumbar vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Temporary external pacing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92953","description":"Temporary external pacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWA1","description":"ICD-GGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFE0","description":"ICD-GDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQB1","description":"ICD-PEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDD0","description":"ICD-EIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDE0","description":"ICD-JFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIB1","description":"ICD-OEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compre audiometry evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0212T","description":"Compre audiometry evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18C","description":"Special Care Low _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ethmoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31205","description":"Removal of ethmoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transplant/graft palm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26489","description":"Transplant/graft palm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB256","description":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50075","description":"Removal of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal) screening_ quantitative real-time target and signal amplification_ methylated DNA markers_ including LASS4_ LRRC4 and PPP2R5C_ a reference marker ZDHHC1_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0464U","description":"Oncology (colorectal) screening_ quantitative real-time target and signal amplification_ methylated DNA markers_ including LASS4_ LRRC4 and PPP2R5C_ a reference marker ZDHHC1_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compatibility test spin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86920","description":"Compatibility test spin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHD1","description":"ICD-IFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens fitting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92311","description":"Contact lens fitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct abdomen w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74160","description":"Ct abdomen w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lens material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66840","description":"Removal of lens material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc shoulder tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23073","description":"Exc shoulder tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGA1","description":"ICD-OCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1604","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1604","description":"HCPCS-C1604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Penile injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54235","description":"Penile injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJF0","description":"ICD-KDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01953","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01953","description":"CPT-01953","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPC0","description":"ICD-BCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Admit w/in 180d req surg rev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9412","description":"Admit w/in 180d req surg rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUA0","description":"ICD-MKUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAD1","description":"ICD-BIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMC1","description":"ICD-OIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBE1","description":"ICD-BCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCA0","description":"ICD-CBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSD0","description":"ICD-HDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCD0","description":"ICD-EFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tte w or w/o fol w/cont_ com","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8921","description":"Tte w or w/o fol w/cont_ com","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including sphenoidotomy_ with removal of tissue from the sphenoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31259","description":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including sphenoidotomy_ with removal of tissue from the sphenoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBF0","description":"ICD-EDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYB0","description":"ICD-KEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDA1","description":"ICD-MFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKF0","description":"ICD-OHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q2058","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","description":"HCPCS-Q2058","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDF0","description":"ICD-BBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABD0","description":"ICD-JABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTF1","description":"ICD-JHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; extended study involving over 5 slides and/or multiple stains (List separately in addition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0834T","description":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; extended study involving over 5 slides and/or multiple stains (List separately in addition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFB0","description":"ICD-CFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Probe_ perc lumb disc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2614","description":"Probe_ perc lumb disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBC0","description":"ICD-JHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Med admin_ not oral/inject","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1503","description":"Med admin_ not oral/inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18H","description":"Special Care High _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWE1","description":"ICD-DDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Two Medica re Diabetes Prevention Program (MDPP) core maintenance sessi on s (MS) were attended by an MDPP beneficiary in months (mo) 7-9 under the MDPP Expanded Model (EM).","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9878","description":"Two Medica re Diabetes Prevention Program (MDPP) core maintenance sessi on s (MS) were attended by an MDPP beneficiary in months (mo) 7-9 under the MDPP Expanded Model (EM).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar artif diskectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22857","description":"Lumbar artif diskectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC11A","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low back disk surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63030","description":"Low back disk surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLE1","description":"ICD-BDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWC1","description":"ICD-LGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gardner vag dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87510","description":"Gardner vag dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGE0","description":"ICD-FAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp5 ped sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0890","description":"Pwc gp5 ped sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0557","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","description":"HCPCS-G0557","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVE0","description":"ICD-BHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQC0","description":"ICD-HFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHND1","description":"ICD-FHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis a igm antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86709","description":"Hepatitis a igm antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVB1","description":"ICD-GDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETD1","description":"ICD-AETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPF0","description":"ICD-FCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Macroscopic exam arthropod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87168","description":"Macroscopic exam arthropod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENF0","description":"ICD-BENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSD1","description":"ICD-HBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infratemporal approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61590","description":"Infratemporal approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cptr dbs alys car elec dta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0206T","description":"Cptr dbs alys car elec dta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Motion fluoroscopy/swallow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92611","description":"Motion fluoroscopy/swallow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFD0","description":"ICD-FAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRA0","description":"ICD-CCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXA1","description":"ICD-NKXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCA1","description":"ICD-CGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0602","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0602","description":"CDT-D0602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVD0","description":"ICD-FFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSE0","description":"ICD-KBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abrasion lesions add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15787","description":"Abrasion lesions add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"First Medicare Diabetes Prevention Program (MDPP) core session was attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP service tha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9873","description":"First Medicare Diabetes Prevention Program (MDPP) core session was attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP service tha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEA0","description":"ICD-NBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNC1","description":"ICD-CDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAA1","description":"ICD-NBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISB0","description":"ICD-KISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone graft peri per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3428","description":"Bone graft peri per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc face tum deep < 2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21013","description":"Exc face tum deep < 2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJA0","description":"ICD-KGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non cutaneous loc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9295","description":"Non cutaneous loc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACD0","description":"ICD-KACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX0C","description":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX4B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dissolve clot heart vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92977","description":"Dissolve clot heart vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHF1","description":"ICD-GCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vehicle mod waiver/service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2039","description":"Vehicle mod waiver/service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC134","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of vitamin b-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84252","description":"Assay of vitamin b-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSA0","description":"ICD-DGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular repair of iliac artery bifurcation (eg_ aneurysm_ pseudoaneurysm_ arteriovenous malformation_ trauma_ dissection) using bifurcated endograft from the common iliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0254T","description":"Endovascular repair of iliac artery bifurcation (eg_ aneurysm_ pseudoaneurysm_ arteriovenous malformation_ trauma_ dissection) using bifurcated endograft from the common iliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair lightweight leg r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1270","description":"Wheelchair lightweight leg r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRF0","description":"ICD-GBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQD1","description":"ICD-PIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Who nontorsion jnts pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3915","description":"Who nontorsion jnts pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ilr device interrogate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93291","description":"Ilr device interrogate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVA0","description":"ICD-BIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat pelvic fracture(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27215","description":"Treat pelvic fracture(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacteria and fungi)_ gram-positive organism identification and drug resistance element detection_ DNA (20 gram-positive bacterial targets_ 4 resistance gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0141U","description":"Infectious disease (bacteria and fungi)_ gram-positive organism identification and drug resistance element detection_ DNA (20 gram-positive bacterial targets_ 4 resistance gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient transfer system >300","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1036","description":"Patient transfer system >300","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMF0","description":"ICD-NDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBF0","description":"ICD-IDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Image test ref carot diam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3100F","description":"Image test ref carot diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXB1","description":"ICD-GEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXC1","description":"ICD-FAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISC1","description":"ICD-OISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of bowel bulge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57268","description":"Repair of bowel bulge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAA1","description":"ICD-MCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCC1","description":"ICD-MKCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKME0","description":"ICD-OKME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWF1","description":"ICD-HBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ak pelvic control belt pad/l","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5694","description":"Ak pelvic control belt pad/l","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHB1","description":"ICD-KGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Persistent asthma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1038F","description":"Persistent asthma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo proc ob care/deliver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59898","description":"Laparo proc ob care/deliver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEA0","description":"ICD-IIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65270","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACC0","description":"ICD-BACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0221","description":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOF0","description":"ICD-OKOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDA0","description":"ICD-FIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNA1","description":"ICD-BFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIE0","description":"ICD-IBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUF0","description":"ICD-NDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fistula repair & colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57307","description":"Fistula repair & colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct capt maxilla","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0382","description":"Cone beam ct capt maxilla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPD0","description":"ICD-KCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISB0","description":"ICD-LISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXA0","description":"ICD-NJXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat eyelid lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67850","description":"Treat eyelid lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAID1","description":"ICD-NAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVE0","description":"ICD-GIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1808","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1808","description":"HCPCS-J1808","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise eyelashes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67835","description":"Revise eyelashes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAB0","description":"ICD-CEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28715","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIC0","description":"ICD-JFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cnslng provided symp mngmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4350F","description":"Cnslng provided symp mngmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chest x-ray 4/> views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71030","description":"Chest x-ray 4/> views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dem severity classified mild","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1490F","description":"Dem severity classified mild","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHME1","description":"ICD-IHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEF1","description":"ICD-NLEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96130","description":"Psychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc face les sbq 2 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21012","description":"Exc face les sbq 2 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Umbilical artery echo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76820","description":"Umbilical artery echo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFE0","description":"ICD-FEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIA0","description":"ICD-IHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAF0","description":"ICD-KHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARB1","description":"ICD-PARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHD0","description":"ICD-JBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD15D","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves_ including fluoroscopic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0781T","description":"Bronchoscopy_ rigid or flexible_ with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves_ including fluoroscopic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDB0","description":"ICD-NHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc s/n/h/f/g mal+mrg 1.1-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11622","description":"Exc s/n/h/f/g mal+mrg 1.1-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD225","description":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVA0","description":"ICD-OJVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lower Esophageal Myotomy_ Transoral (Ie_ Peroral Endoscopic Myotomy [Poem])","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43497","description":"Lower Esophageal Myotomy_ Transoral (Ie_ Peroral Endoscopic Myotomy [Poem])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARE0","description":"ICD-CARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilated Retinal Eye Exam With Interpretation By An Ophthalmologist Or Optometrist Documented And Reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2102","description":"Dilated Retinal Eye Exam With Interpretation By An Ophthalmologist Or Optometrist Documented And Reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Face tent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4619","description":"Face tent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAB1","description":"ICD-NKAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGB0","description":"ICD-OKGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospitalists Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4009","description":"Hospitalists Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECC1","description":"ICD-IECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKC0","description":"ICD-FDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCE1","description":"ICD-JHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFB0","description":"ICD-CDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE114","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMC0","description":"ICD-GDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARC0","description":"ICD-PARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB24D","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGE0","description":"ICD-GFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ketamine and norketamine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80357","description":"Ketamine and norketamine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Root canal therapy 2 canals","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3320","description":"Root canal therapy 2 canals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59840","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAA0","description":"ICD-IFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOC1","description":"ICD-PFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILC1","description":"ICD-NILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEC1","description":"ICD-ICEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBC0","description":"ICD-GDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Icd counseling provided","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4470F","description":"Icd counseling provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDE0","description":"ICD-BGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKE0","description":"ICD-CGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGE1","description":"ICD-OIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rad exp time w/fluor doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9500","description":"Rad exp time w/fluor doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth biopsy of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32251","description":"Anesth biopsy of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diaphragm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4266","description":"Diaphragm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGE0","description":"ICD-BIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMA0","description":"ICD-ACMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCC0","description":"ICD-JHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCC1","description":"ICD-NGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKD1","description":"ICD-JFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA42","description":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAF1","description":"ICD-FCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (lung)_ augmentative algorithmic analysis of digitized whole slide imaging for 8 genes (ALK_ BRAF_ EGFR_ ERBB2_ MET_ NTRK1-3_ RET_ ROS1)_ and KRAS G12C and PD-L1_ if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0414U","description":"Oncology (lung)_ augmentative algorithmic analysis of digitized whole slide imaging for 8 genes (ALK_ BRAF_ EGFR_ ERBB2_ MET_ NTRK1-3_ RET_ ROS1)_ and KRAS G12C and PD-L1_ if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of circulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37160","description":"Revision of circulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTA1","description":"ICD-GBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUE0","description":"ICD-BCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ekg interpret & report preve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0405","description":"Ekg interpret & report preve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPB1","description":"ICD-NHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99283","description":"Emergency dept visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIB1","description":"ICD-BHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1124","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L1821","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","description":"HCPCS-L1821","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD12C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCB0","description":"ICD-OHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ etelcalcetide_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0606","description":"Injection_ etelcalcetide_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTE1","description":"ICD-OFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEE0","description":"ICD-IHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUC1","description":"ICD-OCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHA0","description":"ICD-AGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXE1","description":"ICD-KEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJB1","description":"ICD-JGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUB1","description":"ICD-GDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKA1","description":"ICD-GAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUB1","description":"ICD-AGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath report non routine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0551F","description":"Cytopath report non routine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVA0","description":"ICD-BEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sotalol hydrochloride_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9482","description":"Injection_ sotalol hydrochloride_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair wrist joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25447","description":"Repair wrist joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUB0","description":"ICD-NLUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVA0","description":"ICD-OFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX25","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1102T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1102T","description":"CPT-1102T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEA0","description":"ICD-NLEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHC0","description":"ICD-EEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYD1","description":"ICD-PJYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous vertebroplasties (bone biopsies included when performed)_ first cervicothoracic and any additional cervicothoracic or lumbosacral vertebral bodies_ unilateral or","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7504","description":"Percutaneous vertebroplasties (bone biopsies included when performed)_ first cervicothoracic and any additional cervicothoracic or lumbosacral vertebral bodies_ unilateral or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWE0","description":"ICD-DIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sperm procure subs visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4031","description":"Sperm procure subs visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAF0","description":"ICD-OIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE22A","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mans shoe oxford brace","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3225","description":"Mans shoe oxford brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apligraf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4101","description":"Apligraf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVD0","description":"ICD-KBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tendon lengthening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26476","description":"Tendon lengthening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair uro sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53449","description":"Repair uro sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repositioning of previously implanted aortic counterpulsation ventricular assist device; aortic counterpulsation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0461T","description":"Repositioning of previously implanted aortic counterpulsation ventricular assist device; aortic counterpulsation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTA1","description":"ICD-GDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove thyroid duct lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60280","description":"Remove thyroid duct lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE236","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIA1","description":"ICD-BAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove hip bone les super","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27065","description":"Remove hip bone les super","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA12","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUB0","description":"ICD-NBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC160","description":"Special Care High _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Afamelanotide implant_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7352","description":"Afamelanotide implant_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEB0","description":"ICD-NBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASB1","description":"ICD-LASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYE1","description":"ICD-HAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDC1","description":"ICD-JGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Devlopment test interpt&rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0451","description":"Devlopment test interpt&rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOA1","description":"ICD-LBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Penile contracture device_ manual_ greater than 3 lbs traction force","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4988","description":"Penile contracture device_ manual_ greater than 3 lbs traction force","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apply forearm splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29125","description":"Apply forearm splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBB0","description":"ICD-BHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Typhoid vaccine_ heat- and phenol-inactivated (h-p)_ for subcutaneous orintradermal use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90692","description":"Typhoid vaccine_ heat- and phenol-inactivated (h-p)_ for subcutaneous orintradermal use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vitamin suppl 100 caps","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0194","description":"Vitamin suppl 100 caps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOD0","description":"ICD-LIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29875","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Substernal Implantable Defibrillator Electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0573T","description":"Removal Of Substernal Implantable Defibrillator Electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCC1","description":"ICD-NLCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUD0","description":"ICD-MKUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKF1","description":"ICD-FHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPA1","description":"ICD-CEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBME1","description":"ICD-GBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQA1","description":"ICD-ODQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB4D","description":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-expandable controller","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2375","description":"Non-expandable controller","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAA0","description":"ICD-EFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27246","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-emer transport wait time","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2007","description":"Non-emer transport wait time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDF0","description":"ICD-MLDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Hyperbaric Oxygen Treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X2061","description":"Hospital Special Treatment Room Support Component (Hstrsc) Hyperbaric Oxygen Treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJF1","description":"ICD-FHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJF1","description":"ICD-BEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert bladder cath complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51703","description":"Insert bladder cath complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54380","description":"Repair penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHA0","description":"ICD-GFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inhibin a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86336","description":"Inhibin a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acid conc sol per gallon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4709","description":"Acid conc sol per gallon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Front caster assem complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0077","description":"Front caster assem complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL51","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digoxin immune fab (ovine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1162","description":"Digoxin immune fab (ovine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXC1","description":"ICD-FIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDD1","description":"ICD-EEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFB1","description":"ICD-GIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJB0","description":"ICD-KAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNF1","description":"ICD-FFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploratory elbow surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24000","description":"Exploratory elbow surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 3 genotyping (HPA-3)_ ITGA2B (integrin_ alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex]_ antigen CD41 [GPIIb]) (eg_ neonatal alloimmune thrombo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81107","description":"Human Platelet Antigen 3 genotyping (HPA-3)_ ITGA2B (integrin_ alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex]_ antigen CD41 [GPIIb]) (eg_ neonatal alloimmune thrombo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVB1","description":"ICD-FIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVB0","description":"ICD-OHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJF1","description":"ICD-OAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ferric pyrophosphate citrate solution (TrifericAVNU)_ 0.1 mg of iron","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1445","description":"Injection_ ferric pyrophosphate citrate solution (TrifericAVNU)_ 0.1 mg of iron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening pregabalin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80366","description":"Drug screening pregabalin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1HC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HC11","description":"ICD-1HC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB105","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC224","description":"Special Care High _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUC0","description":"ICD-NBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIA1","description":"ICD-FGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEA1","description":"ICD-JFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of horseshoe kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50540","description":"Revision of horseshoe kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB260","description":"Special Care High _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g._ prior anaphylaxis due to the pneumococcal vaccine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1178","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g._ prior anaphylaxis due to the pneumococcal vaccine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Harvesting of donor multivis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2055","description":"Harvesting of donor multivis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILA0","description":"ICD-MILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAND0","description":"ICD-BAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Site not small cell lung ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9285","description":"Site not small cell lung ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49591","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX56","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI angio chest w or w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71555","description":"MRI angio chest w or w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18A","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL54","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_onabotulinumtoxina","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0585","description":"Injection_onabotulinumtoxina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBB1","description":"ICD-JIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTD1","description":"ICD-MBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36589","description":"Removal tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of cloacal anomaly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46748","description":"Repair of cloacal anomaly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fluocinol acet intravit imp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7313","description":"Fluocinol acet intravit imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYA0","description":"ICD-KEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIB1","description":"ICD-KHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bridge porcelain nobel metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6242","description":"Bridge porcelain nobel metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMD0","description":"ICD-OGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPA1","description":"ICD-ODPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCF0","description":"ICD-NHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD255","description":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAB0","description":"ICD-OLAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Symptom&sign symm polyneuro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1500F","description":"Symptom&sign symm polyneuro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECF1","description":"ICD-EECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAF1","description":"ICD-BHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSA1","description":"ICD-HHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELC0","description":"ICD-JELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKB0","description":"ICD-OBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for prescribing systemic antimicrobials","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9960","description":"Documentation of medical reason(s) for prescribing systemic antimicrobials","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Donor hysterectomy (including cold preservation); recipient uterus allograft transplantation from cadaver or living donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0667T","description":"Donor hysterectomy (including cold preservation); recipient uterus allograft transplantation from cadaver or living donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht arm splint fbrg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4022","description":"Cast sup sht arm splint fbrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Con tissue w dble ped graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4276","description":"Con tissue w dble ped graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMA1","description":"ICD-EGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDB0","description":"ICD-BCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHD1","description":"ICD-KAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXE1","description":"ICD-FEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ak pelvic control belt light","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5692","description":"Ak pelvic control belt light","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL1A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDA1","description":"ICD-JEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX51","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHF1","description":"ICD-MIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Scr c/v cyto_thinlayer_rescr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0145","description":"Scr c/v cyto_thinlayer_rescr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDE1","description":"ICD-AFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTE1","description":"ICD-ECTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTD1","description":"ICD-ECTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast cancer)_ DNA_ PIK3CA (phosphatidylinositol-4_5-bisphosphate 3-kinase_ catalytic subunit alpha) (eg_ breast cancer) gene analysis (ie_ p.C420R_ p.E542K_ p.E545","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0155U","description":"Oncology (breast cancer)_ DNA_ PIK3CA (phosphatidylinositol-4_5-bisphosphate 3-kinase_ catalytic subunit alpha) (eg_ breast cancer) gene analysis (ie_ p.C420R_ p.E542K_ p.E545","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQC1","description":"ICD-HBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAB0","description":"ICD-FDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection intraop add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48400","description":"Injection intraop add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITD1","description":"ICD-JITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8I","description":"Very High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTB1","description":"ICD-FBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRC1","description":"ICD-DIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAF1","description":"ICD-CDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPE1","description":"ICD-OJPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy through stoma; with transendoscopic stent placement (includes predilation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6020","description":"Colonoscopy through stoma; with transendoscopic stent placement (includes predilation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWE0","description":"ICD-OCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL53","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Jaw arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29804","description":"Jaw arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36558","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICA1","description":"ICD-AICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEC0","description":"ICD-CCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHD0","description":"ICD-BHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPB0","description":"ICD-FEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr umbil hern reduc < 5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49580","description":"Rpr umbil hern reduc < 5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release eye tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67343","description":"Release eye tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDF0","description":"ICD-EFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endo knee-shin polyc mch sta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5816","description":"Endo knee-shin polyc mch sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44370","description":"Small bowel endoscopy/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (BMD)_ with concurrent vertebral fracture assessment_ utilizing data","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0743T","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (BMD)_ with concurrent vertebral fracture assessment_ utilizing data","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No electrodiag polyneuro 6mn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3752F","description":"No electrodiag polyneuro 6mn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPD1","description":"ICD-CGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29884","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDID1","description":"ICD-CDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLE0","description":"ICD-FHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv adduct vocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2341","description":"Chemodenerv adduct vocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct interprete tmj","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0368","description":"Cone beam ct interprete tmj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOF1","description":"ICD-DBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB22B","description":"Special Care Low _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC1B","description":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXA0","description":"ICD-OEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breath hydrogen/methane test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91065","description":"Breath hydrogen/methane test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apply hand/wrist cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29085","description":"Apply hand/wrist cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAA0","description":"ICD-IBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXD1","description":"ICD-BAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; screening and interpretation (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0832T","description":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; screening and interpretation (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDA0","description":"ICD-OGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJF1","description":"ICD-BAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Follow-Up And Mrs Score Not Assessed At 90 Days Following Endovascular Stroke Intervention","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0046","description":"Clinical Follow-Up And Mrs Score Not Assessed At 90 Days Following Endovascular Stroke Intervention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1154","description":"Hospice services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHE1","description":"ICD-GCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBB1","description":"ICD-CCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABE0","description":"ICD-AABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYA0","description":"ICD-PAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endoluminal bx urtr rnl plvs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50606","description":"Endoluminal bx urtr rnl plvs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gamma globulin 1 cc inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1460","description":"Gamma globulin 1 cc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNE0","description":"ICD-JCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bundled Payments for Care Improvement Advanced (BPCI Advanced) model home visit for patient assessment performed by clinical staff for an individual not considered homebound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9987","description":"Bundled Payments for Care Improvement Advanced (BPCI Advanced) model home visit for patient assessment performed by clinical staff for an individual not considered homebound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNE1","description":"ICD-CBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Observ/hosp same date","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99234","description":"Observ/hosp same date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1185","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAC1","description":"ICD-KEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSF1","description":"ICD-OFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQD0","description":"ICD-PJQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGC1","description":"ICD-NCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of upper arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24920","description":"Amputation of upper arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01967","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01967","description":"CPT-01967","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKD1","description":"ICD-KBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Francisella tularensis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86668","description":"Francisella tularensis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVD0","description":"ICD-OGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA2C","description":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic analysis of vestibular implant_ unilateral; with subsequent programming","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0729T","description":"Diagnostic analysis of vestibular implant_ unilateral; with subsequent programming","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDA1","description":"ICD-BEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocolld drg filler paste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6240","description":"Hydrocolld drg filler paste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEE0","description":"ICD-NBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFC1","description":"ICD-KHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lung bx plug w/del sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2613","description":"Lung bx plug w/del sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytarabine hcl 100 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9100","description":"Cytarabine hcl 100 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTD0","description":"ICD-OKTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Guide nerv destr elec stim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95873","description":"Guide nerv destr elec stim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMD1","description":"ICD-AGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFA0","description":"ICD-NFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHC1","description":"ICD-NIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELD1","description":"ICD-MELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALB0","description":"ICD-FALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9810","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9810","description":"HCPCS-C9810","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"In111 satumomab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4642","description":"In111 satumomab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hfo w/joint(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3921","description":"Hfo w/joint(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tremelimumab-actl_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9147","description":"Injection_ tremelimumab-actl_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pyridoxine hcl 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3415","description":"Pyridoxine hcl 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWE1","description":"ICD-GAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUF0","description":"ICD-MKUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair fistula w/colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45805","description":"Repair fistula w/colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAC1","description":"ICD-FBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNA1","description":"ICD-ODNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHED0","description":"ICD-NHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWF1","description":"ICD-KHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCC1","description":"ICD-IBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHF0","description":"ICD-ICHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYD1","description":"ICD-LFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heart revascularize (tmr)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33140","description":"Heart revascularize (tmr)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc compl inf antibio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9301","description":"Doc compl inf antibio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB16","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKF0","description":"ICD-ODKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPF1","description":"ICD-CBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPB0","description":"ICD-KBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin pro flex/ext cont","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5859","description":"Knee-shin pro flex/ext cont","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIB1","description":"ICD-BIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFC0","description":"ICD-NHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA106","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA105","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRB0","description":"ICD-OJRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1243","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHA0","description":"ICD-MJHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDF0","description":"ICD-OIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXE0","description":"ICD-BCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPF0","description":"ICD-BDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHD1","description":"ICD-EFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD245","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise inner eye adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65860","description":"Incise inner eye adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemical peel face dermal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15789","description":"Chemical peel face dermal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPD1","description":"ICD-OEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMD0","description":"ICD-EBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJD1","description":"ICD-OAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHE1","description":"ICD-GEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDA1","description":"ICD-NBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYE1","description":"ICD-HFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYB1","description":"ICD-LIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Med risk prostate cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3272F","description":"Med risk prostate cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cholangiography and/or pancreatography; through existing catheter_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74305","description":"Cholangiography and/or pancreatography; through existing catheter_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cltx post ankle fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27767","description":"Cltx post ankle fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ther injection carp tunnel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20526","description":"Ther injection carp tunnel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXC0","description":"ICD-OCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFB0","description":"ICD-ODFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJB0","description":"ICD-BCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCC0","description":"ICD-OKCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular Venous Arterialization_ Tibial Or Peroneal Vein_ With Transcatheter Placement Of Intravascular Stent Graft(S) And Closure By Any Method_ Including Percutaneous Or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0620T","description":"Endovascular Venous Arterialization_ Tibial Or Peroneal Vein_ With Transcatheter Placement Of Intravascular Stent Graft(S) And Closure By Any Method_ Including Percutaneous Or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0875T","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Triflupromazine hcl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3400","description":"Triflupromazine hcl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Had smoke b/4 anes day surg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9645","description":"Had smoke b/4 anes day surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELB1","description":"ICD-AELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic Interventions That Focus On Cognitive Function (Eg_ Attention_ Memory_ Reasoning_ Executive Function_ Problem Solving_ And/Or Pragmatic Functioning) And Compensato","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97129","description":"Therapeutic Interventions That Focus On Cognitive Function (Eg_ Attention_ Memory_ Reasoning_ Executive Function_ Problem Solving_ And/Or Pragmatic Functioning) And Compensato","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEND0","description":"ICD-FEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES136","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETF1","description":"ICD-AETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMF1","description":"ICD-OKMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGID0","description":"ICD-EGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPB1","description":"ICD-GBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esoph bx rprt w/dyspl info","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3126F","description":"Esoph bx rprt w/dyspl info","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJB1","description":"ICD-BIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDE1","description":"ICD-IHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC24D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1302","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1302","description":"CDT-D1302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74010","description":"X-ray exam of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWC1","description":"ICD-PFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICA1","description":"ICD-JICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pain assessment documented as positive_ follow-up plan not documented_ documentation the patient is not eligible at the time of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8939","description":"Pain assessment documented as positive_ follow-up plan not documented_ documentation the patient is not eligible at the time of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWC1","description":"ICD-KHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eye surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66999","description":"Eye surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rerepair fem hernia reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49555","description":"Rerepair fem hernia reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUC0","description":"ICD-JAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abdomen surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49999","description":"Abdomen surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXC0","description":"ICD-NBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skn splt a-grft f/n/hf/g add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15121","description":"Skn splt a-grft f/n/hf/g add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cciiv3 vac im cult prsv free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90661","description":"Cciiv3 vac im cult prsv free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVF0","description":"ICD-NKVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRD1","description":"ICD-KBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPF1","description":"ICD-NAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAD0","description":"ICD-IDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEB0","description":"ICD-BEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMF1","description":"ICD-MGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWB1","description":"ICD-KFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTD1","description":"ICD-JBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMB1","description":"ICD-ECMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Osteopath manj 1-2 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98925","description":"Osteopath manj 1-2 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lymphocyte immune globulin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7504","description":"Lymphocyte immune globulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18D","description":"Clinically Complex _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYF0","description":"ICD-LDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB213","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dispensing fee binaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5160","description":"Dispensing fee binaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the da","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0317","description":"Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endoluminal bx biliary tree","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47543","description":"Endoluminal bx biliary tree","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKED0","description":"ICD-NKED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGE1","description":"ICD-FEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Manipulate finger w/anesth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26340","description":"Manipulate finger w/anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUD1","description":"ICD-BDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL31","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heart infarct image (ef)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78468","description":"Heart infarct image (ef)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Western blot test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84181","description":"Western blot test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAE1","description":"ICD-BCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSA1","description":"ICD-OJSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"So 8 ab rstr can/web pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3660","description":"So 8 ab rstr can/web pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Syst bp ge 130 - 139mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3075F","description":"Syst bp ge 130 - 139mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNC0","description":"ICD-BCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of bladder wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51865","description":"Repair of bladder wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0625U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","description":"CPT-0625U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUB1","description":"ICD-IHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSF0","description":"ICD-KCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Peg interferon alfa-2a/180","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0145","description":"Peg interferon alfa-2a/180","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDD1","description":"ICD-NCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICB1","description":"ICD-JICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair safety vest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0980","description":"Wheelchair safety vest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATB0","description":"ICD-GATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJC1","description":"ICD-GDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiofq trsmtr for implt neu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8683","description":"Radiofq trsmtr for implt neu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1249","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1HB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HB31","description":"ICD-1HB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artacent AC_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4190","description":"Artacent AC_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foot press off load supp dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9283","description":"Foot press off load supp dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPE1","description":"ICD-FGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amnio tri-core amniotic_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4295","description":"Amnio tri-core amniotic_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOA1","description":"ICD-GGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAC0","description":"ICD-ABAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE224","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASF1","description":"ICD-HASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mrs discogenic pain i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0612T","description":"Mrs discogenic pain i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGD0","description":"ICD-KDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4318","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","description":"HCPCS-A4318","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEB0","description":"ICD-KAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5949","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5949","description":"CDT-D5949","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC5C","description":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDD1","description":"ICD-EIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICME0","description":"ICD-ICME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medical reason for no beta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9190","description":"Medical reason for no beta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rollabout chair with casters","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1031","description":"Rollabout chair with casters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"<50% of total number of a patient_s outpatient RA encounters assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1008","description":"<50% of total number of a patient_s outpatient RA encounters assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIF1","description":"ICD-GHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg 0.6-1 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11441","description":"Exc face-mm b9+marg 0.6-1 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gauze > 48 in no w/sal w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6224","description":"Gauze > 48 in no w/sal w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELE1","description":"ICD-MELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGB1","description":"ICD-GEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGC1","description":"ICD-FGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; With Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0637T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; With Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HA11","description":"ICD-4HA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCE0","description":"ICD-EBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINB1","description":"ICD-OINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rbc sed rate automated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85652","description":"Rbc sed rate automated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE10A","description":"Special Care Low _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam neck spine 4/5vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72050","description":"X-ray exam neck spine 4/5vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHA1","description":"ICD-JBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21453","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHB1","description":"ICD-FGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEE1","description":"ICD-JFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXB0","description":"ICD-ODXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPD1","description":"ICD-CBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dynamic surface emg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96002","description":"Dynamic surface emg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAE0","description":"ICD-GAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leukacyte transfusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86950","description":"Leukacyte transfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCD1","description":"ICD-OFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILC0","description":"ICD-FILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSA0","description":"ICD-CBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection(S)_ Bone-Substitute Material (Eg_ Calcium Phosphate) Into Subchondral Bone Defect (Ie_ Bone Marrow Lesion_ Bone Bruise_ Stress Injury_ Microtrabecular Fracture)_ Inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0707T","description":"Injection(S)_ Bone-Substitute Material (Eg_ Calcium Phosphate) Into Subchondral Bone Defect (Ie_ Bone Marrow Lesion_ Bone Bruise_ Stress Injury_ Microtrabecular Fracture)_ Inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone marrow harvest allogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38230","description":"Bone marrow harvest allogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTC1","description":"ICD-BBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt prgrm for implt neurostim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8681","description":"Pt prgrm for implt neurostim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"2high risk med ord","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9367","description":"2high risk med ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXE0","description":"ICD-OBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0565U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","description":"CPT-0565U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB10B","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATB1","description":"ICD-JATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALA1","description":"ICD-CALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nipple Prosthesis_ Custom Fabricated_ Reusable_ Any Material_ Any Type_ Each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8033","description":"Nipple Prosthesis_ Custom Fabricated_ Reusable_ Any Material_ Any Type_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLC1","description":"ICD-EFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urethral insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4336","description":"Urethral insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Statin not presc disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9443","description":"Statin not presc disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Quant her2 ihc eval brst cx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3394F","description":"Quant her2 ihc eval brst cx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Manipulat palm cord post inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26341","description":"Manipulat palm cord post inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECA1","description":"ICD-FECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA51","description":"Medium Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTC0","description":"ICD-BFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ald_ tv amplifier_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5270","description":"Ald_ tv amplifier_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILA0","description":"ICD-JILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anes mediascpy & dx thorscpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52851","description":"Anes mediascpy & dx thorscpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYC0","description":"ICD-HAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC231","description":"Clinically Complex _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93317","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOB0","description":"ICD-PCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUC1","description":"ICD-AAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15956","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHA0","description":"ICD-BHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAE1","description":"ICD-FGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGD1","description":"ICD-NBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUF0","description":"ICD-MFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQC0","description":"ICD-OKQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXF1","description":"ICD-JEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ue fx orth shoul cap forearm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3981","description":"Ue fx orth shoul cap forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0650U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0650U","description":"CPT-0650U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNA1","description":"ICD-OGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3IC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IC11","description":"ICD-3IC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit cont pain per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9326","description":"Hit cont pain per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVC1","description":"ICD-KBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reset dislocated jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21480","description":"Reset dislocated jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB25B","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj secretin synthetic human","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2850","description":"Inj secretin synthetic human","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of leg tendon each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27658","description":"Repair of leg tendon each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flu immunize no admin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8484","description":"Flu immunize no admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METE0","description":"ICD-METE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1298","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPD0","description":"ICD-FAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPC1","description":"ICD-OIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoplasty; for laryngeal stenosis_ with graft_ without indwelling stent placement_ age 12 years or older","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31552","description":"Laryngoplasty; for laryngeal stenosis_ with graft_ without indwelling stent placement_ age 12 years or older","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of lithium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80178","description":"Assay of lithium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder_ initial 30-60 minutes_ provided remotely by hospital staff who are licensed to pr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7901","description":"Service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder_ initial 30-60 minutes_ provided remotely by hospital staff who are licensed to pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bmi is documented below normal parameters and a follow-up plan is documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1287","description":"Bmi is documented below normal parameters and a follow-up plan is documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFD1","description":"ICD-OFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plt_ pher_ l/r cmv-neg_ irr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9053","description":"Plt_ pher_ l/r cmv-neg_ irr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sho lift taper to metatarsal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3300","description":"Sho lift taper to metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disposable canister for pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7000","description":"Disposable canister for pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of estrogens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82671","description":"Assay of estrogens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44160","description":"Removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAA0","description":"ICD-MIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21086","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKA1","description":"ICD-BBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pafolacianine_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9603","description":"Injection_ pafolacianine_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMF1","description":"ICD-NIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKB0","description":"ICD-NEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crisis interven svc_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2011","description":"Crisis interven svc_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of stomach partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43634","description":"Removal of stomach partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLC0","description":"ICD-ECLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFE0","description":"ICD-FHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML35","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCC0","description":"ICD-EHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aspir/inj thyroid cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60300","description":"Aspir/inj thyroid cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIC1","description":"ICD-KDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAB0","description":"ICD-KEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation Device Evaluation(S) (Remote)_ Up To 90 Days_ Substernal Lead Implantable Cardioverter-Defibrillator System With Interim Analysis_ Review(S) And Report(S) By A P","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0578T","description":"Interrogation Device Evaluation(S) (Remote)_ Up To 90 Days_ Substernal Lead Implantable Cardioverter-Defibrillator System With Interim Analysis_ Review(S) And Report(S) By A P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMC1","description":"ICD-MBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRE1","description":"ICD-HGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGA0","description":"ICD-OBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47605","description":"Removal of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBE0","description":"ICD-KBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Femoral endovas graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34813","description":"Femoral endovas graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMD1","description":"ICD-CHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression gauntlet_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6565","description":"Gradient compression gauntlet_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57200","description":"Repair of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLB1","description":"ICD-JCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELD1","description":"ICD-EELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDA0","description":"ICD-FBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDC1","description":"ICD-MJDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXC1","description":"ICD-GHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFB1","description":"ICD-JHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHC0","description":"ICD-MKHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2JB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JB21","description":"ICD-2JB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBE0","description":"ICD-NFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plmt post facet implt lumb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0221T","description":"Plmt post facet implt lumb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWC0","description":"ICD-OIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQF1","description":"ICD-OKQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAF0","description":"ICD-BAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24579","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE10C","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEC0","description":"ICD-MIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Test sock wrist disart/bel e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6680","description":"Test sock wrist disart/bel e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX20","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct rpt to reg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9327","description":"Ct rpt to reg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of head injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62010","description":"Treatment of head injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBB0","description":"ICD-NEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB30","description":"Medium Rehab _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dyspnea scrnd mod-high dysp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3451F","description":"Dyspnea scrnd mod-high dysp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Isoetharine non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7648","description":"Isoetharine non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36010","description":"Place catheter in vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endo knee-shin fluid swing p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5824","description":"Endo knee-shin fluid swing p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Middle cerebral artery echo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76821","description":"Middle cerebral artery echo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFE0","description":"ICD-FFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pressure support ventilator with volume control mode_ may include pressure control mode_ used with invasive interface (e.g. tracheostomy tube)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0463","description":"Pressure support ventilator with volume control mode_ may include pressure control mode_ used with invasive interface (e.g. tracheostomy tube)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMD0","description":"ICD-GIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laminate labial veneer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2960","description":"Laminate labial veneer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA20C","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJE0","description":"ICD-JHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQD0","description":"ICD-CBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHA1","description":"ICD-OCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHA1","description":"ICD-EIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFB1","description":"ICD-JCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BC31","description":"ICD-2BC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPE0","description":"ICD-FBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Facial moulage complete","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5912","description":"Facial moulage complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert body dcmprn lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63102","description":"Remove vert body dcmprn lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPB0","description":"ICD-CAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm >30.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12057","description":"Intmd rpr face/mm >30.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB241","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69631","description":"Repair eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flu vacc iiv4 no preserv id","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90630","description":"Flu vacc iiv4 no preserv id","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHB0","description":"ICD-OEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray stress view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77071","description":"X-ray stress view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA2B","description":"Very High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree_ derived from coronary angiogram data_ for re","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0523T","description":"Intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree_ derived from coronary angiogram data_ for re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Caster fork","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2396","description":"Caster fork","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYA0","description":"ICD-PKYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEF0","description":"ICD-OLEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEA0","description":"ICD-GAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHC1","description":"ICD-ECHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUE0","description":"ICD-MAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient Screened For Tobacco Use And Received Tobacco Cessation Intervention On The Date Of The Encounter Or Within The Previous 12 Months (Counseling_ Pharmacotherapy_ Or Bot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0030","description":"Patient Screened For Tobacco Use And Received Tobacco Cessation Intervention On The Date Of The Encounter Or Within The Previous 12 Months (Counseling_ Pharmacotherapy_ Or Bot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0919T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","description":"CPT-0919T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOD0","description":"ICD-HHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous pulmonary artery revascularization by stent placement_ each additional vessel or separate lesion_ normal or abnormal connections (List separately in addition to c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33904","description":"Percutaneous pulmonary artery revascularization by stent placement_ each additional vessel or separate lesion_ normal or abnormal connections (List separately in addition to c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic nephrectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50546","description":"Laparoscopic nephrectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHE0","description":"ICD-EFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMF0","description":"ICD-EIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJA0","description":"ICD-GGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUD1","description":"ICD-IFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electromagnetic therapy onc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0295","description":"Electromagnetic therapy onc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXB1","description":"ICD-CDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUA1","description":"ICD-AFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKF1","description":"ICD-JGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSB0","description":"ICD-DCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC25D","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEE1","description":"ICD-NIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Campylobacter antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86625","description":"Campylobacter antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anaphylaxis due to the vaccine on or before the date of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1311","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUC1","description":"ICD-BAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWD1","description":"ICD-GGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42200","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A7021","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","description":"HCPCS-A7021","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBA1","description":"ICD-FHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flutamide 125 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0175","description":"Flutamide 125 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay metl 4/more sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2544","description":"Dental onlay metl 4/more sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHE0","description":"ICD-IIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPB0","description":"ICD-JHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home health care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99375","description":"Home health care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHA0","description":"ICD-OCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRB0","description":"ICD-DIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal surg sacrococ teratoma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2405","description":"Fetal surg sacrococ teratoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap colectomy part w/ileum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44205","description":"Lap colectomy part w/ileum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Astigmatism-correct function","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2787","description":"Astigmatism-correct function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct abd & pelv 1/> regns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74178","description":"Ct abd & pelv 1/> regns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIA0","description":"ICD-OLIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bk removable medial brim sus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5672","description":"Bk removable medial brim sus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJA0","description":"ICD-JGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wound prep f/n/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15004","description":"Wound prep f/n/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHF0","description":"ICD-ACHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTE0","description":"ICD-OFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCB0","description":"ICD-EFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCID1","description":"ICD-FCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ amisulpride_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9153","description":"Injection_ amisulpride_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHC1","description":"ICD-CHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJB0","description":"ICD-FCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQB1","description":"ICD-HEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIB0","description":"ICD-AEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOE0","description":"ICD-OLOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRE1","description":"ICD-HBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHA0","description":"ICD-OLHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELD0","description":"ICD-JELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSE1","description":"ICD-PLSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESB0","description":"ICD-HESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pin ulnar styloid fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25651","description":"Pin ulnar styloid fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLD1","description":"ICD-GFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18C","description":"Special Care High _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD210","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB124","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHE0","description":"ICD-BHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC12A","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61516","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01390","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01390","description":"CPT-01390","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKF0","description":"ICD-FFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq dev breast 1st us imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19285","description":"Perq dev breast 1st us imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implt neurostim radiofq rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8682","description":"Implt neurostim radiofq rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUB0","description":"ICD-GHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLA1","description":"ICD-JFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJD1","description":"ICD-JCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHED0","description":"ICD-CHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTA1","description":"ICD-MDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNB1","description":"ICD-KBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSE0","description":"ICD-DHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not have a follow-up assessment within 120 days of the index assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1363","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0504T","description":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYC0","description":"ICD-PAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEF1","description":"ICD-IEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXA0","description":"ICD-OBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services used by patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9709","description":"Hospice services used by patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00836","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00836","description":"CPT-00836","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interim labor facility globa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4005","description":"Interim labor facility globa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ex for speech device rx 1hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92607","description":"Ex for speech device rx 1hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lyme disease antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86618","description":"Lyme disease antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERB0","description":"ICD-CERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; each multiplex probe stain p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0853T","description":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; each multiplex probe stain p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGE1","description":"ICD-NHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKC0","description":"ICD-NBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transperineal periurethral balloon continence device; removal_ each balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0550T","description":"Transperineal periurethral balloon continence device; removal_ each balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25332","description":"Revise wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBA1","description":"ICD-GDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHF1","description":"ICD-GIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMC1","description":"ICD-NKMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8H","description":"High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pten gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81321","description":"Pten gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUB1","description":"ICD-NHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYA1","description":"ICD-OHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDC0","description":"ICD-OBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43621","description":"Removal of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ins/rep subq defibrillator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33270","description":"Ins/rep subq defibrillator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQE1","description":"ICD-KHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHF1","description":"ICD-AIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBD0","description":"ICD-FHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRA1","description":"ICD-OLRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJE1","description":"ICD-BIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE235","description":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ankle/heel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28100","description":"Removal of ankle/heel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0487U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","description":"CPT-0487U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC22D","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAE1","description":"ICD-IBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laa closure w/implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0281T","description":"Laa closure w/implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMD1","description":"ICD-KAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNB1","description":"ICD-BCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLD1","description":"ICD-MCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj prohance multipack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9576","description":"Inj prohance multipack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sputum specimen collection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89220","description":"Sputum specimen collection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig footwear evaluatio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8416","description":"Pt inelig footwear evaluatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise foot tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28088","description":"Excise foot tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIA1","description":"ICD-GCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUE0","description":"ICD-OEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of permanently implantable aortic counterpulsation ventricular assist system; aortic counterpulsation device and vascular hemostatic seal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0456T","description":"Removal of permanently implantable aortic counterpulsation ventricular assist system; aortic counterpulsation device and vascular hemostatic seal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKB0","description":"ICD-KHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXE0","description":"ICD-JHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYE0","description":"ICD-LCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTD0","description":"ICD-MGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCB1","description":"ICD-CCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEA1","description":"ICD-IFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye muscle(s) add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67320","description":"Revise eye muscle(s) add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIID1","description":"ICD-GIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYF0","description":"ICD-LGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXF1","description":"ICD-GBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBD0","description":"ICD-CHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYE0","description":"ICD-CIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEF0","description":"ICD-BBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9171","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9171","description":"HCPCS-C9171","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft axill-brachial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35522","description":"Art byp grft axill-brachial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay tumor ca 19-9","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86301","description":"Immunoassay tumor ca 19-9","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMC0","description":"ICD-CAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOF0","description":"ICD-LAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81545","description":"Oncology thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLB1","description":"ICD-NHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4GA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GA11","description":"ICD-4GA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insrt/redo neurostim 1 array","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61885","description":"Insrt/redo neurostim 1 array","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9246","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9246","description":"CDT-D9246","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy appendectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44970","description":"Laparoscopy appendectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYA1","description":"ICD-LDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX20","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESF0","description":"ICD-LESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q9998","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","description":"HCPCS-Q9998","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUF0","description":"ICD-MAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSC0","description":"ICD-DDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOB0","description":"ICD-KDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX23","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx nasomax fx w/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21348","description":"Opn tx nasomax fx w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foot arch supp longitud/meta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3060","description":"Foot arch supp longitud/meta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFA1","description":"ICD-KBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX35","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTE0","description":"ICD-OLTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGC1","description":"ICD-FBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX12","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA05","description":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKD0","description":"ICD-CBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUD1","description":"ICD-GCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRF0","description":"ICD-OKRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Homecare train pt session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5109","description":"Homecare train pt session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4388","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","description":"HCPCS-Q4388","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJA1","description":"ICD-JIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc rectal tumor endoscopic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0184T","description":"Exc rectal tumor endoscopic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epilepsy Genomic Sequence Analysis Panel_ Must Include Analyses For Aldh7A1_ Cacna1A_ Cdkl5_ Chd2_ Gabrg2_ Grin2A_ Kcnq2_ Mecp2_ Pcdh19_ Polg_ Prrt2_ Scn1A_ Scn1B_ Scn2A_ Scn8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81419","description":"Epilepsy Genomic Sequence Analysis Panel_ Must Include Analyses For Aldh7A1_ Cacna1A_ Cdkl5_ Chd2_ Gabrg2_ Grin2A_ Kcnq2_ Mecp2_ Pcdh19_ Polg_ Prrt2_ Scn1A_ Scn1B_ Scn2A_ Scn8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Topographic brain mapping","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8040","description":"Topographic brain mapping","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXA1","description":"ICD-BCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fecal blood scrn immunoassay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0328","description":"Fecal blood scrn immunoassay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release thumb contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26508","description":"Release thumb contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of chest wall respiratory sensor electrode or electrode array_ including connection to pulse generator (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0466T","description":"Insertion of chest wall respiratory sensor electrode or electrode array_ including connection to pulse generator (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVF1","description":"ICD-NLVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJB0","description":"ICD-GDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Initial psychiatric collaborative care management_ first 70 minutes in the first calendar month of behavioral health care manager activities_ in consultation with a psychiatri","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0502","description":"Initial psychiatric collaborative care management_ first 70 minutes in the first calendar month of behavioral health care manager activities_ in consultation with a psychiatri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antithrombin iii antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85301","description":"Antithrombin iii antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18F","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 30 mcg/0.3 mL dosage_ tris-sucrose formulation_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91320","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 30 mcg/0.3 mL dosage_ tris-sucrose formulation_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not providing tobacco cessation intervention (e.g._ limited life expectancy_ other medical reason)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9907","description":"Documentation of medical reason(s) for not providing tobacco cessation intervention (e.g._ limited life expectancy_ other medical reason)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainable rubber pch w/o fp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4378","description":"Drainable rubber pch w/o fp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTB1","description":"ICD-GGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fos c chld non-ther per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0041","description":"Fos c chld non-ther per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTE1","description":"ICD-MFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; azygos/hemiazygos venous system (List separately in a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93585","description":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; azygos/hemiazygos venous system (List separately in a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIE1","description":"ICD-ODIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous access and closure of femoral artery for delivery of endograft through a large sheath (12 French or larger)_ including ultrasound guidance_ when performed_ unilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34713","description":"Percutaneous access and closure of femoral artery for delivery of endograft through a large sheath (12 French or larger)_ including ultrasound guidance_ when performed_ unilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove skull plate/flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62142","description":"Remove skull plate/flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8B","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ below knee_ 30-40 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6553","description":"Gradient compression stocking_ below knee_ 30-40 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFED1","description":"ICD-CFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBC1","description":"ICD-BGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Basic support routine suppls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0382","description":"Basic support routine suppls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE121","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vitamin k phytonadione inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3430","description":"Vitamin k phytonadione inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEB1","description":"ICD-NBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic intern lock elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6350","description":"Thoracic intern lock elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise urethra stage 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53405","description":"Revise urethra stage 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASC1","description":"ICD-LASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE205","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAE1","description":"ICD-CCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLB1","description":"ICD-IDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSF1","description":"ICD-GHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove windpipe lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31785","description":"Remove windpipe lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGB0","description":"ICD-NDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed total elect w/ matt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0296","description":"Hosp bed total elect w/ matt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHE1","description":"ICD-MCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHD1","description":"ICD-JAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHF1","description":"ICD-CEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cataract surg w/iol 1 stage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66984","description":"Cataract surg w/iol 1 stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWD0","description":"ICD-LDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITE0","description":"ICD-JITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp axillary-axillary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35650","description":"Art byp axillary-axillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUD1","description":"ICD-JDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTE1","description":"ICD-CGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCD0","description":"ICD-JFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lefort iii w/o lefort i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21154","description":"Lefort iii w/o lefort i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWD0","description":"ICD-OGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of vitamin b-6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84207","description":"Assay of vitamin b-6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epifix_ inj_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4145","description":"Epifix_ inj_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Initial hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99221","description":"Initial hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALB1","description":"ICD-EALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of tendons at wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25301","description":"Fusion of tendons at wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Calr gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81219","description":"Calr gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/o cont_ chest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8910","description":"Mra w/o cont_ chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLD0","description":"ICD-GGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A6517","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","description":"HCPCS-A6517","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOA1","description":"ICD-PEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEC1","description":"ICD-MIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of transcortin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84449","description":"Assay of transcortin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJE1","description":"ICD-OIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gene test sickle cell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3850","description":"Gene test sickle cell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOB1","description":"ICD-OLOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eardrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69610","description":"Repair of eardrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD150","description":"Special Care High _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWA1","description":"ICD-DHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDC0","description":"ICD-BGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9489","description":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg_ electrode array and receiver)_ including contact group(s)_ amplitude_ pulse wi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0788T","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg_ electrode array and receiver)_ including contact group(s)_ amplitude_ pulse wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKE1","description":"ICD-CDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICID1","description":"ICD-ICID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRE0","description":"ICD-OIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAA1","description":"ICD-OBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC136","description":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMB0","description":"ICD-NGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of thigh muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27385","description":"Repair of thigh muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIC0","description":"ICD-ODIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIF1","description":"ICD-BHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy consultation performed prior to a screening colonoscopy procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0285","description":"Colonoscopy consultation performed prior to a screening colonoscopy procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADB0","description":"ICD-BADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVC0","description":"ICD-FFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiopharm dx agent noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4641","description":"Radiopharm dx agent noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB11B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sacral nerve stim test lead","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4290","description":"Sacral nerve stim test lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home mgmt pprom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9209","description":"Home mgmt pprom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of acute vitreous hemorrhage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1328","description":"Patients with a diagnosis of acute vitreous hemorrhage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lengthening of thigh bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27466","description":"Lengthening of thigh bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at six months as demon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1024","description":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at six months as demon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHA1","description":"ICD-MKHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHC1","description":"ICD-KDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFD0","description":"ICD-JDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vbac care after delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59614","description":"Vbac care after delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38A","description":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antidepressants class 3-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80333","description":"Antidepressants class 3-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anti-inhibitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7198","description":"Anti-inhibitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQE1","description":"ICD-DCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylindr 4.00d/2.12-4d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2104","description":"Spherocylindr 4.00d/2.12-4d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARE0","description":"ICD-HARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIE0","description":"ICD-JEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sinus endo w/balloon dil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31296","description":"Sinus endo w/balloon dil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETF0","description":"ICD-OETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore wound extremity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20103","description":"Explore wound extremity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKD0","description":"ICD-CHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSA0","description":"ICD-HCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92635","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","description":"CPT-92635","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESB1","description":"ICD-CESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSE0","description":"ICD-PKSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA4A","description":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ther behav svc_ per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2019","description":"Ther behav svc_ per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLC1","description":"ICD-CHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCB1","description":"ICD-EFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33430","description":"Replacement of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3FA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FA31","description":"ICD-3FA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLA1","description":"ICD-CGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Temperature gradient studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93740","description":"Temperature gradient studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGF1","description":"ICD-CCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLD0","description":"ICD-MBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE12A","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMB1","description":"ICD-ABMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mon anesth care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9654","description":"Mon anesth care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVF0","description":"ICD-NIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEA0","description":"ICD-NEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLF1","description":"ICD-IDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUA1","description":"ICD-MJUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAF1","description":"ICD-KEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDD1","description":"ICD-FGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of zinc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84630","description":"Assay of zinc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD22A","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGF1","description":"ICD-FDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj protamine sulfate/10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2720","description":"Inj protamine sulfate/10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Employment Benefits Counseling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1740","description":"Employment Benefits Counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAC1","description":"ICD-AHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise spine nrv >2 segmnts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63190","description":"Incise spine nrv >2 segmnts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABA0","description":"ICD-EABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD204","description":"Reduced Physical Function _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLF1","description":"ICD-NDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging with inhaled hyperpolarized xenon-129 contrast agent_ chest_ including preparation andadministration of agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9791","description":"Magnetic resonance imaging with inhaled hyperpolarized xenon-129 contrast agent_ chest_ including preparation andadministration of agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit2.6-7.5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12042","description":"Intmd rpr n-hf/genit2.6-7.5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA13B","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPC1","description":"ICD-OHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHC0","description":"ICD-JDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5159","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","description":"HCPCS-Q5159","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl devital tis 20 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97597","description":"Rmvl devital tis 20 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMF0","description":"ICD-KEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath fl nongyn filter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88106","description":"Cytopath fl nongyn filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dysphag test done b/4 eating","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6015F","description":"Dysphag test done b/4 eating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELB1","description":"ICD-MELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJC0","description":"ICD-OCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADC0","description":"ICD-JADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rotavirus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86759","description":"Rotavirus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCE0","description":"ICD-BFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pancreatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48153","description":"Pancreatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLE1","description":"ICD-NHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Temsirolimus injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9330","description":"Temsirolimus injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal cancer)_ qualitative real-time PCR of 35 variants of KRAS and NRAS genes (exons 2_ 3_ 4)_ formalin-fixed paraffin-embedded (FFPE)_ predictive_ identificat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0471U","description":"Oncology (colorectal cancer)_ qualitative real-time PCR of 35 variants of KRAS and NRAS genes (exons 2_ 3_ 4)_ formalin-fixed paraffin-embedded (FFPE)_ predictive_ identificat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBD1","description":"ICD-BEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBB0","description":"ICD-GEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYD1","description":"ICD-PHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lipid panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80061","description":"Lipid panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transport chair_ ped size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1037","description":"Transport chair_ ped size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical dress holder reuse","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4463","description":"Surgical dress holder reuse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Piperacillin/tazobactam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2543","description":"Piperacillin/tazobactam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUC0","description":"ICD-FDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI w/o fol w/cont_ breast_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8908","description":"MRI w/o fol w/cont_ breast_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADA1","description":"ICD-EADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65135","description":"Insert ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIE1","description":"ICD-BGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYF0","description":"ICD-HIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYF1","description":"ICD-HDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sleeve lobectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32486","description":"Sleeve lobectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bl smear w/diff wbc count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85007","description":"Bl smear w/diff wbc count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Programmable infusion pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0783","description":"Programmable infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXF1","description":"ICD-OLXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECF1","description":"ICD-OECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDD1","description":"ICD-IGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGF0","description":"ICD-CBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7529","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ep & ablate ventric tachy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93654","description":"Ep & ablate ventric tachy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOD1","description":"ICD-PIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dextran 40 infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7100","description":"Dextran 40 infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBB0","description":"ICD-KIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDF0","description":"ICD-GBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0485U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","description":"CPT-0485U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shorten radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25390","description":"Shorten radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81336","description":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7525","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anatomic guide 3D-printed and designed from image data set(s); first anatomic guide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0561T","description":"Anatomic guide 3D-printed and designed from image data set(s); first anatomic guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGC0","description":"ICD-OIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC136","description":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Platelets_ hla-m_ l/r_ unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9052","description":"Platelets_ hla-m_ l/r_ unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of skull defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62141","description":"Repair of skull defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Next Gen aco model>20min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9870","description":"Next Gen aco model>20min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No pap prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8850","description":"No pap prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIB1","description":"ICD-GIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMC1","description":"ICD-BHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGD0","description":"ICD-JBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home health care supervision","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0181","description":"Home health care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDF0","description":"ICD-JEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL12","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling_ peritoneal washings_ peritoneal biopsy(ies)_ omentectomy_ and diaphragm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38573","description":"Laparoscopy_ surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling_ peritoneal washings_ peritoneal biopsy(ies)_ omentectomy_ and diaphragm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPC1","description":"ICD-NGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEC1","description":"ICD-JDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3EA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EA21","description":"ICD-3EA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCA1","description":"ICD-ADCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Walker rigid adjust/fixed ht","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0130","description":"Walker rigid adjust/fixed ht","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKA1","description":"ICD-OFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE23A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18C","description":"Special Care Low _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMD1","description":"ICD-OJMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXD1","description":"ICD-CDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQF0","description":"ICD-DEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8B","description":"Very High Rehab _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIC0","description":"ICD-EAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB235","description":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26080","description":"Explore/treat finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIE1","description":"ICD-BCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup shrt leg ped plster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4039","description":"Cast sup shrt leg ped plster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3BB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BB11","description":"ICD-3BB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPA0","description":"ICD-NFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Methylprednisolone 20 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1020","description":"Methylprednisolone 20 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBC1","description":"ICD-EIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKB1","description":"ICD-GDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGB0","description":"ICD-OAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33777","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22846","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSF1","description":"ICD-PJSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTA0","description":"ICD-OGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHF0","description":"ICD-GDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERC1","description":"ICD-LERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flecainide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80181","description":"Flecainide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVE1","description":"ICD-NKVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBD1","description":"ICD-MBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD23C","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair bowel fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44650","description":"Repair bowel fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8G","description":"Low Rehab_ ADL Index 0-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUE1","description":"ICD-MEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABE0","description":"ICD-MABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCB0","description":"ICD-FHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD25A","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLE0","description":"ICD-KFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thorac cont paraspinal uprig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2670","description":"Thorac cont paraspinal uprig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27792","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLA0","description":"ICD-NHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPA0","description":"ICD-KGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1422","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","description":"HCPCS-M1422","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"RAS (KRAS and NRAS) gene mutation testing performed before initiation of anti-EGFR MoAb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9840","description":"RAS (KRAS and NRAS) gene mutation testing performed before initiation of anti-EGFR MoAb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUD1","description":"ICD-CEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXC1","description":"ICD-JCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJD0","description":"ICD-OCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLA0","description":"ICD-FDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUC0","description":"ICD-KEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPC1","description":"ICD-FEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Composite skin graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15760","description":"Composite skin graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYD0","description":"ICD-KBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOA1","description":"ICD-PAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLD0","description":"ICD-IGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ glycopyrrolate_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1596","description":"Injection_ glycopyrrolate_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Zidovudine_ oral_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0104","description":"Zidovudine_ oral_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert 2 electrode pm-defib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33217","description":"Insert 2 electrode pm-defib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA44","description":"Default_ /60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC5A","description":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBC0","description":"ICD-AIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Respirator motion mgmt simul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77293","description":"Respirator motion mgmt simul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUF1","description":"ICD-CAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prq cardiac angio addl art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92921","description":"Prq cardiac angio addl art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0548U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","description":"CPT-0548U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rehab thxpy options w/pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4400F","description":"Rehab thxpy options w/pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRF1","description":"ICD-CDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Instillation of antineoplastic pharmacologic/biologic agent into renal pelvis_ any method_ including all imaging guidance_including volumetric measurement if performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9789","description":"Instillation of antineoplastic pharmacologic/biologic agent into renal pelvis_ any method_ including all imaging guidance_including volumetric measurement if performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUE1","description":"ICD-CCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHA0","description":"ICD-KEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQB0","description":"ICD-HIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J8502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","description":"HCPCS-J8502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIE1","description":"ICD-KDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUB0","description":"ICD-KDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBID1","description":"ICD-EBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDC1","description":"ICD-FDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of leg veins/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37735","description":"Removal of leg veins/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAA0","description":"ICD-AAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0502","description":"HCPCS-B0502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEB0","description":"ICD-KDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEA0","description":"ICD-ODEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJC0","description":"ICD-BGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTD1","description":"ICD-CBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of femur 2/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73552","description":"X-ray exam of femur 2/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronidase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3470","description":"Hyaluronidase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL5B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1307","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","description":"HCPCS-J1307","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of fibula fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27784","description":"Treatment of fibula fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nonneedle injection device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4210","description":"Nonneedle injection device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRA0","description":"ICD-LCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYF1","description":"ICD-GDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEID0","description":"ICD-IEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration maxillary sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31030","description":"Exploration maxillary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOF1","description":"ICD-LIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Expired gas collection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94250","description":"Expired gas collection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0767","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0767","description":"HCPCS-E0767","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mattress foam rubber","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0272","description":"Mattress foam rubber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92653","description":"Anesth removal of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00942","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00942","description":"CPT-00942","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome analysis 45","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88263","description":"Chromosome analysis 45","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prefab porc/ceram crown pri","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2929","description":"Prefab porc/ceram crown pri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIE1","description":"ICD-JCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKC1","description":"ICD-BFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0674U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674U","description":"CPT-0674U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQB1","description":"ICD-LAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair bowel-bladder fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44661","description":"Repair bowel-bladder fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc visc aorta 1 graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34841","description":"Endovasc visc aorta 1 graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD254","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVE0","description":"ICD-OBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWE0","description":"ICD-GEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive sternum surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21632","description":"Extensive sternum surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE134","description":"Special Care High _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEB0","description":"ICD-KEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHF1","description":"ICD-JIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth one lung ventilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54151","description":"Anesth one lung ventilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPD0","description":"ICD-FHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWF1","description":"ICD-PAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHB1","description":"ICD-MGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18X","description":"Special Care Low _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQF0","description":"ICD-GDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Recement cast or prefab post","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2915","description":"Recement cast or prefab post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IN GNOTYP CD44 EXONS 2 3 6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0191U","description":"IN GNOTYP CD44 EXONS 2 3 6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDD1","description":"ICD-MFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHF1","description":"ICD-JDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIB1","description":"ICD-KFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Relieve cranial pressure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61345","description":"Relieve cranial pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAD1","description":"ICD-NAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSD0","description":"ICD-DFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXF1","description":"ICD-KGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESB1","description":"ICD-LESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQF0","description":"ICD-KCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; venous anastomosis_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0669T","description":"Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; venous anastomosis_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of skull with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62147","description":"Repair of skull with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0801","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0801","description":"HCPCS-B0801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary stress test/simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94620","description":"Pulmonary stress test/simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBB0","description":"ICD-FEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blinded procedure for New York Heart Association (NYHA) Class II or III heart failure_ or Canadian Cardiovascular Society (CCS) Class III or IV chronic refractory angina; tran","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9782","description":"Blinded procedure for New York Heart Association (NYHA) Class II or III heart failure_ or Canadian Cardiovascular Society (CCS) Class III or IV chronic refractory angina; tran","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystouretero w/stone remove","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52352","description":"Cystouretero w/stone remove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infant safety class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9447","description":"Infant safety class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48000","description":"Drainage of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rbc depletion of harvest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38212","description":"Rbc depletion of harvest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLB0","description":"ICD-MGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLD0","description":"ICD-GHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pin radioulnar dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25671","description":"Pin radioulnar dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Maxillofacial prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5999","description":"Maxillofacial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oral speech device eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92597","description":"Oral speech device eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXF1","description":"ICD-NDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHD1","description":"ICD-AHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE25C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKB1","description":"ICD-KAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METE1","description":"ICD-METE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bumetanide_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1939","description":"Injection_ bumetanide_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Part removal of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28110","description":"Part removal of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove/replace penis prosth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54410","description":"Remove/replace penis prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lung perfusion imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78580","description":"Lung perfusion imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suture small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44602","description":"Suture small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urine shunt to intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50815","description":"Urine shunt to intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEC1","description":"ICD-ODEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gba gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81251","description":"Gba gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee disarticulat leather so","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5640","description":"Knee disarticulat leather so","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICE1","description":"ICD-EICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICA1","description":"ICD-EICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQB1","description":"ICD-KFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICD0","description":"ICD-GICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMD1","description":"ICD-JHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHC0","description":"ICD-IFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIE0","description":"ICD-IHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA14A","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Evaluation cervical mucus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89330","description":"Evaluation cervical mucus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVD1","description":"ICD-BHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Visual acuity screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99173","description":"Visual acuity screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD12D","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93151","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (lung)_ three protein biomarkers_ immunoassay using magnetic nanosensor technology_ plasma_ algorithm reported as risk score for likelihood of malignancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0092U","description":"Oncology (lung)_ three protein biomarkers_ immunoassay using magnetic nanosensor technology_ plasma_ algorithm reported as risk score for likelihood of malignancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRE1","description":"ICD-GBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPA1","description":"ICD-OGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHD1","description":"ICD-ABHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC126","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of aluminum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82108","description":"Assay of aluminum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit inj interferon diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9559","description":"Hit inj interferon diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal and replacement of externally accessible nephroureteral catheter (eg_ external/internal stent) requiring fluoroscopic guidance_ with ureteral stricture balloon dilatio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7546","description":"Removal and replacement of externally accessible nephroureteral catheter (eg_ external/internal stent) requiring fluoroscopic guidance_ with ureteral stricture balloon dilatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of pilonidal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10080","description":"Drainage of pilonidal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRA0","description":"ICD-PCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHF1","description":"ICD-KHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ concentration technique_ smears_ and interpretation (eg_ Saccomanno technique) (List separately in addition to code","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0829T","description":"Digitization of glass microscope slides for cytopathology_ concentration technique_ smears_ and interpretation (eg_ Saccomanno technique) (List separately in addition to code","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC121","description":"Special Care High _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair extra toe(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28344","description":"Repair extra toe(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPF0","description":"ICD-FHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE254","description":"Special Care Low _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTF1","description":"ICD-ICTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ft insert ucb berkeley shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3000","description":"Ft insert ucb berkeley shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair hand deformity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26580","description":"Repair hand deformity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay other fluid chlorides","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82438","description":"Assay other fluid chlorides","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMD1","description":"ICD-KCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repl nasal pillow comb mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7029","description":"Repl nasal pillow comb mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sacituzumab govitecan-hziy_ 2.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9317","description":"Injection_ sacituzumab govitecan-hziy_ 2.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-invasive vagus nerve stimulator (GammaCore-S)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1020","description":"Non-invasive vagus nerve stimulator (GammaCore-S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft wrist bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25440","description":"Repair/graft wrist bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66740","description":"Destruction ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUC0","description":"ICD-MBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient has mitral stenosis or prosthetic heart valves or patient has transient or reversible cause of AF (e.g._ pneumonia_ hyperthyroidism_ pregnancy_ cardiac surgery)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9746","description":"Patient has mitral stenosis or prosthetic heart valves or patient has transient or reversible cause of AF (e.g._ pneumonia_ hyperthyroidism_ pregnancy_ cardiac surgery)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40490","description":"Biopsy of lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28E","description":"Clinically Complex _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFC1","description":"ICD-BFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hep c antiviral started","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9205","description":"Hep c antiviral started","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth upper gi visualize","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74051","description":"Anesth upper gi visualize","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYB1","description":"ICD-HHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSD1","description":"ICD-CHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCB0","description":"ICD-AFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28C","description":"Special Care High _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcath stent cca w/eps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37215","description":"Transcath stent cca w/eps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ natalizumab-sztn (tyruko)_ biosimilar_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5134","description":"Injection_ natalizumab-sztn (tyruko)_ biosimilar_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVD1","description":"ICD-JAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat tail bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27202","description":"Treat tail bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug test presump not opt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0479","description":"Drug test presump not opt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDE0","description":"ICD-EIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Access thoracic lymph duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38794","description":"Access thoracic lymph duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUC1","description":"ICD-OIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of prealbumin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84134","description":"Assay of prealbumin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUB1","description":"ICD-GFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr pul art unifocal w/o cpb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33925","description":"Rpr pul art unifocal w/o cpb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-2 antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86702","description":"Hiv-2 antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1394","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","description":"HCPCS-M1394","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Humidifier heated used w pap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0562","description":"Humidifier heated used w pap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWE1","description":"ICD-HFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIE1","description":"ICD-GAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBA0","description":"ICD-IBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Membrane wrap-hydro_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4290","description":"Membrane wrap-hydro_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt consid poss risk fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3572F","description":"Pt consid poss risk fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB15D","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFA0","description":"ICD-BFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDD0","description":"ICD-OHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Team conf w/pat by hc prof","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99366","description":"Team conf w/pat by hc prof","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOB1","description":"ICD-DFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBA0","description":"ICD-ICBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJD0","description":"ICD-GIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of hip tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27003","description":"Incision of hip tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CT/MRI chest follup not rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9556","description":"CT/MRI chest follup not rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ onasemnogene abeparvovec-xioi_ per treatment_ up to 5x10^15 vector genomes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3399","description":"Injection_ onasemnogene abeparvovec-xioi_ per treatment_ up to 5x10^15 vector genomes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDF1","description":"ICD-OFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1011T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","description":"CPT-1011T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERF0","description":"ICD-CERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANA0","description":"ICD-KANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair throat wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42900","description":"Repair throat wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTE1","description":"ICD-MCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELF1","description":"ICD-JELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bevacizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9257","description":"Bevacizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hi enrgy eswt plantar fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28890","description":"Hi enrgy eswt plantar fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMB0","description":"ICD-ADMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of fibula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27707","description":"Incision of fibula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKC0","description":"ICD-CIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAID0","description":"ICD-EAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNB1","description":"ICD-GFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee lift loop drop lock rin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2492","description":"Knee lift loop drop lock rin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAF0","description":"ICD-NEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXD1","description":"ICD-GEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Impreg gauze no h20/sal/yard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6266","description":"Impreg gauze no h20/sal/yard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIA0","description":"ICD-KFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth cabg w/pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56751","description":"Anesth cabg w/pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3IC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IC21","description":"ICD-3IC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"(Rapivab) Injection_ Peramivir_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9451","description":"(Rapivab) Injection_ Peramivir_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISF1","description":"ICD-LISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ef incomplete/modular","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4155","description":"Ef incomplete/modular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patten bottom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2370","description":"Patten bottom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87662","description":"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression glove_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6581","description":"Gradient compression glove_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETE0","description":"ICD-FETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRB1","description":"ICD-KDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coupling gel or paste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4559","description":"Coupling gel or paste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIF1","description":"ICD-NHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative Ultrasound Tissue Characterization (Non-Elastographic)_ Including Interpretation And Report_ Obtained Without Diagnostic Ultrasound Examination Of The Same Anatom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0689T","description":"Quantitative Ultrasound Tissue Characterization (Non-Elastographic)_ Including Interpretation And Report_ Obtained Without Diagnostic Ultrasound Examination Of The Same Anatom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adults who have at least 180 days of continuous pharmacotherapy with a medication prescribed for OUD without a gap of more than","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1034","description":"Adults who have at least 180 days of continuous pharmacotherapy with a medication prescribed for OUD without a gap of more than","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERC0","description":"ICD-CERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Waterjet prostate abltj cmpl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0421T","description":"Waterjet prostate abltj cmpl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPD0","description":"ICD-GFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTE0","description":"ICD-JCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTC1","description":"ICD-MFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA22","description":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHA0","description":"ICD-KFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDB0","description":"ICD-AFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAF0","description":"ICD-EBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUF1","description":"ICD-FHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELE0","description":"ICD-KELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Obtaining screen pap smear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0091","description":"Obtaining screen pap smear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apexification/recalc initial","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3351","description":"Apexification/recalc initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trim skin lesions over 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11057","description":"Trim skin lesions over 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLF1","description":"ICD-JGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reticyte/hgb concentrate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85046","description":"Reticyte/hgb concentrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEC1","description":"ICD-NIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orth foot add charge split s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3257","description":"Orth foot add charge split s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBC1","description":"ICD-KBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHA1","description":"ICD-BBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL4A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFD0","description":"ICD-NGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagosc dilate balloon 30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43214","description":"Esophagosc dilate balloon 30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not naming ct studies according to a standardized nomenclature provided (eg_CT studies performed for radiation treatment planning)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9320","description":"Documentation of medical reason(s) for not naming ct studies according to a standardized nomenclature provided (eg_CT studies performed for radiation treatment planning)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTA0","description":"ICD-IDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18B","description":"Clinically Complex _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0550U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0550U","description":"CPT-0550U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cipaglucosidase alfa-atga_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1203","description":"Injection_ cipaglucosidase alfa-atga_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHF0","description":"ICD-JBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Grade 2 or above diarrhea and/or grade 2 or above colitis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1181","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sterile water/saline_ 500 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4217","description":"Sterile water/saline_ 500 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin a1c level >9.0%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3046F","description":"Hemoglobin a1c level >9.0%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXF0","description":"ICD-JAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Conz of cervix w/scope leep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57461","description":"Conz of cervix w/scope leep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQE0","description":"ICD-LFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18F","description":"Clinically Complex _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap rmvl gastr adj device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43772","description":"Lap rmvl gastr adj device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dermapure 1 square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4152","description":"Dermapure 1 square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle for the reduction of snoring and obstructive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1028","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle for the reduction of snoring and obstructive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB02","description":"Very High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGC1","description":"ICD-GBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOD1","description":"ICD-HGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKE0","description":"ICD-FGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICC1","description":"ICD-GICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDE0","description":"ICD-IBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALF1","description":"ICD-JALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sinusitis comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9464","description":"Sinusitis comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCA1","description":"ICD-CBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inpatient consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99252","description":"Inpatient consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA150","description":"Clinically Complex _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES24D","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment plan development","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1007","description":"Treatment plan development","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECC0","description":"ICD-GECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pharm ther osteo rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8633","description":"Pharm ther osteo rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1013T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","description":"CPT-1013T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Development of cognitive skills to improve attention_ memory_ problem solving (includes compensatory training)_ direct (one-on-one) patient contact_ each 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0515","description":"Development of cognitive skills to improve attention_ memory_ problem solving (includes compensatory training)_ direct (one-on-one) patient contact_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDB0","description":"ICD-ABDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGC0","description":"ICD-CDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine lamina 1/2 scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63011","description":"Remove spine lamina 1/2 scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Xray place dist ext thor ao","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75959","description":"Xray place dist ext thor ao","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABB0","description":"ICD-IABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSA0","description":"ICD-PGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repl garment for aed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0608","description":"Repl garment for aed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHC0","description":"ICD-EDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIB0","description":"ICD-NJIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC46","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA24C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRA1","description":"ICD-HGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67314","description":"Revise eye muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain shoulder bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23031","description":"Drain shoulder bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWD0","description":"ICD-OJWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVF0","description":"ICD-KDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJF0","description":"ICD-CIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Deb bone add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11047","description":"Deb bone add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Car-car bp grft/endovas taa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33891","description":"Car-car bp grft/endovas taa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIF1","description":"ICD-EDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEB1","description":"ICD-NFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m bicisate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9557","description":"Tc99m bicisate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ battery status_ electrode selectability and polarity_ impedanc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95979","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ battery status_ electrode selectability and polarity_ impedanc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFC1","description":"ICD-FFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA126","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adlt disp und/pull on abv xl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4544","description":"Adlt disp und/pull on abv xl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD110","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mammo assess inc xray docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3340F","description":"Mammo assess inc xray docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUE1","description":"ICD-KCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMB0","description":"ICD-IDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRE0","description":"ICD-HHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJB1","description":"ICD-NDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWF1","description":"ICD-DBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ost skn barr w/o conv >4 sqi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4415","description":"Ost skn barr w/o conv >4 sqi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Personal care ser per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1019","description":"Personal care ser per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraop oct brst/node spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0351T","description":"Intraop oct brst/node spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIC0","description":"ICD-IBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB13D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVB1","description":"ICD-ODVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNA0","description":"ICD-CBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPE0","description":"ICD-FCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA21C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Preparation of tumor cavity_ with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with primary craniotomy (List separately","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0735T","description":"Preparation of tumor cavity_ with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with primary craniotomy (List separately","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rn services up to 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1002","description":"Rn services up to 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAE1","description":"ICD-GEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exam/biopsy of vulva w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56821","description":"Exam/biopsy of vulva w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home injectable therapy_ palivizumab_ including administrative services_ professional pharmacy services_ care coordination_ and all necessary supplies an","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9562","description":"Home injectable therapy_ palivizumab_ including administrative services_ professional pharmacy services_ care coordination_ and all necessary supplies an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cmprs burngarment foot-thigh","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6508","description":"Cmprs burngarment foot-thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Soft protect helmet custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A8002","description":"Soft protect helmet custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"3d render w/intrp postproces","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76377","description":"3d render w/intrp postproces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUC0","description":"ICD-FEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWB0","description":"ICD-CGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Re-Cement Or Re-Bond Bilateral Space Maintainer - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1551","description":"Re-Cement Or Re-Bond Bilateral Space Maintainer - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Warfarin or another FDA-approved oral anticoagulant is prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8967","description":"Warfarin or another FDA-approved oral anticoagulant is prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"FMRI brain by tech","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70554","description":"FMRI brain by tech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUB0","description":"ICD-EEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHA1","description":"ICD-CBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct midface w/graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7949","description":"Reconstruct midface w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFF1","description":"ICD-FDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXA0","description":"ICD-KCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHD1","description":"ICD-BGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cabotegravir_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0739","description":"Injection_ cabotegravir_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILC0","description":"ICD-BILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKC0","description":"ICD-FIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSB1","description":"ICD-DHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDID1","description":"ICD-GDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDA0","description":"ICD-OFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 xtra hd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0828","description":"Pwc gp 2 xtra hd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Triptorelin pamoate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3315","description":"Triptorelin pamoate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOC0","description":"ICD-OEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1AB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AB21","description":"ICD-1AB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lumizyme injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0221","description":"Lumizyme injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bimatoprost_ intracameral implant_ 1 microgram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3751","description":"Injection_ bimatoprost_ intracameral implant_ 1 microgram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB213","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA03","description":"Default_ /SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPC1","description":"ICD-JAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIE0","description":"ICD-KIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACD0","description":"ICD-EACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antithromb no presc no reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8698","description":"Antithromb no presc no reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68100","description":"Biopsy of eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDC1","description":"ICD-JEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUD1","description":"ICD-IEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55714","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","description":"CPT-55714","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLC1","description":"ICD-MKLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hiv meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8500","description":"Hiv meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Irrigation of bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51700","description":"Irrigation of bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fluoroestradiol f 18_ diagnostic_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9591","description":"Fluoroestradiol f 18_ diagnostic_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHB0","description":"ICD-KEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of web finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26562","description":"Repair of web finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bladder lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51520","description":"Removal of bladder lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKF0","description":"ICD-KIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93315","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAC1","description":"ICD-JEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAME0","description":"ICD-FAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AB31","description":"ICD-3AB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB24","description":"Very High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGID0","description":"ICD-CGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLF0","description":"ICD-ABLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAE0","description":"ICD-MAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of spinal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63172","description":"Drainage of spinal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Denture tiss conditn maxill","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5850","description":"Denture tiss conditn maxill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSF0","description":"ICD-LHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Irrigation Supply; Sleeve_ Disposable_ Per Month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4437","description":"Irrigation Supply; Sleeve_ Disposable_ Per Month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aquatic therapy/exercises","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97113","description":"Aquatic therapy/exercises","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLE1","description":"ICD-MFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01852","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01852","description":"CPT-01852","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTB1","description":"ICD-OHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX2B","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Factor viia (antihemophilic factor_ recombinant)-jncw (sevenfact)_ 1 microgram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7212","description":"Factor viia (antihemophilic factor_ recombinant)-jncw (sevenfact)_ 1 microgram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHD1","description":"ICD-JCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise spine&cord 2 trx thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63197","description":"Incise spine&cord 2 trx thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICC0","description":"ICD-CICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suprachoroidal injection of a pharmacologic agent (does not include supply of medication)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0465T","description":"Suprachoroidal injection of a pharmacologic agent (does not include supply of medication)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove hip pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15944","description":"Remove hip pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB241","description":"Special Care Low _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFC0","description":"ICD-CGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophageal mucosal integrity testing by electrical impedance_ transoral (list separately in addition to code for primary procedure)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9777","description":"Esophageal mucosal integrity testing by electrical impedance_ transoral (list separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEC1","description":"ICD-CCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWA1","description":"ICD-GHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrical bone stimulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20975","description":"Electrical bone stimulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Report_ diabetes measures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8485","description":"Report_ diabetes measures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Disposable liner/shield/pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4535","description":"Disposable liner/shield/pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0173A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Audiology mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0062","description":"Audiology mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDA1","description":"ICD-OLDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endoscope_ single-use (i.e. disposable)_ urinary tract_ imaging/illumination device (insertable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1747","description":"Endoscope_ single-use (i.e. disposable)_ urinary tract_ imaging/illumination device (insertable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0601U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","description":"CPT-0601U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ edaravone_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9493","description":"Injection_ edaravone_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBC0","description":"ICD-JDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVB1","description":"ICD-CFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTC1","description":"ICD-ACTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunofluorescent study_ each antibody; indirect method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88347","description":"Immunofluorescent study_ each antibody; indirect method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOC0","description":"ICD-LHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3CC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CC11","description":"ICD-3CC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIA1","description":"ICD-KCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colectomy w/neo-rectum pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44158","description":"Colectomy w/neo-rectum pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSE1","description":"ICD-LHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC255","description":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCF0","description":"ICD-MJCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antepartum care only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59426","description":"Antepartum care only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0715T","description":"Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB225","description":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemophilus influenza b vaccine (hib)_ prp-d conjugate_ for booster use only_ intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90646","description":"Hemophilus influenza b vaccine (hib)_ prp-d conjugate_ for booster use only_ intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine potassium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84133","description":"Assay of urine potassium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIC1","description":"ICD-KFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown resin w/base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6721","description":"Crown resin w/base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA25D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDF0","description":"ICD-BHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00914","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00914","description":"CPT-00914","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJE0","description":"ICD-FBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip fracture(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27227","description":"Treat hip fracture(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGD0","description":"ICD-OAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0603","description":"HCPCS-A0603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOD1","description":"ICD-PJOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"remove erupted tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7210","description":"remove erupted tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEB0","description":"ICD-JHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBB1","description":"ICD-MGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC45","description":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1112","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N.gonorrhoeae dna dir prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87590","description":"N.gonorrhoeae dna dir prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA21B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Phys blood bank serv reactj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86078","description":"Phys blood bank serv reactj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD116","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter_ intradiscal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1754","description":"Catheter_ intradiscal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tebentafusp-tebn_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9095","description":"Injection_ tebentafusp-tebn_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22843","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFE1","description":"ICD-OLFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair rectum/remove sigmoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45550","description":"Repair rectum/remove sigmoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCF0","description":"ICD-IDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-93897","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","description":"CPT-93897","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQD0","description":"ICD-DFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35301","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50045","description":"Exploration of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRA1","description":"ICD-DDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCC0","description":"ICD-AHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVA0","description":"ICD-GAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDC1","description":"ICD-ABDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Optokinetic nystagmus test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92534","description":"Optokinetic nystagmus test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBA1","description":"ICD-FFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIED1","description":"ICD-OIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unite biomatrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4129","description":"Unite biomatrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMA1","description":"ICD-OLMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGB0","description":"ICD-NEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchial allergy tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95070","description":"Bronchial allergy tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMD1","description":"ICD-KBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sleep study attended","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95807","description":"Sleep study attended","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNA1","description":"ICD-OHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISF1","description":"ICD-GISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITA0","description":"ICD-KITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA20A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cryptosporidium ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87272","description":"Cryptosporidium ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepb vacc 4 dose immunsup im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90747","description":"Hepb vacc 4 dose immunsup im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEA1","description":"ICD-KFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMA0","description":"ICD-BCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUC0","description":"ICD-AEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ imm glob bivigam_ 500mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1556","description":"Inj_ imm glob bivigam_ 500mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFC0","description":"ICD-BAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Granisetron hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1626","description":"Granisetron hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPD1","description":"ICD-NEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHB1","description":"ICD-ABHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTB0","description":"ICD-FFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endoskeletal axial rotation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5984","description":"Endoskeletal axial rotation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSC1","description":"ICD-PKSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES116","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQD0","description":"ICD-GGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEID0","description":"ICD-OEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYC1","description":"ICD-LDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPD0","description":"ICD-GDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Test socket shldr disart/tho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6684","description":"Test socket shldr disart/tho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A6516","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","description":"HCPCS-A6516","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIF0","description":"ICD-ECIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompress spinal cord thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63064","description":"Decompress spinal cord thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28293","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANA0","description":"ICD-FANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJD0","description":"ICD-BCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (hematolymphoid neoplasia)_ RNA_ BCR/ABL1 major and minor breakpoint fusion transcripts_ quantitative PCR amplification_ blood or bone marrow_ report of fusion not de","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0016U","description":"Oncology (hematolymphoid neoplasia)_ RNA_ BCR/ABL1 major and minor breakpoint fusion transcripts_ quantitative PCR amplification_ blood or bone marrow_ report of fusion not de","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD25C","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBA0","description":"ICD-MGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMF1","description":"ICD-BAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE22C","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert heyman uteri capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58346","description":"Insert heyman uteri capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services for patient received any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9723","description":"Hospice services for patient received any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEF0","description":"ICD-FAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRA1","description":"ICD-CCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRA0","description":"ICD-KFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPF1","description":"ICD-KGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFE1","description":"ICD-OJFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUA0","description":"ICD-OEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAC1","description":"ICD-JHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIB1","description":"ICD-ECIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4390","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","description":"HCPCS-Q4390","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of gentamicin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80170","description":"Assay of gentamicin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; data upload_ analysis and initial report configura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0535T","description":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; data upload_ analysis and initial report configura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTE0","description":"ICD-KGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMF0","description":"ICD-BEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBED1","description":"ICD-EBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57400","description":"Dilation of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alveolus clsd reduc stblz te","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7771","description":"Alveolus clsd reduc stblz te","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor wght kininogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85293","description":"Clot factor wght kininogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYE1","description":"ICD-PKYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAB0","description":"ICD-MFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CoreText or ProText_ per cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4246","description":"CoreText or ProText_ per cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth chest drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52451","description":"Anesth chest drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noonan spectrum disorders","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81442","description":"Noonan spectrum disorders","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYA1","description":"ICD-PJYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Buprenorphine hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0592","description":"Buprenorphine hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4439","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","description":"HCPCS-Q4439","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Genotype dna hiv reverse t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87901","description":"Genotype dna hiv reverse t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pain doc pos and plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8730","description":"Pain doc pos and plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLC0","description":"ICD-OJLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tenoglide tendon prot_ cm2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9356","description":"Tenoglide tendon prot_ cm2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBB0","description":"ICD-CIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRD0","description":"ICD-KGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92629","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","description":"CPT-92629","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noninvas vasc dx study proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93998","description":"Noninvas vasc dx study proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQA0","description":"ICD-DIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE20B","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFB1","description":"ICD-BGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystouretero w/lithotripsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52353","description":"Cystouretero w/lithotripsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAC1","description":"ICD-FDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amino acids quan 6 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82139","description":"Amino acids quan 6 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Donor pneumonectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32850","description":"Donor pneumonectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4393","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","description":"HCPCS-Q4393","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABB0","description":"ICD-MABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ot re-evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97004","description":"Ot re-evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDE1","description":"ICD-NGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTD0","description":"ICD-BFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CT scan of the paranasal sinuses ordered at the time of diagnosis for documented reasons","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9348","description":"CT scan of the paranasal sinuses ordered at the time of diagnosis for documented reasons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABC0","description":"ICD-NABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBD1","description":"ICD-JHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Portable liquid oxygen sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0433","description":"Portable liquid oxygen sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB53","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKE0","description":"ICD-KBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ diclofenac sodium_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1130","description":"Injection_ diclofenac sodium_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Snrpn/ube3a gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81331","description":"Snrpn/ube3a gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intra-atrial pacing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93610","description":"Intra-atrial pacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1224","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE114","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Frnt cstr cmpl sem-pneum tir","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0072","description":"Frnt cstr cmpl sem-pneum tir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCA1","description":"ICD-JDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFED0","description":"ICD-EFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9813","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9813","description":"HCPCS-C9813","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m oxidronate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9561","description":"Tc99m oxidronate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Growth hormone panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80430","description":"Growth hormone panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWE1","description":"ICD-DGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIF0","description":"ICD-CIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology tissue of origin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81504","description":"Oncology tissue of origin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEC1","description":"ICD-CEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWF1","description":"ICD-PGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWF1","description":"ICD-GDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44121","description":"Removal of small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lumasiran_ 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9074","description":"Injection_ lumasiran_ 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNF0","description":"ICD-OBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJF0","description":"ICD-BBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXB0","description":"ICD-FAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFC0","description":"ICD-GDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63271","description":"Excise intrspinl lesion thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8I","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pericardiocentesis_ Including Imaging Guidance_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33016","description":"Pericardiocentesis_ Including Imaging Guidance_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aud osseo dev_ int/ext comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8690","description":"Aud osseo dev_ int/ext comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tisagenlecleucel_ up to 250 million CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2040","description":"Tisagenlecleucel_ up to 250 million CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKC0","description":"ICD-OAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLA0","description":"ICD-IHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUA0","description":"ICD-IDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0596U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","description":"CPT-0596U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31610","description":"Incision of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01730","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01730","description":"CPT-01730","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBD0","description":"ICD-BHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVE0","description":"ICD-OGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prosthetic donning sleeve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7600","description":"Prosthetic donning sleeve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDD0","description":"ICD-MEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEF1","description":"ICD-NIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACB1","description":"ICD-IACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBF1","description":"ICD-BBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8F","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCID1","description":"ICD-MCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMD1","description":"ICD-JAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ercp lithotripsy calculi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43265","description":"Ercp lithotripsy calculi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD150","description":"Special Care Low _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of indwelling bladder and peritoneal catheters_ including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump_ including imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0872T","description":"Replacement of indwelling bladder and peritoneal catheters_ including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump_ including imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNC0","description":"ICD-KHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXD0","description":"ICD-FDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXC1","description":"ICD-OCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENB0","description":"ICD-FENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0401","description":"HCPCS-B0401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinogen antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85385","description":"Fibrinogen antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIE0","description":"ICD-KGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immune admin oral/nasal addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90474","description":"Immune admin oral/nasal addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hd low limb pros vacuum pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5782","description":"Hd low limb pros vacuum pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHA0","description":"ICD-OFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB4D","description":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of ureters","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50760","description":"Fusion of ureters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Power adapter_ combo vad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0478","description":"Power adapter_ combo vad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of epiglottis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31420","description":"Removal of epiglottis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (lung and colon cancer)_ DNA_ qualitative_ next-generation sequencing detection of single-nucleotide variants and deletions in EGFR and KRAS genes_ formalin-fixed par","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0448U","description":"Oncology (lung and colon cancer)_ DNA_ qualitative_ next-generation sequencing detection of single-nucleotide variants and deletions in EGFR and KRAS genes_ formalin-fixed par","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQF1","description":"ICD-CGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24116","description":"Remove/graft bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dil macula/fundus exam/w doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8397","description":"Dil macula/fundus exam/w doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urine screen for bacteria","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81007","description":"Urine screen for bacteria","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAE1","description":"ICD-NLAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise excessive skin arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15836","description":"Excise excessive skin arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOF1","description":"ICD-CBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC0D","description":"High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIC0","description":"ICD-MJIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML4A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYE1","description":"ICD-DEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWA1","description":"ICD-KIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of parathormone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83970","description":"Assay of parathormone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95144","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBB0","description":"ICD-IGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOA1","description":"ICD-OFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCB1","description":"ICD-NKCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound breast complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76641","description":"Ultrasound breast complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0554U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","description":"CPT-0554U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA50","description":"Very High Rehab _ ADL Index 0-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX46","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPE0","description":"ICD-NEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy_ flexible; with ablation of tumor(s)_ polyp(s)_ or other lesions(s) not amenable to removal by hot biopsy forceps_ bipolar cautery or snare technique","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6022","description":"Sigmoidoscopy_ flexible; with ablation of tumor(s)_ polyp(s)_ or other lesions(s) not amenable to removal by hot biopsy forceps_ bipolar cautery or snare technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Staggered spondaic word test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92572","description":"Staggered spondaic word test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAA0","description":"ICD-OFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEC0","description":"ICD-NDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSD0","description":"ICD-CGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISA0","description":"ICD-DISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patch_ lidocaine/tetracaine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9285","description":"Patch_ lidocaine/tetracaine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKB0","description":"ICD-NIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCE1","description":"ICD-AGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Corneal hysteresis deter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92145","description":"Corneal hysteresis deter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUD1","description":"ICD-JCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUD1","description":"ICD-MHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHD1","description":"ICD-OAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"T cell absolute count/ratio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86360","description":"T cell absolute count/ratio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Manual fully reclining back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1226","description":"Manual fully reclining back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJC0","description":"ICD-OIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJB0","description":"ICD-ODJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4392","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","description":"HCPCS-Q4392","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oral mr contrast_ 100 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9954","description":"Oral mr contrast_ 100 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEC0","description":"ICD-KGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOC0","description":"ICD-LBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0107","description":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA34","description":"Default_ /30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDB0","description":"ICD-FGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJC0","description":"ICD-GDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1GC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GC11","description":"ICD-1GC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Skin barrier powder per oz","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4371","description":"Skin barrier powder per oz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVD1","description":"ICD-BEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Saquinavir_ 200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0140","description":"Saquinavir_ 200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1323","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQB0","description":"ICD-OKQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOF0","description":"ICD-CAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx isodose plan simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77316","description":"Brachytx isodose plan simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC150","description":"Clinically Complex _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTA0","description":"ICD-OBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUD1","description":"ICD-OHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit new","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99205","description":"Office/outpatient visit new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65280","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXE0","description":"ICD-FEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIB0","description":"ICD-EFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOC0","description":"ICD-OCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITB1","description":"ICD-NITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKC0","description":"ICD-BIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ plazomicin_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0291","description":"Injection_ plazomicin_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACE1","description":"ICD-BACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOF1","description":"ICD-HEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHC1","description":"ICD-KCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBF1","description":"ICD-AGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIC0","description":"ICD-JHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4EB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EB11","description":"ICD-4EB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAED1","description":"ICD-FAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYB0","description":"ICD-OCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55708","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","description":"CPT-55708","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative visual axis identification using patient fixation (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0514T","description":"Intraoperative visual axis identification using patient fixation (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUF1","description":"ICD-JGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWF1","description":"ICD-KBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMA0","description":"ICD-CHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of forearm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73090","description":"X-ray exam of forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy and dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31528","description":"Laryngoscopy and dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Absorpt drg <=16 sq in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6254","description":"Absorpt drg <=16 sq in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNF0","description":"ICD-OHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPB0","description":"ICD-KCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD106","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMF0","description":"ICD-JAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAB1","description":"ICD-OAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lodging per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9976","description":"Lodging per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Quality care for the treatment of ear_ nose_ and throat disorders mips value pathway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1367","description":"Quality care for the treatment of ear_ nose_ and throat disorders mips value pathway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cast supplies unlisted","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4050","description":"Cast supplies unlisted","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCC0","description":"ICD-OHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 60th birthday and before the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1177","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 60th birthday and before the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAE0","description":"ICD-MFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANA1","description":"ICD-KANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JA31","description":"ICD-4JA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor liver 3-segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47144","description":"Prep donor liver 3-segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXA1","description":"ICD-FBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICE0","description":"ICD-NICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVC0","description":"ICD-NEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Absorpt drg > 48 sq in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6256","description":"Absorpt drg > 48 sq in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB131","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAA0","description":"ICD-NLAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCE1","description":"ICD-NDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAD0","description":"ICD-JGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATA0","description":"ICD-FATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth lung chest wall surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54651","description":"Anesth lung chest wall surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA211","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJC0","description":"ICD-FIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB113","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace socket brim cust fit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4030","description":"Replace socket brim cust fit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQA1","description":"ICD-OCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHD0","description":"ICD-BCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEF1","description":"ICD-NEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQB1","description":"ICD-KDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLC1","description":"ICD-IFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB30","description":"High Rehab _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23605","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHB0","description":"ICD-IIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remis 6m w/o 6mos phq-9 <5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9574","description":"Remis 6m w/o 6mos phq-9 <5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJB0","description":"ICD-JDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDA0","description":"ICD-ODDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWC0","description":"ICD-PCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion palate prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42281","description":"Insertion palate prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc forearm tum deep 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25073","description":"Exc forearm tum deep 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25630","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPB0","description":"ICD-NIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB150","description":"Special Care High _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBF1","description":"ICD-ABBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99377","description":"Hospice care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUF1","description":"ICD-AHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPD1","description":"ICD-BIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGE0","description":"ICD-BDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ necitumumab_ 1mg (Portrazza)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9475","description":"Injection_ necitumumab_ 1mg (Portrazza)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter_ transluminal intravascular lithotripsy_ coronary","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1761","description":"Catheter_ transluminal intravascular lithotripsy_ coronary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLC0","description":"ICD-NGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB231","description":"Special Care High _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQE0","description":"ICD-KCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXC1","description":"ICD-OIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1701","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1701","description":"CDT-D1701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCE1","description":"ICD-FFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26420","description":"Repair/graft finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXD1","description":"ICD-JGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE146","description":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including sphenoidotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31257","description":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including sphenoidotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYC1","description":"ICD-PIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPE1","description":"ICD-BAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLC0","description":"ICD-CCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISD0","description":"ICD-GISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUD1","description":"ICD-BBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of hymen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56700","description":"Partial removal of hymen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensv oral eval prob focus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0160","description":"Extensv oral eval prob focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENE0","description":"ICD-JENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sugars multiple quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84379","description":"Sugars multiple quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC24","description":"High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mogamulizumab-kpkc_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9038","description":"Injection_ mogamulizumab-kpkc_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEA0","description":"ICD-MFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUD0","description":"ICD-EHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Budesonide comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7634","description":"Budesonide comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61870","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inject congenital card cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93563","description":"Inject congenital card cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00880","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00880","description":"CPT-00880","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGE0","description":"ICD-NAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKB0","description":"ICD-JIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFC1","description":"ICD-NCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99378","description":"Hospice care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBA0","description":"ICD-OBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJA1","description":"ICD-FBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37272","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","description":"CPT-37272","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECD1","description":"ICD-IECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hc pro phone call 5-10 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98966","description":"Hc pro phone call 5-10 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYA0","description":"ICD-CEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace trilateral socket br","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4010","description":"Replace trilateral socket br","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFA1","description":"ICD-OKFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull/brain biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61750","description":"Incise skull/brain biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETE1","description":"ICD-EETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ureter stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50610","description":"Removal of ureter stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWE0","description":"ICD-HCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood clot retraction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85170","description":"Blood clot retraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1275","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIB1","description":"ICD-IHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWA0","description":"ICD-GAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLB0","description":"ICD-JHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens aniseikonic bifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2218","description":"Lens aniseikonic bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGD1","description":"ICD-GCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENF0","description":"ICD-GENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fluorodopa f-18_ diagnostic_ per mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9602","description":"Fluorodopa f-18_ diagnostic_ per mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35306","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJF0","description":"ICD-CGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJA0","description":"ICD-NAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFB0","description":"ICD-NCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTA1","description":"ICD-KCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTC0","description":"ICD-AHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJD0","description":"ICD-CFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Proton trmt intermediate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77523","description":"Proton trmt intermediate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01860","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01860","description":"CPT-01860","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRD0","description":"ICD-OFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32_ 33_ 34_ 54_ or 56 for more than 90 consecutive days during","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1284","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32_ 33_ 34_ 54_ or 56 for more than 90 consecutive days during","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNE0","description":"ICD-OJNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise spinal cord vsls crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63250","description":"Revise spinal cord vsls crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYC1","description":"ICD-KDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise thigh muscles/tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27400","description":"Revise thigh muscles/tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQA1","description":"ICD-KFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFD1","description":"ICD-NIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic laryngoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31579","description":"Diagnostic laryngoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETB0","description":"ICD-OETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42500","description":"Repair salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNA1","description":"ICD-CCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERF0","description":"ICD-HERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQB0","description":"ICD-LIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JA11","description":"ICD-3JA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc >1 sinus ct w 90d dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9351","description":"Doc >1 sinus ct w 90d dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADE1","description":"ICD-GADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat thumb fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26645","description":"Treat thumb fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECD0","description":"ICD-KECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISF0","description":"ICD-OISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBF1","description":"ICD-CHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSE1","description":"ICD-LCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE10C","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDA1","description":"ICD-GDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64784","description":"Remove nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software_ data collection_ transmission_ and storage_ each 30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0741T","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software_ data collection_ transmission_ and storage_ each 30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"corticotomy - four or more teeth or tooth spaces_ per quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7297","description":"corticotomy - four or more teeth or tooth spaces_ per quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dentures maxill part metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5213","description":"Dentures maxill part metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKD0","description":"ICD-NJKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mammogram one breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77055","description":"Mammogram one breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLE0","description":"ICD-BHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0016","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTD0","description":"ICD-KBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iv oct for proc init vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0291T","description":"Iv oct for proc init vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient Or Care Partner Decline Assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0036","description":"Patient Or Care Partner Decline Assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/o dysphag/wt loss/nutr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3761F","description":"Pt w/o dysphag/wt loss/nutr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBC1","description":"ICD-NJBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWC0","description":"ICD-DFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia removal pleura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54251","description":"Anesthesia removal pleura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCD0","description":"ICD-NCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Walker folding adjust/fixed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0135","description":"Walker folding adjust/fixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAF0","description":"ICD-OCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHA0","description":"ICD-NCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx orbit w/o manipulj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21400","description":"Closed tx orbit w/o manipulj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDA0","description":"ICD-IEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Carpal tunnel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64721","description":"Carpal tunnel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKA1","description":"ICD-KAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise/rmv pn/gastr stimul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64595","description":"Revise/rmv pn/gastr stimul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJE1","description":"ICD-FFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (thyroid)_ DNA and mRNA of 112 genes_ next-generation sequencing_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0138U","description":"Oncology (thyroid)_ DNA and mRNA of 112 genes_ next-generation sequencing_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWD0","description":"ICD-KBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAF0","description":"ICD-OJAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Asth not controlled","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9434","description":"Asth not controlled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGB1","description":"ICD-NGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient received at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9775","description":"Patient received at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOD1","description":"ICD-OGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSF1","description":"ICD-KCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGC0","description":"ICD-CAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWF0","description":"ICD-PKWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBF0","description":"ICD-NIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEB1","description":"ICD-MCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of pulmonary valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92990","description":"Revision of pulmonary valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Core build-up incl any pins","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2950","description":"Core build-up incl any pins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Subtemporal decompression","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61340","description":"Subtemporal decompression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No 7d f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9407","description":"No 7d f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise arm/leg nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64708","description":"Revise arm/leg nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSD1","description":"ICD-KCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of spermatic ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54900","description":"Fusion of spermatic ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4368","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","description":"HCPCS-Q4368","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTA0","description":"ICD-NDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEF0","description":"ICD-MFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHB1","description":"ICD-IEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETE0","description":"ICD-BETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTB1","description":"ICD-GBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETA1","description":"ICD-NETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Virtual reality (VR) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic servi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0771T","description":"Virtual reality (VR) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic servi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRC0","description":"ICD-PBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rad w backup invasive intrfc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0472","description":"Rad w backup invasive intrfc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous diskectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62287","description":"Percutaneous diskectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFE1","description":"ICD-CGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUC1","description":"ICD-EHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA125","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81405","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXA0","description":"ICD-NFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Emer response sys instal&tst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5160","description":"Emer response sys instal&tst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Indic for head ct not valid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9533","description":"Indic for head ct not valid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAF0","description":"ICD-BCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0910T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","description":"CPT-0910T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDA1","description":"ICD-IFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDE0","description":"ICD-JBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Self-mgmt educ & train 1 pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98960","description":"Self-mgmt educ & train 1 pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMD1","description":"ICD-JEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBC1","description":"ICD-AIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16074","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16074","description":"CPT-16074","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSD1","description":"ICD-LBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIA1","description":"ICD-GFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEND0","description":"ICD-BEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69554","description":"Remove ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPB0","description":"ICD-GHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ercp lesion ablate w/dilate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43278","description":"Ercp lesion ablate w/dilate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYB1","description":"ICD-GBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCC1","description":"ICD-ODCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAE0","description":"ICD-MDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostomy inner cannula","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4623","description":"Tracheostomy inner cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECC0","description":"ICD-MECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ther/diag concurrent inf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96368","description":"Ther/diag concurrent inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Allergen specific IgE; qualitative_ multiallergen screen (eg_ disk_ sponge_ card)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86005","description":"Allergen specific IgE; qualitative_ multiallergen screen (eg_ disk_ sponge_ card)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKE0","description":"ICD-GIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hdr rdncl skn surf brachytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77767","description":"Hdr rdncl skn surf brachytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision or removal of neurostimulator electrode array_ sacral_ with integrated neurostimulator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0787T","description":"Revision or removal of neurostimulator electrode array_ sacral_ with integrated neurostimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGID1","description":"ICD-CGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGB0","description":"ICD-GIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKC0","description":"ICD-JIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAF0","description":"ICD-MFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOD1","description":"ICD-GIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHB1","description":"ICD-ADHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of intracatheter or catheter into renal pelvis for drainag and/or injection_ percutaneous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50392","description":"Introduction of intracatheter or catheter into renal pelvis for drainag and/or injection_ percutaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0904","description":"HCPCS-A0904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUC0","description":"ICD-IAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neg press wound tx >50 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97608","description":"Neg press wound tx >50 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPB1","description":"ICD-CEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJD0","description":"ICD-OAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Residential Habilitation 1-3","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0100","description":"Residential Habilitation 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-heu tc-99m add-on/dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9969","description":"Non-heu tc-99m add-on/dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pten gene known fam variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81322","description":"Pten gene known fam variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPA0","description":"ICD-KBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of finger/thumb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26952","description":"Amputation of finger/thumb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHE0","description":"ICD-IBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTF0","description":"ICD-KGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reoperation bypass graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35700","description":"Reoperation bypass graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flurazepam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6051","description":"Flurazepam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIF1","description":"ICD-EIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFME0","description":"ICD-BFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemolysins/agglutinins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86941","description":"Hemolysins/agglutinins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFD1","description":"ICD-BBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2IA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IA11","description":"ICD-2IA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPB1","description":"ICD-KBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA04","description":"Default_ /EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSD0","description":"ICD-PFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBF1","description":"ICD-NKBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comp animat ret imag series","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0380T","description":"Comp animat ret imag series","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECB0","description":"ICD-EECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMA1","description":"ICD-KFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Renin stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80417","description":"Renin stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANB0","description":"ICD-CANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx nasomax fx w/fixj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21346","description":"Opn tx nasomax fx w/fixj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1358","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHA0","description":"ICD-GGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENA1","description":"ICD-CENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thigh length surg stocking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4495","description":"Thigh length surg stocking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair upper jaw fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30580","description":"Repair upper jaw fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLB0","description":"ICD-BDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBD0","description":"ICD-JHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACB0","description":"ICD-OACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIA1","description":"ICD-EDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alarm symp assessed-1+ prsnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1071F","description":"Alarm symp assessed-1+ prsnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB12B","description":"Special Care Low _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRA0","description":"ICD-KBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCE0","description":"ICD-MHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab_ excludes biosimilar_ 10mg (Herceptin)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9355","description":"Injection_ trastuzumab_ excludes biosimilar_ 10mg (Herceptin)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC10B","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOC1","description":"ICD-PHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Liver imaging with flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78202","description":"Liver imaging with flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth heart surg <1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56152","description":"Anesth heart surg <1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHB1","description":"ICD-MIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJME1","description":"ICD-MJME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE12A","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQA1","description":"ICD-PCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVC0","description":"ICD-NGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEA0","description":"ICD-IHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18H","description":"Clinically Complex _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE117","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXA0","description":"ICD-GHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDE1","description":"ICD-EFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00561","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00561","description":"CPT-00561","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote multi-day complex uroflowmetry (eg_ calibrated electronic equipment); device supply with automated report generation_ up to 10 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0812T","description":"Remote multi-day complex uroflowmetry (eg_ calibrated electronic equipment); device supply with automated report generation_ up to 10 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIA0","description":"ICD-IEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTC0","description":"ICD-ICTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJF1","description":"ICD-FFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC12","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"1 med visit in 24mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9247","description":"1 med visit in 24mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0109","description":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEA0","description":"ICD-EBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0958T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","description":"CPT-0958T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implt nrostm pls gen sng rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8685","description":"Implt nrostm pls gen sng rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Power operated vehicle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1230","description":"Power operated vehicle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHF1","description":"ICD-OHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28A","description":"Special Care Low _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert vad art&vein access","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33991","description":"Insert vad art&vein access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLF1","description":"ICD-KHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB55","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0150","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0150","description":"HCPCS-E0150","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOD0","description":"ICD-KEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYF0","description":"ICD-GBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sodium thiosulfate_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0208","description":"Injection_ sodium thiosulfate_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLE0","description":"ICD-FGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFD1","description":"ICD-GAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSB1","description":"ICD-DBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHB0","description":"ICD-BDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUA1","description":"ICD-OIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pad band w>=3in <5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6441","description":"Pad band w>=3in <5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOF0","description":"ICD-DCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADD1","description":"ICD-GADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneumocystis carinii ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87281","description":"Pneumocystis carinii ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFE1","description":"ICD-NCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWE1","description":"ICD-PJWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWA1","description":"ICD-LCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0643","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0643","description":"HCPCS-J0643","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perc rf ablate renal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50592","description":"Perc rf ablate renal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Icar ischm mntrng sys device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0304T","description":"Icar ischm mntrng sys device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOC0","description":"ICD-PIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSA0","description":"ICD-HFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJB0","description":"ICD-FBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA120","description":"Reduced Physical Function _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antineutrophil Cytoplasmic Antibody (Anca); Screen_ Each Antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86036","description":"Antineutrophil Cytoplasmic Antibody (Anca); Screen_ Each Antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQF0","description":"ICD-DGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTA1","description":"ICD-EBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFC0","description":"ICD-NGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA55","description":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYB1","description":"ICD-OKYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOB0","description":"ICD-DEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCA0","description":"ICD-ABCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVB1","description":"ICD-NLVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No bp measure doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8756","description":"No bp measure doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWC0","description":"ICD-KCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJA0","description":"ICD-BDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dentures complete maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5110","description":"Dentures complete maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDF1","description":"ICD-JGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKC1","description":"ICD-BHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Computed tomography scan taken for the purpose of biomechanical computed tomography analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0558T","description":"Computed tomography scan taken for the purpose of biomechanical computed tomography analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRA1","description":"ICD-DBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDF1","description":"ICD-IDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remov vertbr dcmprn thrclmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63087","description":"Remov vertbr dcmprn thrclmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0402","description":"HCPCS-A0402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXD0","description":"ICD-BIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDD0","description":"ICD-OLDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJA1","description":"ICD-BEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous femoral-popliteal arterial revascularization_ with transcatheter placement of intravascular stent graft(s) and closure by any method_ including percutaneous or open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0505T","description":"Endovenous femoral-popliteal arterial revascularization_ with transcatheter placement of intravascular stent graft(s) and closure by any method_ including percutaneous or open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth major vein ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88251","description":"Anesth major vein ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGD1","description":"ICD-FDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIC0","description":"ICD-NDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Galsulfase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1458","description":"Galsulfase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBB0","description":"ICD-CFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPD1","description":"ICD-FDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQA0","description":"ICD-DBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adult day care per half day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5101","description":"Adult day care per half day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC156","description":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUA1","description":"ICD-EIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove lung catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32552","description":"Remove lung catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tx contour defects >10.0 cc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11954","description":"Tx contour defects >10.0 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bl draw < 3 yrs fem/jugular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36400","description":"Bl draw < 3 yrs fem/jugular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp subclav-vertebrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35645","description":"Art byp subclav-vertebrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urine pch w ex wear bar conv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4393","description":"Urine pch w ex wear bar conv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection for hip x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27095","description":"Injection for hip x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJF1","description":"ICD-FEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUD1","description":"ICD-NHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFB0","description":"ICD-OKFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96573","description":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPE1","description":"ICD-OBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB12A","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCE0","description":"ICD-MFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJC1","description":"ICD-NGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXB0","description":"ICD-FEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB33","description":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Head surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21499","description":"Head surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Self care d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8989","description":"Self care d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis b dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87516","description":"Hepatitis b dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abd imag and followup no rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9550","description":"Abd imag and followup no rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAB0","description":"ICD-MDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGE0","description":"ICD-CAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB14A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEA0","description":"ICD-CDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3291","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","description":"HCPCS-J3291","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acetate conc sol per gallon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4708","description":"Acetate conc sol per gallon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insj/rplc nstim apnea sen ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0425T","description":"Insj/rplc nstim apnea sen ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1DB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DB31","description":"ICD-1DB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDE0","description":"ICD-CBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_phys coor-care ovrsght","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9008","description":"Mccd_phys coor-care ovrsght","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNE1","description":"ICD-GDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous placement of drainage catheter for combined internal and external biliary drainage or of a drainage stent for internal biliary drainage in patients w","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75982","description":"Percutaneous placement of drainage catheter for combined internal and external biliary drainage or of a drainage stent for internal biliary drainage in patients w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1272","description":"Patients on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSA1","description":"ICD-OGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMC1","description":"ICD-GEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPF1","description":"ICD-GBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIC1","description":"ICD-IDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary colon cancer disorders (eg_ Lynch syndrome_ PTEN hamartoma syndrome_ Cowden syndrome_ familial adenomatosis polyposis)_ genomic sequence analysis panel utili","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0101U","description":"Hereditary colon cancer disorders (eg_ Lynch syndrome_ PTEN hamartoma syndrome_ Cowden syndrome_ familial adenomatosis polyposis)_ genomic sequence analysis panel utili","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/lobectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32663","description":"Thoracoscopy w/lobectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNB0","description":"ICD-JGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTF0","description":"ICD-MBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1082T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1082T","description":"CPT-1082T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGF1","description":"ICD-ODGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQD1","description":"ICD-KIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc acc_ lith-based battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2397","description":"Pwc acc_ lith-based battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAED0","description":"ICD-IAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWA0","description":"ICD-DEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ glucagon hydrochloride (fresenius kabi)_ not therapeutically equivalent to j1610_ per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1611","description":"Injection_ glucagon hydrochloride (fresenius kabi)_ not therapeutically equivalent to j1610_ per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTB1","description":"ICD-BBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNC1","description":"ICD-BDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTB0","description":"ICD-BDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1HA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HA31","description":"ICD-1HA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC24C","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEE1","description":"ICD-BEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISA0","description":"ICD-KISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8G","description":"Very High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26372","description":"Repair/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMC0","description":"ICD-GHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNE0","description":"ICD-NCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coronary artery graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33504","description":"Coronary artery graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"L hrt art/grft angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93459","description":"L hrt art/grft angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA12","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAD0","description":"ICD-ADAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHF0","description":"ICD-GCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of intranasal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30117","description":"Removal of intranasal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOC0","description":"ICD-DGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASC1","description":"ICD-PASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Re-evaluation of physical therapy established plan of care_ requiring these components: An examination including a review of history and use of standardized tests and measures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97164","description":"Re-evaluation of physical therapy established plan of care_ requiring these components: An examination including a review of history and use of standardized tests and measures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB125","description":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBE0","description":"ICD-AIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect diaphragm simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39560","description":"Resect diaphragm simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQF0","description":"ICD-OKQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Needle biopsy muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20206","description":"Needle biopsy muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ed svc ckd grp per session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0421","description":"Ed svc ckd grp per session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEF0","description":"ICD-NKEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDE0","description":"ICD-GBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAE1","description":"ICD-ECAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01440","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01440","description":"CPT-01440","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Cardiac Catheterization Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0622","description":"Hospital Special Treatment Room Support Component (Hstrsc) Cardiac Catheterization Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Recording (Includes Connection And Initial Recording)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93246","description":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Recording (Includes Connection And Initial Recording)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUB0","description":"ICD-OEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Speech lang current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9174","description":"Speech lang current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAB0","description":"ICD-EGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sleep apnea assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8839","description":"Sleep apnea assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6037","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","description":"HCPCS-L6037","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Imm admin by intramuscular inj of (SARS[1]CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNALNP_ spike protein_ pres free_ 10 mcg/0.2 mL dosage; booster dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0074A","description":"Imm admin by intramuscular inj of (SARS[1]CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNALNP_ spike protein_ pres free_ 10 mcg/0.2 mL dosage; booster dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of intracatheter or catheter into renal pelvis for drainage and/or injection_ percutaneous_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74475","description":"Introduction of intracatheter or catheter into renal pelvis for drainage and/or injection_ percutaneous_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMF1","description":"ICD-OHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLE1","description":"ICD-GDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYF1","description":"ICD-OEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDC0","description":"ICD-OGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auto interm peritoneal dialy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1592","description":"Auto interm peritoneal dialy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB01","description":"Very High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coordinated specialty care_ team-based_ for first episode psychosis_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2040","description":"Coordinated specialty care_ team-based_ for first episode psychosis_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE25D","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFF0","description":"ICD-NFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISD1","description":"ICD-KISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEC1","description":"ICD-KAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wbc antibody identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86021","description":"Wbc antibody identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWD1","description":"ICD-DEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB22A","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fndngs mammo 2pt w/in 3 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5060F","description":"Fndngs mammo 2pt w/in 3 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUF1","description":"ICD-NCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD155","description":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exclusion Of Left Atrial Appendage_ Open_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_ Ligation_ Plication_ Clip)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33267","description":"Exclusion Of Left Atrial Appendage_ Open_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_ Ligation_ Plication_ Clip)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Imported lipodox inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2049","description":"Imported lipodox inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGE0","description":"ICD-GEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC24D","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC115","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD241","description":"Special Care High _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pneum drive wheel tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2381","description":"Pneum drive wheel tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig neg scrn depres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8510","description":"Pt inelig neg scrn depres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOC1","description":"ICD-CDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee disc/dial lock/adj flex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2425","description":"Knee disc/dial lock/adj flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUB1","description":"ICD-MDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOE1","description":"ICD-GFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTD0","description":"ICD-NLTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKC0","description":"ICD-OGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompress forearm 1 space","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25023","description":"Decompress forearm 1 space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aflibercept hd_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9161","description":"Injection_ aflibercept hd_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACB0","description":"ICD-NACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00352","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00352","description":"CPT-00352","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB5C","description":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Meropenem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2185","description":"Meropenem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWE1","description":"ICD-OAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise intraspinl lesion crv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63265","description":"Excise intraspinl lesion crv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prq card angio/athrect 1 art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92924","description":"Prq card angio/athrect 1 art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBB0","description":"ICD-GFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HEPATITIS B SURFACE ANTIGEN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87340","description":"IAAD IA HEPATITIS B SURFACE ANTIGEN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9294","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","description":"HCPCS-A9294","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEA0","description":"ICD-JGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCED0","description":"ICD-MCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWD1","description":"ICD-HGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYA1","description":"ICD-GAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAC1","description":"ICD-MIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIB0","description":"ICD-EBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g._ prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven da","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1172","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g._ prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRA0","description":"ICD-OGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWB0","description":"ICD-LIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNF1","description":"ICD-OJNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pentostatin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9268","description":"Pentostatin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cd4+cell count <200cells/mm3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3494F","description":"Cd4+cell count <200cells/mm3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABD1","description":"ICD-OABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hla class i&ii antibody qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86828","description":"Hla class i&ii antibody qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ cervical or vaginal (any reporting system)_ requiring interpretation by physician (List separately in addition to co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0831T","description":"Digitization of glass microscope slides for cytopathology_ cervical or vaginal (any reporting system)_ requiring interpretation by physician (List separately in addition to co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interv hlth/behav fam w/pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96154","description":"Interv hlth/behav fam w/pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB44","description":"Medium Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOE1","description":"ICD-OHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKA0","description":"ICD-GIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHC1","description":"ICD-GHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAE1","description":"ICD-NJAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA241","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPC0","description":"ICD-BHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSF1","description":"ICD-GCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adhesive_ liquid or equal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4364","description":"Adhesive_ liquid or equal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL55","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trapeze bar free standing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0940","description":"Trapeze bar free standing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient-Months Where There Are More Than One Medicare Capitated Payment (Mcp) Provider Listed For The Month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1025","description":"Patient-Months Where There Are More Than One Medicare Capitated Payment (Mcp) Provider Listed For The Month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECC0","description":"ICD-NECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pathology lab procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89240","description":"Pathology lab procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ epcoritamab-bysp_ 0.16 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9155","description":"Injection_ epcoritamab-bysp_ 0.16 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDC1","description":"ICD-MDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mouth piece","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4617","description":"Mouth piece","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQD0","description":"ICD-OGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX60","description":"Very High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUA0","description":"ICD-MAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHA1","description":"ICD-GFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTD0","description":"ICD-FHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artificial larynx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8500","description":"Artificial larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28B","description":"Special Care Low _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRB1","description":"ICD-OLRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dialysate conc pow per pack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4765","description":"Dialysate conc pow per pack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVE0","description":"ICD-CGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Audiometry air & bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0209T","description":"Audiometry air & bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHE0","description":"ICD-ICHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKE0","description":"ICD-GEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Als 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0433","description":"Als 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJF0","description":"ICD-OEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKD1","description":"ICD-KIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPA0","description":"ICD-GGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ pacing_ transesoph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1756","description":"Cath_ pacing_ transesoph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIF1","description":"ICD-KDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOE1","description":"ICD-CHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin exo mech stance ph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5716","description":"Knee-shin exo mech stance ph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Activated carbon filter_ ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4680","description":"Activated carbon filter_ ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMD0","description":"ICD-IGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tacrolimus imme rel oral 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7507","description":"Tacrolimus imme rel oral 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth vascular access","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53251","description":"Anesth vascular access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcyl bifocal over 12.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2214","description":"Lens sphcyl bifocal over 12.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exam feces for meat fibers","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89160","description":"Exam feces for meat fibers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEA1","description":"ICD-MAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair hvy duty detach a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1290","description":"Wheelchair hvy duty detach a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEB1","description":"ICD-BDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9938","description":"Patients age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc prosth delayed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33886","description":"Endovasc prosth delayed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 3 mcg/0.3 mL dosage_ tris-sucrose formulation_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91318","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 3 mcg/0.3 mL dosage_ tris-sucrose formulation_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q0234","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0234","description":"HCPCS-Q0234","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNC1","description":"ICD-NGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Car seat/bed test 60 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94780","description":"Car seat/bed test 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient_ who has a reactive hcv antibody test_ and has a follow up hcv viral test that detected hcv viremia_ is referred within 1 month of the reactive hcv antibody test to a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1229","description":"Patient_ who has a reactive hcv antibody test_ and has a follow up hcv viral test that detected hcv viremia_ is referred within 1 month of the reactive hcv antibody test to a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACA0","description":"ICD-OACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMC1","description":"ICD-CBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUF1","description":"ICD-KFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Harvest stem cell concentrte","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38215","description":"Harvest stem cell concentrte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elbow arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29834","description":"Elbow arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18I","description":"Special Care High _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAD0","description":"ICD-OAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Suction susp ak/knee disart","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5652","description":"Suction susp ak/knee disart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Omnicardiogram/cardiointegra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9025","description":"Omnicardiogram/cardiointegra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB255","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRA1","description":"ICD-LIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIC0","description":"ICD-KHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWA0","description":"ICD-PCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGF0","description":"ICD-OFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUA1","description":"ICD-NGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGE1","description":"ICD-NKGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDF1","description":"ICD-AIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Close tear duct opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68760","description":"Close tear duct opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKF1","description":"ICD-KBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEE1","description":"ICD-MDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVC1","description":"ICD-FDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIA1","description":"ICD-MDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fem focal defic constant fri","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5230","description":"Fem focal defic constant fri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUC0","description":"ICD-MAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTF1","description":"ICD-KHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ckd meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8495","description":"Ckd meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of hip bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27147","description":"Revision of hip bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHED1","description":"ICD-CHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bupren/nal 3.1 to 6mg bupren","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0573","description":"Bupren/nal 3.1 to 6mg bupren","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSC0","description":"ICD-PCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Warfarin therapy rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4012F","description":"Warfarin therapy rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAB0","description":"ICD-IAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAC1","description":"ICD-CBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1301","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1301","description":"CDT-D1301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKE1","description":"ICD-GHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAND0","description":"ICD-KAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Athletic train reeval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97006","description":"Athletic train reeval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPB0","description":"ICD-JBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAB1","description":"ICD-EGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAF1","description":"ICD-CGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gardner vag dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87512","description":"Gardner vag dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair arm rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0994","description":"Wheelchair arm rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDD0","description":"ICD-OKDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1488","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","description":"HCPCS-M1488","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITB1","description":"ICD-MITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCA1","description":"ICD-IHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score le pt no elg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8657","description":"Fun stat score le pt no elg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASB0","description":"ICD-OASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26860","description":"Fusion of finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp2 std sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0835","description":"Pwc gp2 std sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUF0","description":"ICD-AFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cochlear implt f/up exam <7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92601","description":"Cochlear implt f/up exam <7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tissue culture tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88239","description":"Tissue culture tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD14B","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHA0","description":"ICD-EFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKF1","description":"ICD-NJKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBD0","description":"ICD-OFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLB1","description":"ICD-IFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPE1","description":"ICD-CGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAC0","description":"ICD-CDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANF0","description":"ICD-BANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Free omental flap microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49906","description":"Free omental flap microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBA0","description":"ICD-GHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remv&replc pm gen dual lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33228","description":"Remv&replc pm gen dual lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWF0","description":"ICD-OHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGE0","description":"ICD-CGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of temporary anchorage device without flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7300","description":"Removal of temporary anchorage device without flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTF1","description":"ICD-JFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKD1","description":"ICD-OJKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home mgmt gest hypertension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9211","description":"Home mgmt gest hypertension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infect agent det by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ amplified probe technique","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"U0003","description":"Infect agent det by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBED0","description":"ICD-BBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTB0","description":"ICD-KDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ melphalan (apotex)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9249","description":"Injection_ melphalan (apotex)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTC1","description":"ICD-KGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXA0","description":"ICD-OAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLC1","description":"ICD-BGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJD1","description":"ICD-BIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTE0","description":"ICD-NDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVB1","description":"ICD-NAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA2C","description":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJF0","description":"ICD-GAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOA1","description":"ICD-CDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputee adapter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0959","description":"Amputee adapter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28X","description":"Special Care High _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Novafix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4208","description":"Novafix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ inebilizumab-cdon_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1823","description":"Injection_ inebilizumab-cdon_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4207","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4207","description":"HCPCS-Q4207","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE235","description":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNF0","description":"ICD-NCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing care not clinically indicated because the patient needed a home program only_ referral to another provider or facility_ or consultation only_ as documented in the medi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1146","description":"Ongoing care not clinically indicated because the patient needed a home program only_ referral to another provider or facility_ or consultation only_ as documented in the medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOB0","description":"ICD-GFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX2A","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Childbirth refresher class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9437","description":"Childbirth refresher class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tis trnfr s/a/l 10 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14020","description":"Tis trnfr s/a/l 10 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTA0","description":"ICD-IHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFE0","description":"ICD-JIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRC1","description":"ICD-LFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQA1","description":"ICD-GHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M0237","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","description":"HCPCS-M0237","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDE0","description":"ICD-FEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOA0","description":"ICD-HHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLB1","description":"ICD-GHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGA1","description":"ICD-KEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2CC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CC21","description":"ICD-2CC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole (abilify asimtufii)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0402","description":"Injection_ aripiprazole (abilify asimtufii)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHA1","description":"ICD-ECHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr s/a/t/ext 12.6-20","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12035","description":"Intmd rpr s/a/t/ext 12.6-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace cover w/c seat cush","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2619","description":"Replace cover w/c seat cush","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"K flow/funct image w/o drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78707","description":"K flow/funct image w/o drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQD0","description":"ICD-HFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUE1","description":"ICD-ABUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX13","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Office-Based Treatment For Opioid Use Disorder_ Including Development Of The Treatment Plan_ Care Coordination_ Individual Therapy And Group Therapy And Counseling; At Least 7","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2086","description":"Office-Based Treatment For Opioid Use Disorder_ Including Development Of The Treatment Plan_ Care Coordination_ Individual Therapy And Group Therapy And Counseling; At Least 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEB0","description":"ICD-OHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEA1","description":"ICD-NAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home visit nb care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99502","description":"Home visit nb care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYA0","description":"ICD-HDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No antihist/decong rx/recom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4134F","description":"No antihist/decong rx/recom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB213","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUB0","description":"ICD-OKUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBF1","description":"ICD-CIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGA0","description":"ICD-CIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Choline C 11_ diagnostic_ per study dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9461","description":"Choline C 11_ diagnostic_ per study dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILA1","description":"ICD-FILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFB1","description":"ICD-NGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1005T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","description":"CPT-1005T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including frontal sinus exploration_ with removal of tissue from frontal sinus_ when perfor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31253","description":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including frontal sinus exploration_ with removal of tissue from frontal sinus_ when perfor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical_ with frontal sinus exploration_ including removal of tissue from frontal sinus_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31276","description":"Nasal/sinus endoscopy_ surgical_ with frontal sinus exploration_ including removal of tissue from frontal sinus_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC23B","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCF0","description":"ICD-BBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELC0","description":"ICD-NELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE12B","description":"Special Care High _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt queried pain fxn w/ instr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1502F","description":"Pt queried pain fxn w/ instr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Actin (Smooth Muscle) Antibody (Asma)_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86015","description":"Actin (Smooth Muscle) Antibody (Asma)_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No brst cncr dx min invasive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8877","description":"No brst cncr dx min invasive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0648U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0648U","description":"CPT-0648U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISB1","description":"ICD-KISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYC0","description":"ICD-HEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vedolizumab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80280","description":"Vedolizumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEB0","description":"ICD-MIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Platelets_ irradiated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9032","description":"Platelets_ irradiated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC24B","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRC1","description":"ICD-PDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Heart symp image plnr spect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0332T","description":"Heart symp image plnr spect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8X","description":"High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Audit/dast over 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99409","description":"Audit/dast over 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANC1","description":"ICD-NANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX30","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr s/n/a/gen/trk12.6-20.0cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12005","description":"Rpr s/n/a/gen/trk12.6-20.0cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay total hydroxyproline","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83505","description":"Assay total hydroxyproline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETF0","description":"ICD-FETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC240","description":"Reduced Physical Function _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHA0","description":"ICD-EEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLF1","description":"ICD-IBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXD1","description":"ICD-OLXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMA0","description":"ICD-OHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Epidrm a-grft f/n/hf/g addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15116","description":"Epidrm a-grft f/n/hf/g addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDA1","description":"ICD-ADDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cftr gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81223","description":"Cftr gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTB1","description":"ICD-NJTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVA0","description":"ICD-NLVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove skin tags add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11201","description":"Remove skin tags add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX45","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDB1","description":"ICD-MJDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBA1","description":"ICD-KFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prescription digital visual therapy_ software-only_ FDA cleared_ per course of treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9292","description":"Prescription digital visual therapy_ software-only_ FDA cleared_ per course of treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA236","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Njx px nfrosgrm &/urtrgrm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50430","description":"Njx px nfrosgrm &/urtrgrm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUF1","description":"ICD-MIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJB1","description":"ICD-BBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUB1","description":"ICD-MIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCC1","description":"ICD-FDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQE0","description":"ICD-HBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYE1","description":"ICD-PEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQF1","description":"ICD-GAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive (60 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2009","description":"Comprehensive (60 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mecp2 gene full seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81302","description":"Mecp2 gene full seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1374","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","description":"HCPCS-M1374","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFB0","description":"ICD-GGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Donor hysterectomy (including cold preservation); laparoscopic or robotic_ from living donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0666T","description":"Donor hysterectomy (including cold preservation); laparoscopic or robotic_ from living donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis_ including small sequence changes_ copy number variants_ deletions_ duplications_ mobile e","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0336U","description":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis_ including small sequence changes_ copy number variants_ deletions_ duplications_ mobile e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX05","description":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDA0","description":"ICD-GDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thiopurine S-methyltransferase (TPMT)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84433","description":"Thiopurine S-methyltransferase (TPMT)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOE0","description":"ICD-OFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28I","description":"Special Care Low _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVE0","description":"ICD-KIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ped home apnea rec hk-up","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94775","description":"Ped home apnea rec hk-up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGD1","description":"ICD-FCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0601","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0601","description":"CDT-D0601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES14B","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACED1","description":"ICD-ACED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHE0","description":"ICD-KHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fixed prosthodontic proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6999","description":"Fixed prosthodontic proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALB1","description":"ICD-GALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLF0","description":"ICD-IFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Complex rehabilitative power wheelchair accessory_ power seat elevation system_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2298","description":"Complex rehabilitative power wheelchair accessory_ power seat elevation system_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Secondary urethral surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54348","description":"Secondary urethral surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAC1","description":"ICD-BBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANE0","description":"ICD-NANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEF0","description":"ICD-OBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWC0","description":"ICD-GDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB10C","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTA1","description":"ICD-NLTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCD0","description":"ICD-GFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise spermatic cord veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55530","description":"Revise spermatic cord veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJA1","description":"ICD-FEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise stomach-bowel fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43855","description":"Revise stomach-bowel fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63103","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAF0","description":"ICD-KIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXD0","description":"ICD-FGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDD0","description":"ICD-GEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXA0","description":"ICD-NKXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sach foot_ replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5971","description":"Sach foot_ replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUE0","description":"ICD-EBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psysoc rehab svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2018","description":"Psysoc rehab svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVF1","description":"ICD-GIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28F","description":"Special Care Low _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No reas_ no ret or w/in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9515","description":"No reas_ no ret or w/in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Syph scrng docd as done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3512F","description":"Syph scrng docd as done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"M/phmtrc alysishquant/semiq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88369","description":"M/phmtrc alysishquant/semiq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Denture interm cmplt mandbl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5811","description":"Denture interm cmplt mandbl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oral antiplat thx rx dischrg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4073F","description":"Oral antiplat thx rx dischrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ext wear ost skn barr >4sqin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4408","description":"Ext wear ost skn barr >4sqin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lso sc r ant/pos pnl pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0637","description":"Lso sc r ant/pos pnl pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC0A","description":"Medium Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMC1","description":"ICD-CEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBA0","description":"ICD-EEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEA1","description":"ICD-CCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Visual ep acuity screen auto","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0333T","description":"Visual ep acuity screen auto","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67311","description":"Revise eye muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dorsiflexion assist each joi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2210","description":"Dorsiflexion assist each joi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMD0","description":"ICD-MJMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LC11","description":"ICD-2LC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELE1","description":"ICD-FELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bl donor search management","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38204","description":"Bl donor search management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 1 std port cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0814","description":"Pwc gp 1 std port cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELF1","description":"ICD-OELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor pancreas/venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48552","description":"Prep donor pancreas/venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sp bone algrft struct add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20931","description":"Sp bone algrft struct add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVC0","description":"ICD-JFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSA0","description":"ICD-ODSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp femoral-popliteal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35656","description":"Art byp femoral-popliteal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSC1","description":"ICD-GDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8E","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICB0","description":"ICD-NICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDB1","description":"ICD-AGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHD0","description":"ICD-OBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSF0","description":"ICD-PJSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMF0","description":"ICD-FAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"late eposode 0-13 therapies_clinical severity level 1_ functional sererity level","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKS","description":"late eposode 0-13 therapies_clinical severity level 1_ functional sererity level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWF1","description":"ICD-PHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEID1","description":"ICD-AEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIA0","description":"ICD-NEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFD1","description":"ICD-CBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWB1","description":"ICD-PGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDC1","description":"ICD-JBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXE0","description":"ICD-CBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair lower leg epiphyses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27734","description":"Repair lower leg epiphyses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/snare","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44394","description":"Colonoscopy w/snare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHC0","description":"ICD-AFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABF1","description":"ICD-EABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAC1","description":"ICD-FCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHE1","description":"ICD-FFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEE0","description":"ICD-OEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49594","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIF0","description":"ICD-NHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1424","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","description":"HCPCS-M1424","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICD0","description":"ICD-AICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX0D","description":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHC0","description":"ICD-AAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"EpiFix or Epicord_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4131","description":"EpiFix or Epicord_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Follow-up surgery of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66250","description":"Follow-up surgery of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCE0","description":"ICD-NCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIC0","description":"ICD-GBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFB0","description":"ICD-FBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCB1","description":"ICD-OBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0681U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681U","description":"CPT-0681U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC221","description":"Special Care High _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTD1","description":"ICD-BGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXA0","description":"ICD-KDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTD1","description":"ICD-MKTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGA1","description":"ICD-KDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQB1","description":"ICD-HGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRA1","description":"ICD-CDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB214","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct entire forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21179","description":"Reconstruct entire forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8X","description":"High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA24A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGC1","description":"ICD-GDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35226","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHF1","description":"ICD-BBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHD0","description":"ICD-IAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67922","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXC0","description":"ICD-OJXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01991","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01991","description":"CPT-01991","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA235","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES216","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE11A","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compounded drug_ noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7999","description":"Compounded drug_ noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens fitting for tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92071","description":"Contact lens fitting for tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aprotonin_ 10_000 kiu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0365","description":"Aprotonin_ 10_000 kiu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Us guide tissue ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76940","description":"Us guide tissue ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOD1","description":"ICD-OKOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services given to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9740","description":"Hospice services given to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD10B","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAB0","description":"ICD-BHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1451","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","description":"HCPCS-M1451","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIC0","description":"ICD-FGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"T3 reverse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84482","description":"T3 reverse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYC1","description":"ICD-DCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSD0","description":"ICD-LCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient has copd symptoms (e.g._ dyspnea_ cough/sputum_ wheezing)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1218","description":"Patient has copd symptoms (e.g._ dyspnea_ cough/sputum_ wheezing)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBC1","description":"ICD-GEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPB0","description":"ICD-NFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLD0","description":"ICD-BGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJD0","description":"ICD-KBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52235","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJD1","description":"ICD-CBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No unplnd hosp readm in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9309","description":"No unplnd hosp readm in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Placental alpha-micro globulin-1 (PAMG-1)_ immunoassay with direct optical observation_ cervico-vaginal fluid_ each specimen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0066U","description":"Placental alpha-micro globulin-1 (PAMG-1)_ immunoassay with direct optical observation_ cervico-vaginal fluid_ each specimen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9076","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","description":"HCPCS-J9076","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHB0","description":"ICD-KBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPD0","description":"ICD-FCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft arm/leg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64893","description":"Nerve graft arm/leg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of urethra lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53260","description":"Treatment of urethra lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1245","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc order given vte prophylx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4044F","description":"Doc order given vte prophylx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIC0","description":"ICD-MDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVD0","description":"ICD-CHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ givosiran_ 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9056","description":"Injection_ givosiran_ 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADID1","description":"ICD-ADID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trilaciclib_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9078","description":"Injection_ trilaciclib_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEC0","description":"ICD-NKEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35207","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVA1","description":"ICD-BEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC241","description":"Special Care Low _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64468","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","description":"CPT-64468","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXE1","description":"ICD-BFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal or debulking of intracardiac mass (eg_ vegetations_ thrombus) via suction (eg_ vacuum_ aspiration) device_ percutaneous approach_ w/ intraoperative reinf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0644T","description":"Transcatheter removal or debulking of intracardiac mass (eg_ vegetations_ thrombus) via suction (eg_ vacuum_ aspiration) device_ percutaneous approach_ w/ intraoperative reinf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trnslum dil eye canal w/stnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66175","description":"Trnslum dil eye canal w/stnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLB1","description":"ICD-KGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBF1","description":"ICD-FGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD240","description":"Reduced Physical Function _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"T cell absolute count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86361","description":"T cell absolute count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPF1","description":"ICD-OGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFD1","description":"ICD-NAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECD1","description":"ICD-NECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA254","description":"Clinically Complex _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAD1","description":"ICD-OLAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHED0","description":"ICD-FHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Routine ophthalmological exa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0621","description":"Routine ophthalmological exa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr ing hernia init blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49501","description":"Rpr ing hernia init blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYF1","description":"ICD-CHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQE1","description":"ICD-ODQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blinded Procedure For Nyha Class Iii/Iv Heart Failure; Transcatheter Implantation Of Interatrial Shunt Or Placebo Control_ Including Right Heart Catheterization_ Trans-Esophag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9758","description":"Blinded Procedure For Nyha Class Iii/Iv Heart Failure; Transcatheter Implantation Of Interatrial Shunt Or Placebo Control_ Including Right Heart Catheterization_ Trans-Esophag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML1C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUC1","description":"ICD-JDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLC0","description":"ICD-GFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove cranial cavity fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61001","description":"Remove cranial cavity fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENA0","description":"ICD-NENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQD1","description":"ICD-LGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHC0","description":"ICD-AGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX24","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ONC BRST CA AI ASSMT 12 FEAT","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0220U","description":"ONC BRST CA AI ASSMT 12 FEAT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0106","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0106","description":"CDT-D0106","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSF0","description":"ICD-HDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC20A","description":"Clinically Complex _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4543","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","description":"HCPCS-A4543","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4351","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","description":"HCPCS-Q4351","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient admitted to the ICU in the last 30 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9853","description":"Patient admitted to the ICU in the last 30 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDF1","description":"ICD-NIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25150","description":"Partial removal of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVC1","description":"ICD-NDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Below knee surgical stocking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4500","description":"Below knee surgical stocking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/90d mrs >2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9648","description":"Pt w/90d mrs >2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB114","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMC1","description":"ICD-AGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hiv rna vrl ldnot cm diam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9004F","description":"Aortic anrysm 6/> cm diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inject/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67500","description":"Inject/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6034","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","description":"HCPCS-L6034","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIE0","description":"ICD-CHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTC0","description":"ICD-ECTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDA1","description":"ICD-MKDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADA1","description":"ICD-FADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES235","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23150","description":"Removal of humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTB0","description":"ICD-EFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ondansetron 4 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0119","description":"Ondansetron 4 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXF1","description":"ICD-NJXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIA0","description":"ICD-GEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Zoster (shingles) vaccine (HZV)_ recombinant_ sub-unit_ adjuvanted_ for intramuscular injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90750","description":"Zoster (shingles) vaccine (HZV)_ recombinant_ sub-unit_ adjuvanted_ for intramuscular injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYD0","description":"ICD-PJYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXC0","description":"ICD-OIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oral function therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92526","description":"Oral function therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRA1","description":"ICD-PJRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHE1","description":"ICD-OKHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWE0","description":"ICD-GCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients Who Use Palliative Care Services Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9995","description":"Patients Who Use Palliative Care Services Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA0C","description":"Low Rehab_ ADL Index 0-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy balloon <30mm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43220","description":"Esophagoscopy balloon <30mm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ filgrastim-aafi_ biosimilar_ (Nivestym)_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5110","description":"Injection_ filgrastim-aafi_ biosimilar_ (Nivestym)_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE15B","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJA0","description":"ICD-NKJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLF1","description":"ICD-NJLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients With Mechanical Prosthetic Heart Valve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0043","description":"Patients With Mechanical Prosthetic Heart Valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJD1","description":"ICD-KIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-META1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"META1","description":"ICD-META1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUA0","description":"ICD-OBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intracranial angioplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61630","description":"Intracranial angioplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of progesterone 17-d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83498","description":"Assay of progesterone 17-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUE0","description":"ICD-GBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-da","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB56","description":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOF1","description":"ICD-CAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repos car modulj tranvns elt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0415T","description":"Repos car modulj tranvns elt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABD0","description":"ICD-GABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostoma filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4481","description":"Tracheostoma filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Co-morbid condition assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1026F","description":"Co-morbid condition assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIB0","description":"ICD-KAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4AA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AA11","description":"ICD-4AA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDB1","description":"ICD-ABDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEB1","description":"ICD-KAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBF1","description":"ICD-JIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clsd red simp malar/zygom fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7660","description":"Clsd red simp malar/zygom fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGA0","description":"ICD-OGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43117","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLB0","description":"ICD-AGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home visit est pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99337","description":"Domicil/r-home visit est pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8H","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMD1","description":"ICD-AEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIA0","description":"ICD-MIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAID1","description":"ICD-MAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB12","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACA0","description":"ICD-KACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Absolute quantitation of myocardial blood flow (AQMBF)_ single-photon emission computed tomography (SPECT)_ with exercise or pharmacologic stress_ and at rest_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0742T","description":"Absolute quantitation of myocardial blood flow (AQMBF)_ single-photon emission computed tomography (SPECT)_ with exercise or pharmacologic stress_ and at rest_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENE1","description":"ICD-KENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB32","description":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove groin lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38765","description":"Remove groin lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUB1","description":"ICD-IIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKE1","description":"ICD-BCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHB0","description":"ICD-AGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAB0","description":"ICD-IIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Telethx isodose plan simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77306","description":"Telethx isodose plan simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rad dos limts b/4 3d rad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0520F","description":"Rad dos limts b/4 3d rad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Management of established patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0524","description":"Management of established patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB02","description":"Medium Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemo intralesional over 7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96406","description":"Chemo intralesional over 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breast stacked diep/gap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2067","description":"Breast stacked diep/gap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVF0","description":"ICD-GDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCC0","description":"ICD-NDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87513","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","description":"CPT-87513","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mechanical allergen particle barrier/inhalation filter_ cream_ nasal_ topical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1026","description":"Mechanical allergen particle barrier/inhalation filter_ cream_ nasal_ topical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA54","description":"Default_ /90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antisperm antibodies test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3655","description":"Antisperm antibodies test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64865","description":"Repair of facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCB1","description":"ICD-MGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINF0","description":"ICD-KINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gum graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41870","description":"Gum graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant eye drug system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67027","description":"Implant eye drug system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"XWRAP_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4204","description":"XWRAP_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Construct bladder opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51980","description":"Construct bladder opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCA1","description":"ICD-CDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Composite drsg >16<=48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6204","description":"Composite drsg >16<=48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auricular prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5914","description":"Auricular prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fos c chld non-ther per mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0042","description":"Fos c chld non-ther per mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Whlchr ampu fxd arm leg rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1170","description":"Whlchr ampu fxd arm leg rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ureter endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50970","description":"Ureter endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLC1","description":"ICD-NBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of nail bed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11760","description":"Repair of nail bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVB0","description":"ICD-NDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFA1","description":"ICD-BHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOE1","description":"ICD-PFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHE1","description":"ICD-EAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place cath carotid/inom art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36222","description":"Place cath carotid/inom art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBD1","description":"ICD-NBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNF0","description":"ICD-FBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2CA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CA31","description":"ICD-2CA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51550","description":"Partial removal of bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATA1","description":"ICD-KATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTD0","description":"ICD-EGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLE1","description":"ICD-CDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHE0","description":"ICD-MCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOD0","description":"ICD-LHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exposure impact tooth orthod","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7280","description":"Exposure impact tooth orthod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 4 hd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0870","description":"Pwc gp 4 hd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAC1","description":"ICD-OIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CoreCyte_ for topical use only_ per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4240","description":"CoreCyte_ for topical use only_ per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEF1","description":"ICD-IAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bl smear w/o diff wbc count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85008","description":"Bl smear w/o diff wbc count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDA1","description":"ICD-GGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bupivicaine hydro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0020","description":"Injection_ bupivicaine hydro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Idursulfase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1743","description":"Idursulfase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOC1","description":"ICD-OEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ epoetin alfa_ 1000 units (for esrd on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0886","description":"Injection_ epoetin alfa_ 1000 units (for esrd on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pump for water circulating p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0236","description":"Pump for water circulating p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"JAK2 (Janus kinase 2) (eg_ myeloproliferative disorder) gene analysis_ targeted sequence analysis exons 12-15","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0027U","description":"JAK2 (Janus kinase 2) (eg_ myeloproliferative disorder) gene analysis_ targeted sequence analysis exons 12-15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bls-emergency","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0429","description":"Bls-emergency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ non-stranded_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2699","description":"Brachytx_ non-stranded_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKC1","description":"ICD-CCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronidase recombinant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3473","description":"Hyaluronidase recombinant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis delta agent antbdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86692","description":"Hepatitis delta agent antbdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HER2/neu positive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9830","description":"HER2/neu positive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6062","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAF1","description":"ICD-OLAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Add le poly knee custom kafo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2387","description":"Add le poly knee custom kafo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEE0","description":"ICD-JIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophagomyotomy thoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43331","description":"Esophagomyotomy thoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auto test panel pricing code_ 21 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP21","description":"Auto test panel pricing code_ 21 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKF0","description":"ICD-JHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWB0","description":"ICD-KFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBF1","description":"ICD-ICBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended-release (Sublocade)_ less than or equal to 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9991","description":"Injection_ buprenorphine extended-release (Sublocade)_ less than or equal to 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJC1","description":"ICD-NFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystourethro w/implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52441","description":"Cystourethro w/implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDF0","description":"ICD-NDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Consultation with a medical health care professional","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9311","description":"Consultation with a medical health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGA0","description":"ICD-OIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTD0","description":"ICD-ECTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITE0","description":"ICD-FITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTC1","description":"ICD-MCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Body fluid cell count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89050","description":"Body fluid cell count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWA1","description":"ICD-GAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPA1","description":"ICD-FBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWB0","description":"ICD-DIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLE1","description":"ICD-KCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFE0","description":"ICD-BEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJF1","description":"ICD-NEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise inner eye strands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67030","description":"Incise inner eye strands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27536","description":"Treat knee fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIED1","description":"ICD-EIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFC1","description":"ICD-FBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"3d render w/intrp postproces","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76376","description":"3d render w/intrp postproces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEC0","description":"ICD-OHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of esophagus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43101","description":"Excision of esophagus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amitriptyline injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1320","description":"Amitriptyline injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18F","description":"Clinically Complex _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHA1","description":"ICD-ADHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETC1","description":"ICD-IETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEC1","description":"ICD-IFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of pelvis bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26991","description":"Drainage of pelvis bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKE1","description":"ICD-KAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFD1","description":"ICD-NEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCF0","description":"ICD-BHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove mastoid structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69505","description":"Remove mastoid structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERE1","description":"ICD-LERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counselin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1289","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counselin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay prostate phosphatase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84066","description":"Assay prostate phosphatase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rerepair ventrl hern block","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49566","description":"Rerepair ventrl hern block","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lingual frenectomy (frenulectomy)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7962","description":"Lingual frenectomy (frenulectomy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXE0","description":"ICD-OLXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACD1","description":"ICD-NACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVF1","description":"ICD-NAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPA0","description":"ICD-NLPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Add mech leg elevation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1009","description":"Add mech leg elevation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Multi-axial rotation unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5986","description":"Multi-axial rotation unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOA0","description":"ICD-CBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant temple bone w/stimul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69714","description":"Implant temple bone w/stimul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYB0","description":"ICD-PHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0683","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","description":"HCPCS-G0683","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vehicle Modifications","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0139","description":"Vehicle Modifications","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYF1","description":"ICD-GCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ algorithm reported as a probabilit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0365U","description":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ algorithm reported as a probabilit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMD0","description":"ICD-MIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transperineal periurethral balloon continence device; bilateral placement_ including cystoscopy and fluoroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0548T","description":"Transperineal periurethral balloon continence device; bilateral placement_ including cystoscopy and fluoroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECF0","description":"ICD-EECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQA1","description":"ICD-OJQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD15A","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mnt subs tx for change dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0270","description":"Mnt subs tx for change dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB0C","description":"Low Rehab_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision Or Replacement (Including Removal Of Existing Device)_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69719","description":"Revision Or Replacement (Including Removal Of Existing Device)_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX4C","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYA1","description":"ICD-LHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDF1","description":"ICD-AHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2106","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPA1","description":"ICD-OFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlh uterus 250 g or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58570","description":"Tlh uterus 250 g or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJB0","description":"ICD-OLJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYA1","description":"ICD-HIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVA0","description":"ICD-NJVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0920T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","description":"CPT-0920T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablate inf turbinate superf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30801","description":"Ablate inf turbinate superf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES15C","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKF1","description":"ICD-KDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphere bifocal 7.12-20.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2202","description":"Lens sphere bifocal 7.12-20.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biological materials","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3431","description":"Biological materials","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Influenza b ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87275","description":"Influenza b ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLME0","description":"ICD-NLME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC120","description":"Special Care High _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE154","description":"Clinically Complex _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCD1","description":"ICD-AGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ moxetumomab pasudotox-tdfk_ 0.01 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9313","description":"Injection_ moxetumomab pasudotox-tdfk_ 0.01 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKA1","description":"ICD-NEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit new","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99204","description":"Office/outpatient visit new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAA0","description":"ICD-IHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pantoprazole sodium_ 40 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2470","description":"Injection_ pantoprazole sodium_ 40 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC260","description":"Special Care High _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compres burngarment bodysuit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6501","description":"Compres burngarment bodysuit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFA1","description":"ICD-JGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYC0","description":"ICD-GFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRE1","description":"ICD-KHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXC1","description":"ICD-NIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI lumbar spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72149","description":"MRI lumbar spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWB0","description":"ICD-OCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETA0","description":"ICD-OETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKE0","description":"ICD-CHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Within The Past 2 Years_ Calcium And/Or Vitamin D Optimization Has Been Ordered Or Performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2119","description":"Within The Past 2 Years_ Calcium And/Or Vitamin D Optimization Has Been Ordered Or Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQB0","description":"ICD-LGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUA1","description":"ICD-GGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD10A","description":"Special Care High _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of intraosseous basivertebral nerve_ first two vertebral bodies_ including imaging guidance (e.g._ fluoroscopy)_ lu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9752","description":"Destruction of intraosseous basivertebral nerve_ first two vertebral bodies_ including imaging guidance (e.g._ fluoroscopy)_ lu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCB1","description":"ICD-KDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEC0","description":"ICD-GAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKC1","description":"ICD-KHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNC0","description":"ICD-NDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plmt post facet implt thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0220T","description":"Plmt post facet implt thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mr angio upr extr w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73225","description":"Mr angio upr extr w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAB0","description":"ICD-KCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Pan Tumor)_ Whole Genome Sequencing Of Paired Malignant And Normal Dna Specimens_ Fresh Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Blood Or Bone Marrow_ Comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0297U","description":"Oncology (Pan Tumor)_ Whole Genome Sequencing Of Paired Malignant And Normal Dna Specimens_ Fresh Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Blood Or Bone Marrow_ Comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDA0","description":"ICD-MCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional_ two or more tests_ any method; first 30 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96136","description":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional_ two or more tests_ any method; first 30 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laser tx skin < 250 sq cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96920","description":"Laser tx skin < 250 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLC0","description":"ICD-KHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Denosumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0897","description":"Denosumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAE0","description":"ICD-CAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELA1","description":"ICD-IELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8X","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWD0","description":"ICD-LFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYA0","description":"ICD-KGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Us exam of head and neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76536","description":"Us exam of head and neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADD1","description":"ICD-BADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0667U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0667U","description":"CPT-0667U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETE0","description":"ICD-KETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ocular instrumnt screen bil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99177","description":"Ocular instrumnt screen bil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALF0","description":"ICD-MALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUE1","description":"ICD-JGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37256","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","description":"CPT-37256","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUD0","description":"ICD-OFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter left ventricular restoration device implantation including right and left heart catheterization and left ventriculography when performed_ arterial approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0643T","description":"Transcatheter left ventricular restoration device implantation including right and left heart catheterization and left ventriculography when performed_ arterial approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKE1","description":"ICD-BIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC5D","description":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9232","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9232","description":"HCPCS-J9232","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQE0","description":"ICD-LGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBA1","description":"ICD-NLBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Change of windpipe airway","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31502","description":"Change of windpipe airway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXE1","description":"ICD-JGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended-release (Sublocade)_ greater than 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9992","description":"Injection_ buprenorphine extended-release (Sublocade)_ greater than 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD106","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB104","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC12C","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Methacholine chloride_ neb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7674","description":"Methacholine chloride_ neb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Atropine comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7635","description":"Atropine comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anus surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46999","description":"Anus surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neurawrap nerve protector_cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9353","description":"Neurawrap nerve protector_cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLD0","description":"ICD-OJLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hmes filter holder or cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7503","description":"Hmes filter holder or cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQE1","description":"ICD-CFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bed pan fracture","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0276","description":"Bed pan fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADD0","description":"ICD-AADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair venous blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35460","description":"Repair venous blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWD1","description":"ICD-OBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKD1","description":"ICD-CAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tail bone ulcer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15922","description":"Removal of tail bone ulcer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAD1","description":"ICD-CEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive surgery of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42845","description":"Extensive surgery of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLB0","description":"ICD-ECLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGB1","description":"ICD-KFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAC1","description":"ICD-NKAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sex transformation f to m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55980","description":"Sex transformation f to m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device_ aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93591","description":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device_ aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPE0","description":"ICD-CAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Flu immuno admind rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4274F","description":"Flu immuno admind rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCF1","description":"ICD-JHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMB0","description":"ICD-AAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incis w/discectomy lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22224","description":"Incis w/discectomy lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFE1","description":"ICD-JIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBB0","description":"ICD-ADBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid repair/modifying","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5014","description":"Hearing aid repair/modifying","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWE1","description":"ICD-DCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHD0","description":"ICD-JHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGD1","description":"ICD-GBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aztreonam_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0457","description":"Injection_ aztreonam_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOA1","description":"ICD-PKOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst w/enterocele compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58294","description":"Vag hyst w/enterocele compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDC1","description":"ICD-OEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPA0","description":"ICD-JAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2130","description":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Induced abortion 25-28 wks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2265","description":"Induced abortion 25-28 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lens trifocal seg width > 28","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2319","description":"Lens trifocal seg width > 28","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Temp fml iu valve-pmp rplcmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0597T","description":"Temp fml iu valve-pmp rplcmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75831","description":"Vein x-ray kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22855","description":"Remove spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYF0","description":"ICD-CGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADB0","description":"ICD-JADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWC0","description":"ICD-CGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUC1","description":"ICD-OEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vivaglobin_ inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1562","description":"Vivaglobin_ inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrocorticogram from an implanted brain neurostimulator pulse generator/transmitter_ including recording_ with interpretation and written report_ up to 30 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95836","description":"Electrocorticogram from an implanted brain neurostimulator pulse generator/transmitter_ including recording_ with interpretation and written report_ up to 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAME0","description":"ICD-IAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJE0","description":"ICD-OCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAE1","description":"ICD-NIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of thigh/knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27497","description":"Decompression of thigh/knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYB0","description":"ICD-OBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSB0","description":"ICD-CBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUA0","description":"ICD-CEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKE0","description":"ICD-FCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINA1","description":"ICD-GINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUA1","description":"ICD-NKUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25151","description":"Partial removal of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Med nutrition indiv subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97803","description":"Med nutrition indiv subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDD0","description":"ICD-NGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50949","description":"Laparoscope proc ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Whchr h-duty det arm leg res","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1280","description":"Whchr h-duty det arm leg res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD13A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove part of neck vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22100","description":"Remove part of neck vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBD0","description":"ICD-ICBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco-use counsel 3-10 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0436","description":"Tobacco-use counsel 3-10 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUB1","description":"ICD-ACUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXB0","description":"ICD-OLXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mucus trap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8210","description":"Mucus trap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMA0","description":"ICD-IFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJC0","description":"ICD-FBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA2A","description":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ins cath ren art 2nd+ unilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36253","description":"Ins cath ren art 2nd+ unilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDF0","description":"ICD-MKDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRC1","description":"ICD-DFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Major vessel shunt & graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33764","description":"Major vessel shunt & graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWE0","description":"ICD-GBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-sterile eye pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6411","description":"Non-sterile eye pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoe styled positioning dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3160","description":"Shoe styled positioning dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITC0","description":"ICD-KITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFE0","description":"ICD-CGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nurse practr visit outs cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0274","description":"Nurse practr visit outs cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0973T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","description":"CPT-0973T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGD0","description":"ICD-KHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC32","description":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNB1","description":"ICD-CCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76080","description":"X-ray exam of fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEC1","description":"ICD-EDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5276","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7529","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7529","description":"HCPCS-J7529","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFE0","description":"ICD-JFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEC0","description":"ICD-FFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCD1","description":"ICD-ADCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABE1","description":"ICD-OABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mammogram both breasts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77056","description":"Mammogram both breasts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9708","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKC0","description":"ICD-OCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytp urine 3-5 probes cmptr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88121","description":"Cytp urine 3-5 probes cmptr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBA0","description":"ICD-FFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSD0","description":"ICD-HHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"REvenfenacin inhalation solution_ FDA-approved final product_ noncompounded_administered through DME_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7677","description":"REvenfenacin inhalation solution_ FDA-approved final product_ noncompounded_administered through DME_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01938","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","description":"CPT-01938","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath tbs c/v auto redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88166","description":"Cytopath tbs c/v auto redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Factor viii recombinant nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7192","description":"Factor viii recombinant nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC0C","description":"High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Pan Tumor)_ Whole Transcriptome Sequencing Of Paired Malignant And Normal Rna Specimens_ Fresh Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Blood Or Bone Marro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0298U","description":"Oncology (Pan Tumor)_ Whole Transcriptome Sequencing Of Paired Malignant And Normal Rna Specimens_ Fresh Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Blood Or Bone Marro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJA0","description":"ICD-GHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0558U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","description":"CPT-0558U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8C","description":"Very High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSE0","description":"ICD-ODSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAE1","description":"ICD-KCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHD0","description":"ICD-NKHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00450","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00450","description":"CPT-00450","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYB1","description":"ICD-HCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"3D Echocardiographic Imaging And Postprocessing During Transesophageal Echocardiography_ Or During Transthoracic Echocardiography For Congenital Cardiac Anomalies_ For The Ass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93319","description":"3D Echocardiographic Imaging And Postprocessing During Transesophageal Echocardiography_ Or During Transthoracic Echocardiography For Congenital Cardiac Anomalies_ For The Ass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Uri episodes where the patient had a competing comorbid condition during the 12 months prior to or on the episode date (e.g._ tuberculosis_ neutropenia_ cystic fibrosis_ chron","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2173","description":"Uri episodes where the patient had a competing comorbid condition during the 12 months prior to or on the episode date (e.g._ tuberculosis_ neutropenia_ cystic fibrosis_ chron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITB0","description":"ICD-IITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aminocaproic acid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0017","description":"Injection_ aminocaproic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGB0","description":"ICD-NAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSB1","description":"ICD-CDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1803","description":"HCPCS-A1803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPD1","description":"ICD-JBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLA0","description":"ICD-GBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNB0","description":"ICD-BDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid fitting/checking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5011","description":"Hearing aid fitting/checking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFB0","description":"ICD-BAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anatomic model 3D-printed from image data set(s); first individually prepared and processed component of an anatomic structure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0559T","description":"Anatomic model 3D-printed from image data set(s); first individually prepared and processed component of an anatomic structure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antipsychotics nos 7/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80344","description":"Antipsychotics nos 7/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abut support retainer titani","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6194","description":"Abut support retainer titani","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Silicone gel insert or equal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6692","description":"Silicone gel insert or equal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFE1","description":"ICD-BFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIC1","description":"ICD-NBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insj/rplc nstim apnea pls gn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0427T","description":"Insj/rplc nstim apnea pls gn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSA1","description":"ICD-PKSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endodontic procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3999","description":"Endodontic procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0162","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","description":"HCPCS-J0162","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB12A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA14C","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWD0","description":"ICD-PEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC23A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLC1","description":"ICD-CGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTF1","description":"ICD-NGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pos clin depres scrn f/u doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8431","description":"Pos clin depres scrn f/u doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Candida dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87481","description":"Candida dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neoxflo or clarixflo 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4155","description":"Neoxflo or clarixflo 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thromblytic art/ven therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37213","description":"Thromblytic art/ven therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTF0","description":"ICD-IDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8006","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8006","description":"HCPCS-C8006","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTE0","description":"ICD-EDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Oritavancin_ 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9444","description":"Injection_ Oritavancin_ 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQA1","description":"ICD-HDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC15C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abd imag w/o liv/kid/adr les","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9551","description":"Abd imag w/o liv/kid/adr les","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home visit resp therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99503","description":"Home visit resp therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Oral And/Or Oropharyngeal Cancer)_ Gene Expression Profiling By Rna Sequencing At Least 20 Molecular Features (Eg_ Human And/Or Microbial Mrna)_ Saliva_ Algorithm Re","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0296U","description":"Oncology (Oral And/Or Oropharyngeal Cancer)_ Gene Expression Profiling By Rna Sequencing At Least 20 Molecular Features (Eg_ Human And/Or Microbial Mrna)_ Saliva_ Algorithm Re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA251","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFB0","description":"ICD-NEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCC1","description":"ICD-GFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIA0","description":"ICD-JFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Grad comp non-elastic bk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6545","description":"Grad comp non-elastic bk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIE1","description":"ICD-GIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACF0","description":"ICD-MACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of gdh enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82965","description":"Assay of gdh enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1JB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JB21","description":"ICD-1JB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLD0","description":"ICD-BHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIE1","description":"ICD-AFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0838T","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prescription of contact lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92314","description":"Prescription of contact lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prkns diag rviewed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1400F","description":"Prkns diag rviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cstm dme other than wheelchr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0900","description":"Cstm dme other than wheelchr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBF1","description":"ICD-EHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gallium ga-68_ dotatate_ diagnostic_ 0.1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9587","description":"Gallium ga-68_ dotatate_ diagnostic_ 0.1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOF1","description":"ICD-LEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of hydrocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55040","description":"Removal of hydrocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE214","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no us","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8807","description":"Doc reas no us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVD0","description":"ICD-JGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXB1","description":"ICD-BEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA ROTAVIRUS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87425","description":"IAAD IA ROTAVIRUS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMB1","description":"ICD-MKMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nutritional counseling_ diet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9470","description":"Nutritional counseling_ diet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth heart surg <1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56159","description":"Anesth heart surg <1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX36","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHE1","description":"ICD-ABHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNA1","description":"ICD-JHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Albumin; urine (eg_ microalbumin)_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82043","description":"Albumin; urine (eg_ microalbumin)_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWC0","description":"ICD-CFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHB1","description":"ICD-CGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urinary cath anchor device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4333","description":"Urinary cath anchor device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUC1","description":"ICD-ECUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64681","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA23D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE114","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXC1","description":"ICD-OAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUB0","description":"ICD-NFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFND0","description":"ICD-GFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYF0","description":"ICD-CHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXF1","description":"ICD-KBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQD0","description":"ICD-OEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB240","description":"Reduced Physical Function _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYF1","description":"ICD-PCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rolapitant_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9464","description":"Injection_ rolapitant_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8G","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDF1","description":"ICD-GCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amphotericin b liposome inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0289","description":"Amphotericin b liposome inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYE1","description":"ICD-CFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spinal orthosis nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1499","description":"Spinal orthosis nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVA0","description":"ICD-BDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDC0","description":"ICD-MDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYB0","description":"ICD-OLYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXD0","description":"ICD-NJXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB44","description":"Low Rehab_ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No assess bone loss","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8863","description":"No assess bone loss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB251","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJE1","description":"ICD-BGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAB0","description":"ICD-OBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ibalizumab-uiyk_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1746","description":"Injection_ ibalizumab-uiyk_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEC0","description":"ICD-IHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medical supplies and equipme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9061","description":"Medical supplies and equipme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cross-over vein graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34520","description":"Cross-over vein graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE23C","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ pmkr/aicd combination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1899","description":"Lead_ pmkr/aicd combination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKE0","description":"ICD-CDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTC0","description":"ICD-OFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIE1","description":"ICD-CFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18I","description":"Special Care High _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLF1","description":"ICD-JDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ureter endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50961","description":"Ureter endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMB0","description":"ICD-NCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vit d 1 25-dihydroxy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82652","description":"Vit d 1 25-dihydroxy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sc ther infusion up to 1 hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96369","description":"Sc ther infusion up to 1 hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral - bitewing radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0708","description":"Intraoral - bitewing radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Continent stoma catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5082","description":"Continent stoma catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21010","description":"Incision of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECE0","description":"ICD-NECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leg Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 3.0 Or Leg Pain Measured By The Visual Analog Scale","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2140","description":"Leg Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 3.0 Or Leg Pain Measured By The Visual Analog Scale","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE12B","description":"Reduced Physical Function _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vancomycin hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3370","description":"Vancomycin hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLD0","description":"ICD-KHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1501","description":"HCPCS-A1501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acetaminophen injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0131","description":"Acetaminophen injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYE0","description":"ICD-OJYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc neg elder mal no plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8734","description":"Doc neg elder mal no plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIB1","description":"ICD-ODIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of sesamoid bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28315","description":"Removal of sesamoid bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Observational behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by one tec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0360T","description":"Observational behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by one tec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism ehealthline clinical decision support mechanism_ as defined by the medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1021","description":"Clinical decision support mechanism ehealthline clinical decision support mechanism_ as defined by the medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDA0","description":"ICD-KBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cid ext controller repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8628","description":"Cid ext controller repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"PTEN (phosphatase and tensin homolog) (eg_ Cowden syndrome_ PTEN hamartoma tumor syndrome)_ full gene analysis_ including small sequence changes in exonic and intronic regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0235U","description":"PTEN (phosphatase and tensin homolog) (eg_ Cowden syndrome_ PTEN hamartoma tumor syndrome)_ full gene analysis_ including small sequence changes in exonic and intronic regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0525T","description":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pild/placebo control clin tr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0276","description":"Pild/placebo control clin tr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0807T","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD24A","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wcd device interrogate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93292","description":"Wcd device interrogate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Deep sedation/general anesthesia-each additional 15 minutes","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9221","description":"Deep sedation/general anesthesia-each additional 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPA0","description":"ICD-OFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJB1","description":"ICD-FEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thiethylperazine maleate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3280","description":"Thiethylperazine maleate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","description":"HCPCS-J2003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct capt mandible","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0381","description":"Cone beam ct capt mandible","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92652","description":"Anesth removal of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2039","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","description":"HCPCS-A2039","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Med reas rpt no histo type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9423","description":"Med reas rpt no histo type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Crown resin w/ base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2721","description":"Crown resin w/ base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLE1","description":"ICD-OBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKD0","description":"ICD-OHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kidney imaging morphol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78700","description":"Kidney imaging morphol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSF0","description":"ICD-PDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB205","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQF0","description":"ICD-HCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0626T","description":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAA1","description":"ICD-FGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIF1","description":"ICD-FEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient transfer system <300","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1035","description":"Patient transfer system <300","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPF1","description":"ICD-OHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTD0","description":"ICD-OFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking full lngth 18-30","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6536","description":"Gc stocking full lngth 18-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB26","description":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ stranded_ i-125","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2638","description":"Brachytx_ stranded_ i-125","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLB1","description":"ICD-JFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth amniocentesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84251","description":"Anesth amniocentesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"External urinary catheters; disposable_ with wicking material_ for use with suction pump_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6590","description":"External urinary catheters; disposable_ with wicking material_ for use with suction pump_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA25D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDE0","description":"ICD-GHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFA1","description":"ICD-NEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain blood from under nail","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11740","description":"Drain blood from under nail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHE0","description":"ICD-JCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGF0","description":"ICD-GFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUB0","description":"ICD-ABUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINB0","description":"ICD-OINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBD1","description":"ICD-AEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Smallpox and monkeypox vaccine_ attenuated vaccinia virus_ live_ non-replicating_ preservative free_ 0.5 mL dosage_ suspension_ for subcutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90611","description":"Smallpox and monkeypox vaccine_ attenuated vaccinia virus_ live_ non-replicating_ preservative free_ 0.5 mL dosage_ suspension_ for subcutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAE1","description":"ICD-OKAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87469","description":"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB12A","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA4D","description":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBB1","description":"ICD-IIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy for lvrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32672","description":"Thoracoscopy for lvrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecg monit/reprt up to 48 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93227","description":"Ecg monit/reprt up to 48 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1020T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","description":"CPT-1020T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Us urine capacity measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51798","description":"Us urine capacity measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No pcp proph low cd4 norsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9217","description":"No pcp proph low cd4 norsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sf3B1 (Splicing Factor [3B] Subunit B1) (Eg_ Myelodysplastic Syndrome/Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ A672T_ E622D_ L833F_ R625C_ R625L)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81347","description":"Sf3B1 (Splicing Factor [3B] Subunit B1) (Eg_ Myelodysplastic Syndrome/Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ A672T_ E622D_ L833F_ R625C_ R625L)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBA0","description":"ICD-IIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSB0","description":"ICD-OHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYB1","description":"ICD-GDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fixed wing air transport","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0430","description":"Fixed wing air transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJD1","description":"ICD-JAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFC0","description":"ICD-ODFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVE0","description":"ICD-FGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTF1","description":"ICD-ODTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acth stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80406","description":"Acth stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCE0","description":"ICD-CFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration carotid artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35701","description":"Exploration carotid artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36581","description":"Replace tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC35","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor xi pta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85270","description":"Clot factor xi pta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Care management services for behavioral health conditions_ at least 20 minutes of clinical psychologist or clinical social worker time_ per calendar month. (these services inc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0323","description":"Care management services for behavioral health conditions_ at least 20 minutes of clinical psychologist or clinical social worker time_ per calendar month. (these services inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1GB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GB21","description":"ICD-1GB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTF0","description":"ICD-OGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOA0","description":"ICD-CDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Japanese encephalitis virus vaccine_ for subcutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90735","description":"Japanese encephalitis virus vaccine_ for subcutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKC0","description":"ICD-BCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid dispensing fee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5090","description":"Hearing aid dispensing fee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHF1","description":"ICD-GDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSF1","description":"ICD-CGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9979","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBF0","description":"ICD-CBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOB1","description":"ICD-KHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOF0","description":"ICD-HCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUC1","description":"ICD-FBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYB0","description":"ICD-GGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERE0","description":"ICD-OERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBF0","description":"ICD-JCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBB1","description":"ICD-MJBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAC1","description":"ICD-NEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp carotid-subclavian","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35606","description":"Art byp carotid-subclavian","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFC1","description":"ICD-BHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYC1","description":"ICD-GGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous measurement of five biomarkers (tissue oxygenation [StO2]_ oxyhemoglobin [ctHbO2]_ deoxyhemoglobin [ctHbR]_ papillary and reticular dermal hemoglobin concentrat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0061U","description":"Transcutaneous measurement of five biomarkers (tissue oxygenation [StO2]_ oxyhemoglobin [ctHbO2]_ deoxyhemoglobin [ctHbR]_ papillary and reticular dermal hemoglobin concentrat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBC0","description":"ICD-GGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bld glucose monitor w lance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2101","description":"Bld glucose monitor w lance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEE1","description":"ICD-GEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTF0","description":"ICD-BBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"RFC1 (replication factor C subunit 1)_ repeat expansion variant analysis by traditional and repeat-primed PCR_ blood_ saliva_ or buccal swab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0378U","description":"RFC1 (replication factor C subunit 1)_ repeat expansion variant analysis by traditional and repeat-primed PCR_ blood_ saliva_ or buccal swab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOB0","description":"ICD-CGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clean out mastoid cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69222","description":"Clean out mastoid cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNF1","description":"ICD-CGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOB0","description":"ICD-PBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3KA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KA31","description":"ICD-3KA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGD1","description":"ICD-FEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sheath upper limb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8415","description":"Sheath upper limb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBC0","description":"ICD-IFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Set-up cardiovert-defibrill","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93745","description":"Set-up cardiovert-defibrill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIB1","description":"ICD-NIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Addition_ endoskeletal knee-shin system_ 4 bar linkage or multiaxial_ fluid swing and stance phase control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5615","description":"Addition_ endoskeletal knee-shin system_ 4 bar linkage or multiaxial_ fluid swing and stance phase control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESE0","description":"ICD-HESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSB1","description":"ICD-GDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMD0","description":"ICD-KDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGND1","description":"ICD-OGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEB1","description":"ICD-JCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENF1","description":"ICD-CENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0649U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0649U","description":"CPT-0649U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam ribs/chest4/> vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71111","description":"X-ray exam ribs/chest4/> vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWE1","description":"ICD-OFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatry (Mood Disorders)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 144 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0291U","description":"Psychiatry (Mood Disorders)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 144 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Waist belt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2190","description":"Waist belt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0546","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","description":"HCPCS-G0546","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCB1","description":"ICD-AFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Torsion straight knee joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2380","description":"Torsion straight knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIF1","description":"ICD-CHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0564U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","description":"CPT-0564U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUF1","description":"ICD-AFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDF0","description":"ICD-GIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDF1","description":"ICD-FBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA10B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBC0","description":"ICD-IIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRD1","description":"ICD-OIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMC1","description":"ICD-FGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCB0","description":"ICD-GHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHE1","description":"ICD-CFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00860","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00860","description":"CPT-00860","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX3A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hgb not doc rns not gvn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8974","description":"Hgb not doc rns not gvn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBB1","description":"ICD-NCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSD1","description":"ICD-OCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment with protocol modification administered by physician or other qualified health care professional with one patient; each additional 30 minutes of pa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0369T","description":"Adaptive behavior treatment with protocol modification administered by physician or other qualified health care professional with one patient; each additional 30 minutes of pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sialidase enzyme assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87905","description":"Sialidase enzyme assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCB0","description":"ICD-CDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTE0","description":"ICD-IFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl devital tis addl 20cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97598","description":"Rmvl devital tis addl 20cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUB1","description":"ICD-MFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHE1","description":"ICD-JFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHB0","description":"ICD-MGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTF1","description":"ICD-MDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHC0","description":"ICD-ODHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cont pas motion exercise dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0935","description":"Cont pas motion exercise dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cms medical evidence form 2728 for dialysis patients: initial form completed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1265","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9341","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","description":"HCPCS-J9341","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spoke protectors","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0065","description":"Spoke protectors","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chemo iv infusion addl hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96415","description":"Chemo iv infusion addl hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYD0","description":"ICD-KGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUF1","description":"ICD-KEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSA0","description":"ICD-DBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cult skin graft t/a/l +%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15152","description":"Cult skin graft t/a/l +%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCD0","description":"ICD-GBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXA0","description":"ICD-GGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx nsclc stg3b-4 metasta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9066","description":"Onc dx nsclc stg3b-4 metasta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDD0","description":"ICD-IDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMD0","description":"ICD-JHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEA1","description":"ICD-JBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHF1","description":"ICD-ACHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC25A","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIC1","description":"ICD-FGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINF1","description":"ICD-GINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of sperm duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55200","description":"Incision of sperm duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAD1","description":"ICD-BBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADF0","description":"ICD-NADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stimulated iui case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4035","description":"Stimulated iui case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUA1","description":"ICD-FCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKA0","description":"ICD-OBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDA0","description":"ICD-NJDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVC0","description":"ICD-BHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0962T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","description":"CPT-0962T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEE0","description":"ICD-EIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch urine w lock flng/ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4434","description":"Ost pch urine w lock flng/ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUC1","description":"ICD-OJUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pediatric electric hand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7008","description":"Pediatric electric hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open tx nose & septal fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21335","description":"Open tx nose & septal fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC12D","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair nerve add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64837","description":"Repair nerve add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVD1","description":"ICD-BFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Place cath carotd art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36224","description":"Place cath carotd art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUB1","description":"ICD-AFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunodiffusion ouchterlony","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86331","description":"Immunodiffusion ouchterlony","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICD1","description":"ICD-OICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJA0","description":"ICD-KBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEF1","description":"ICD-GCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBD0","description":"ICD-NBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEB1","description":"ICD-IDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINF0","description":"ICD-GINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYC1","description":"ICD-DFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0687U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687U","description":"CPT-0687U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of ankle joint open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27870","description":"Fusion of ankle joint open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ triptorelin_ extended-release_ 3.75 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3316","description":"Injection_ triptorelin_ extended-release_ 3.75 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA22D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement nasal cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7032","description":"Replacement nasal cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onsite Ac C Tx Nsg Fac Res W/Pne Billd Sid-Benef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9679","description":"Onsite Ac C Tx Nsg Fac Res W/Pne Billd Sid-Benef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0803","description":"HCPCS-C0803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ abdomen; 1 view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74018","description":"Radiologic examination_ abdomen; 1 view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ncntc r-t fluor wnd img 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0598T","description":"Ncntc r-t fluor wnd img 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Small disposable underpad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4542","description":"Small disposable underpad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ex for nonspeech dev rx add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92618","description":"Ex for nonspeech dev rx add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNF0","description":"ICD-NDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWA0","description":"ICD-PDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVF0","description":"ICD-OKVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYD0","description":"ICD-KDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daratumumab 10 mg and hyaluronidase-fihj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9062","description":"Injection_ daratumumab 10 mg and hyaluronidase-fihj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMB1","description":"ICD-EFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTB1","description":"ICD-IFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Physical performance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97750","description":"Physical performance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMB0","description":"ICD-JGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPE1","description":"ICD-NBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of implant from hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26320","description":"Removal of implant from hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESD0","description":"ICD-PESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reopen fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58350","description":"Reopen fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Acesso AC_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4312","description":"Acesso AC_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCD0","description":"ICD-ICCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLE1","description":"ICD-EBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXC1","description":"ICD-BHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl& replc pulse gen 1 lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33262","description":"Rmvl& replc pulse gen 1 lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPD0","description":"ICD-NJPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIF0","description":"ICD-ABIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVD0","description":"ICD-CGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wrist arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29847","description":"Wrist arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA0B","description":"Low Rehab_ ADL Index 0-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1739","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1739","description":"HCPCS-C1739","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cine/vid x-ray throat/esoph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74230","description":"Cine/vid x-ray throat/esoph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOD0","description":"ICD-KIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gatifloxacin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1590","description":"Gatifloxacin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDF0","description":"ICD-JFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSD1","description":"ICD-GCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1 Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66988","description":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1 Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTA1","description":"ICD-GGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ eptinezumab-jjmr_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3032","description":"Injection_ eptinezumab-jjmr_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQD1","description":"ICD-KGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hematology_ Red Blood Cell (Rbc) Adhesion To Endothelial/Subendothelial Adhesion Molecules_ Functional Assessment_ Whole Blood_ With Algorithmic Analysis And Result Reported A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0304U","description":"Hematology_ Red Blood Cell (Rbc) Adhesion To Endothelial/Subendothelial Adhesion Molecules_ Functional Assessment_ Whole Blood_ With Algorithmic Analysis And Result Reported A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5271","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGA1","description":"ICD-JAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18C","description":"Special Care High _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEB0","description":"ICD-FFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24576","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Orbitocranial approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61584","description":"Orbitocranial approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Serum immunoelectrophoresis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86320","description":"Serum immunoelectrophoresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIF0","description":"ICD-EDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prep corneal endo allograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65757","description":"Prep corneal endo allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML2B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPA1","description":"ICD-BBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Major vessel shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33762","description":"Major vessel shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYB1","description":"ICD-GCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLC1","description":"ICD-IGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB56","description":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m medronate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9503","description":"Tc99m medronate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAC0","description":"ICD-OJAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cryoprecipitated fibrinogen complex_ pathogen reduced_ eachunit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9026","description":"Cryoprecipitated fibrinogen complex_ pathogen reduced_ eachunit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOC1","description":"ICD-DBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50290","description":"Removal of kidney lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJF0","description":"ICD-NGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACE1","description":"ICD-IACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2IC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IC31","description":"ICD-2IC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSF0","description":"ICD-CHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinolytic antiplasmin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85410","description":"Fibrinolytic antiplasmin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chromatography_ quantitative_ column (eg_ gas liquid or hplc); single analyte not elsewhere specified_ single stationary and mobile phase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82491","description":"Chromatography_ quantitative_ column (eg_ gas liquid or hplc); single analyte not elsewhere specified_ single stationary and mobile phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHME1","description":"ICD-NHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLE1","description":"ICD-NDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAF1","description":"ICD-JBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDD0","description":"ICD-NBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Interrogate crtd sns w/pgrmg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0273T","description":"Interrogate crtd sns w/pgrmg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPA0","description":"ICD-GBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of circulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37140","description":"Revision of circulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open tx iliac spine uni/bil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0412","description":"Open tx iliac spine uni/bil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Additional switch_ ext power","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6611","description":"Additional switch_ ext power","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACE1","description":"ICD-MACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of enterocutaneous fistula small intestine or colon (excluding anorectal fistula) with plug (e.g._ porcine small intestine submocosa[SIS])","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9796","description":"Repair of enterocutaneous fistula small intestine or colon (excluding anorectal fistula) with plug (e.g._ porcine small intestine submocosa[SIS])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC40","description":"High Rehab _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis B screening in non-pregnant_ high risk individual includes hepatitis B surface antigen (HBSAG) followed by a neutralizing confirmatory test for initially reactive re","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0499","description":"Hepatitis B screening in non-pregnant_ high risk individual includes hepatitis B surface antigen (HBSAG) followed by a neutralizing confirmatory test for initially reactive re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIE0","description":"ICD-CDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replace non-molded thigh lac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4045","description":"Replace non-molded thigh lac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lev 5 hosp type b ed visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0384","description":"Lev 5 hosp type b ed visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie_ caval valve implantation [CAVI]); open femoral vein approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0806T","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie_ caval valve implantation [CAVI]); open femoral vein approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPE0","description":"ICD-CFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLF1","description":"ICD-GGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVE1","description":"ICD-CGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEE0","description":"ICD-AGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSE1","description":"ICD-OKSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct extra finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26587","description":"Reconstruct extra finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA210","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray guide gi dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74360","description":"X-ray guide gi dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTE1","description":"ICD-JDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUA1","description":"ICD-AIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEE1","description":"ICD-GCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBC0","description":"ICD-MGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Craniectomy_ suboccipital; for mesencephalic tractotomy or pedunculotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61480","description":"Craniectomy_ suboccipital; for mesencephalic tractotomy or pedunculotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPE1","description":"ICD-FIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEF1","description":"ICD-ACEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fuse esophagus & stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43320","description":"Fuse esophagus & stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC36","description":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage ext line_ dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4672","description":"Drainage ext line_ dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4DA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DA21","description":"ICD-4DA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYB0","description":"ICD-PCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITF0","description":"ICD-JITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUE1","description":"ICD-IHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Com wrap-around sv_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2021","description":"Com wrap-around sv_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDF0","description":"ICD-IIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVF0","description":"ICD-ODVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patient_s 13th birthday","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1160","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patient_s 13th birthday","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 14 acyl carnitines and microbiome-derived metabolites_ liquid chromatography with tandem mass spectrom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0322U","description":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 14 acyl carnitines and microbiome-derived metabolites_ liquid chromatography with tandem mass spectrom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove sympathetic nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64809","description":"Remove sympathetic nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD10C","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEB0","description":"ICD-EGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES224","description":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGE1","description":"ICD-OGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of apolipoprotein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82172","description":"Assay of apolipoprotein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDF0","description":"ICD-CEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42225","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQB1","description":"ICD-PCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPD1","description":"ICD-KCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trichogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96902","description":"Trichogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUB1","description":"ICD-CAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA113","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"BellaCell HD or Surederm_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4220","description":"BellaCell HD or Surederm_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIC0","description":"ICD-EDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNE1","description":"ICD-NBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0101","description":"HCPCS-B0101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD120","description":"Special Care High _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tempr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0278T","description":"Tempr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Listeria monocytogenes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86723","description":"Listeria monocytogenes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA44","description":"Low Rehab_ ADL Index 0-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRD0","description":"ICD-OBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stool collection pouch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4330","description":"Stool collection pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Influenza immunization was not administered for reasons documented by clinician (e.g._ patient allergy or other medical reasons_ patient declined or other patient reasons_ vac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1300","description":"Influenza immunization was not administered for reasons documented by clinician (e.g._ patient allergy or other medical reasons_ patient declined or other patient reasons_ vac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ melphalan (hepzato)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9248","description":"Injection_ melphalan (hepzato)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUA0","description":"ICD-OIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERE0","description":"ICD-PERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTD1","description":"ICD-JHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOD0","description":"ICD-PIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEA0","description":"ICD-OFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKB0","description":"ICD-ODKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVE1","description":"ICD-OBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52007","description":"Cystoscopy and biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC06","description":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB22C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKB0","description":"ICD-BIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCE1","description":"ICD-KHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRD1","description":"ICD-HFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARC0","description":"ICD-CARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transfer device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0705","description":"Transfer device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFC1","description":"ICD-NHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRF1","description":"ICD-LDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYD0","description":"ICD-LIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKD1","description":"ICD-KGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFE0","description":"ICD-BIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTF0","description":"ICD-OKTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDF0","description":"ICD-FHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dentures immediat maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5130","description":"Dentures immediat maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB214","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sub pt/ot goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8994","description":"Sub pt/ot goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive chest wall surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19272","description":"Extensive chest wall surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ guselkumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1628","description":"Injection_ guselkumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ toe caps_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6573","description":"Gradient compression garment_ toe caps_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Body Surface-Activation Mapping Of Pacemaker Or Pacing Cardioverter-Defibrillator Lead(S) To Optimize Electrical Synchrony_ Cardiac Resynchronization Therapy Device_ Including","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0695T","description":"Body Surface-Activation Mapping Of Pacemaker Or Pacing Cardioverter-Defibrillator Lead(S) To Optimize Electrical Synchrony_ Cardiac Resynchronization Therapy Device_ Including","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUE0","description":"ICD-IFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pentobarbital sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2515","description":"Pentobarbital sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/decompression","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44408","description":"Colonoscopy w/decompression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA14C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTC0","description":"ICD-FHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Osteopath manj 3-4 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98926","description":"Osteopath manj 3-4 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTE0","description":"ICD-FDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIF0","description":"ICD-CHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of scrotum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55120","description":"Removal of scrotum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHC0","description":"ICD-ECHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy islet cell trans","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0342","description":"Laparoscopy islet cell trans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEA1","description":"ICD-FFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYA1","description":"ICD-GCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQE0","description":"ICD-DHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anal sp inf pmp w/reprg&fill","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62369","description":"Anal sp inf pmp w/reprg&fill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bmi not documented and no reason is given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1314","description":"Bmi not documented and no reason is given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDA1","description":"ICD-BBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQC0","description":"ICD-HEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of diaphragm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39545","description":"Revision of diaphragm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of bladder wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51860","description":"Repair of bladder wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1826","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","description":"HCPCS-E1826","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrode stimulation brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95961","description":"Electrode stimulation brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA0A","description":"High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Admin ecg contrast agent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93352","description":"Admin ecg contrast agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ascending aortic graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33864","description":"Ascending aortic graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hand/chin ctrl spec joystick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2373","description":"Hand/chin ctrl spec joystick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDA0","description":"ICD-JBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADF1","description":"ICD-MADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endo bk ultra-light material","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5940","description":"Endo bk ultra-light material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDF0","description":"ICD-IDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx brst stg3-hr_ no pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9073","description":"Onc dx brst stg3-hr_ no pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHC1","description":"ICD-KHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair middle ear structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69666","description":"Repair middle ear structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2DB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DB31","description":"ICD-2DB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of bone cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20615","description":"Treatment of bone cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Add to spinal orthosis nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0999","description":"Add to spinal orthosis nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHC0","description":"ICD-OIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prior dx/active clin ascvd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9662","description":"Prior dx/active clin ascvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGD0","description":"ICD-NEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD224","description":"Special Care High _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECED0","description":"ICD-ECED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Chiropractic manj 5 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98942","description":"Chiropractic manj 5 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESA1","description":"ICD-OESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gen_ neuro_ non-hf rechg bat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1820","description":"Gen_ neuro_ non-hf rechg bat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHC1","description":"ICD-MCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCD0","description":"ICD-NJCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILE1","description":"ICD-FILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQE1","description":"ICD-DGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFC0","description":"ICD-GIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Pan Tumor)_ Whole Genome Sequencing And Optical Genome Mapping Of Paired Malignant And Normal Dna Specimens_ Fresh Tissue_ Blood_ Or Bone Marrow_ Comparative Sequenc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0300U","description":"Oncology (Pan Tumor)_ Whole Genome Sequencing And Optical Genome Mapping Of Paired Malignant And Normal Dna Specimens_ Fresh Tissue_ Blood_ Or Bone Marrow_ Comparative Sequenc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KB21","description":"ICD-2KB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHF0","description":"ICD-OAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter mitral valve annulus reconstruction_ with implantation of adjustable annulus reconstruction device_ percutaneous approach including transseptal puncture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0544T","description":"Transcatheter mitral valve annulus reconstruction_ with implantation of adjustable annulus reconstruction device_ percutaneous approach including transseptal puncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIF1","description":"ICD-OIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVB0","description":"ICD-GBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFD0","description":"ICD-OCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Leucovorin calcium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0640","description":"Leucovorin calcium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0663","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","description":"HCPCS-G0663","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5939","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5939","description":"CDT-D5939","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Es sph augmnt device removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0393T","description":"Es sph augmnt device removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGE0","description":"ICD-CBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0566U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","description":"CPT-0566U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX2C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRC0","description":"ICD-OLRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of anal fissure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46200","description":"Removal of anal fissure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFA1","description":"ICD-FHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRD1","description":"ICD-KIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOA0","description":"ICD-DGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prostatic microwave thermotx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53850","description":"Prostatic microwave thermotx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIF0","description":"ICD-FIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9486","description":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Imp/abut rem dent part mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6113","description":"Imp/abut rem dent part mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy & biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50555","description":"Kidney endoscopy & biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plan of care to address moderate to severe pain documented on or before the date of the second visit with a clinician","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1001","description":"Plan of care to address moderate to severe pain documented on or before the date of the second visit with a clinician","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUE0","description":"ICD-MBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQD0","description":"ICD-OIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Opiates 1 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80361","description":"Opiates 1 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vessel mapping hemo access","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0365","description":"Vessel mapping hemo access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65600","description":"Revision of cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB15","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28X","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"JR GNOTYP ABCG2 EXONS 2-26","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0193U","description":"JR GNOTYP ABCG2 EXONS 2-26","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUA1","description":"ICD-CEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSF1","description":"ICD-HBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FB11","description":"ICD-1FB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL36","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECE1","description":"ICD-IECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWA1","description":"ICD-DBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Financial management_ self-directed_ waiver; per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2050","description":"Financial management_ self-directed_ waiver; per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEE1","description":"ICD-KEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQE1","description":"ICD-HEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01965","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01965","description":"CPT-01965","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCC0","description":"ICD-FCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx rectal t1-2 no progr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9090","description":"Onc dx rectal t1-2 no progr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57335","description":"Repair vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISD1","description":"ICD-HISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01112","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01112","description":"CPT-01112","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mastoidectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69501","description":"Mastoidectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1002","description":"HCPCS-A1002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB220","description":"Special Care Low _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMD0","description":"ICD-ICMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHE1","description":"ICD-AEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMA0","description":"ICD-BHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hit cont chem diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9330","description":"Hit cont chem diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Venous thrombosis imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78457","description":"Venous thrombosis imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tumor imaging limited area","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78800","description":"Tumor imaging limited area","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJD1","description":"ICD-BFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC4C","description":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHF0","description":"ICD-NKHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIA1","description":"ICD-AHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVA0","description":"ICD-NAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYB1","description":"ICD-HAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRC0","description":"ICD-HGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHC0","description":"ICD-GBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABF0","description":"ICD-EABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFD0","description":"ICD-FGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"General anesthesia_ first 15 minutes","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9222","description":"General anesthesia_ first 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUC0","description":"ICD-BFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITA1","description":"ICD-BITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35005","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHB1","description":"ICD-JIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0389T","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Syst bp >/= 140 mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3077F","description":"Syst bp >/= 140 mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism (adverse drug reactions)_ DNA_ 22 drug metabolism and transporter genes_ real-time PCR_ blood or buccal swab_ genotype and metabolizer status for therapeutic d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0015U","description":"Drug metabolism (adverse drug reactions)_ DNA_ 22 drug metabolism and transporter genes_ real-time PCR_ blood or buccal swab_ genotype and metabolizer status for therapeutic d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRE0","description":"ICD-GFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTC1","description":"ICD-KBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWA1","description":"ICD-GEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA50","description":"Default_ /90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy_ flexible; with transendoscopic stent placement (includes predilation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6023","description":"Sigmoidoscopy_ flexible; with transendoscopic stent placement (includes predilation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFB0","description":"ICD-GHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pre-htn or htn doc_ f/u indc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8950","description":"Pre-htn or htn doc_ f/u indc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEF1","description":"ICD-GAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj anesthetic per 10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4737","description":"Inj anesthetic per 10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMC1","description":"ICD-CHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N block inj paracervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64435","description":"N block inj paracervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KA11","description":"ICD-2KA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRA0","description":"ICD-CBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILE1","description":"ICD-JILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"W/c seat lift mechanism","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0985","description":"W/c seat lift mechanism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair umbilical lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49611","description":"Repair umbilical lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAB1","description":"ICD-OCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQC0","description":"ICD-GCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOE0","description":"ICD-OIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 90-days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0518","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 90-days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resp virus 12-25 targets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87633","description":"Resp virus 12-25 targets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOD0","description":"ICD-KAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Breath test heart reject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0085T","description":"Breath test heart reject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogens_ identification of 20 bacterial and fungal organisms and identification of 16 associated antib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0321U","description":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogens_ identification of 20 bacterial and fungal organisms and identification of 16 associated antib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAF1","description":"ICD-MLAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAA1","description":"ICD-IGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48145","description":"Partial removal of pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAD1","description":"ICD-IFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Buprenorphine (Implant Insertion); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Ther","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2070","description":"Medication Assisted Treatment_ Buprenorphine (Implant Insertion); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHD0","description":"ICD-BFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc of dsm-iv init eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9212","description":"Doc of dsm-iv init eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJC1","description":"ICD-OHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEC0","description":"ICD-KDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARB1","description":"ICD-OARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB260","description":"Special Care Low _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVB0","description":"ICD-NIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49616","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33736","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDD0","description":"ICD-CFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam entire spi 2/3 vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72082","description":"X-ray exam entire spi 2/3 vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMF1","description":"ICD-FCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVC0","description":"ICD-JIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLB1","description":"ICD-CGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC140","description":"Clinically Complex _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95983","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34201","description":"Removal of artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTA0","description":"ICD-OCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEED1","description":"ICD-BEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOF1","description":"ICD-CFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJA1","description":"ICD-CBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTA1","description":"ICD-NGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision orbitofacial bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21275","description":"Revision orbitofacial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Egd varices ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43244","description":"Egd varices ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMC0","description":"ICD-EEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ana crown exp 1-3 per quad","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4231","description":"Ana crown exp 1-3 per quad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKC0","description":"ICD-OHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB25A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of chin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21120","description":"Reconstruction of chin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQD0","description":"ICD-OHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Co/membane diffuse capacity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94729","description":"Co/membane diffuse capacity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; each additional 100 cm2_ or each additional 1% of body surface area of infants a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0480T","description":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; each additional 100 cm2_ or each additional 1% of body surface area of infants a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral periapical ea add","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0230","description":"Intraoral periapical ea add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEF1","description":"ICD-GIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cog&behav imprmnt scrng done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3755F","description":"Cog&behav imprmnt scrng done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDF1","description":"ICD-ECDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPE0","description":"ICD-JIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bl draw <3 yrs other vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36406","description":"Bl draw <3 yrs other vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01760","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01760","description":"CPT-01760","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01937","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","description":"CPT-01937","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coronary art/grft angio s&i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93455","description":"Coronary art/grft angio s&i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA and RNA)_ gastrointestinal pathogens_ 31 bacterial_ viral_ and parasitic organisms and identification of 21 associated antibiot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0369U","description":"Infectious agent detection by nucleic acid (DNA and RNA)_ gastrointestinal pathogens_ 31 bacterial_ viral_ and parasitic organisms and identification of 21 associated antibiot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rituximab-pvvr_ biosimilar_ (ruxience)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5119","description":"Injection_ rituximab-pvvr_ biosimilar_ (ruxience)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRD0","description":"ICD-CHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Egd biopsy single/multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43239","description":"Egd biopsy single/multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2JA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JA11","description":"ICD-2JA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert/place heart catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93503","description":"Insert/place heart catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3HC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HC21","description":"ICD-3HC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHC1","description":"ICD-AGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBA1","description":"ICD-NBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYA0","description":"ICD-LCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hpv combo assay ca screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0476","description":"Hpv combo assay ca screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of upper eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15822","description":"Revision of upper eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGB1","description":"ICD-FCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWD0","description":"ICD-DEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES32D","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDD1","description":"ICD-KFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylinder 4.00d/>6.00d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2106","description":"Spherocylinder 4.00d/>6.00d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFE1","description":"ICD-ODFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assess anginal symptom/level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1002F","description":"Assess anginal symptom/level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJF0","description":"ICD-KHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of haloperidol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80173","description":"Assay of haloperidol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion or subcutaneous injection_ casirivimaband imdevimab_ includes infusion or injection and post administration monitoring_ subsequent repeat doses","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0240","description":"Intravenous infusion or subcutaneous injection_ casirivimaband imdevimab_ includes infusion or injection and post administration monitoring_ subsequent repeat doses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFF1","description":"ICD-KEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWA1","description":"ICD-HBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0505","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0505","description":"HCPCS-A0505","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJD1","description":"ICD-GBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"O2 saturation16<=48 in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6255","description":"Absorpt drg >16<=48 in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUD1","description":"ICD-OGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDME1","description":"ICD-EDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Grafix Prime and GrafixPL Prime_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4133","description":"Grafix Prime and GrafixPL Prime_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLD0","description":"ICD-EHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRF0","description":"ICD-LBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE11C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression gauntlet_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6582","description":"Gradient compression gauntlet_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTC0","description":"ICD-NDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology_ RNA_ gene expression by whole transcriptome sequencing_ formalin-","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0128U","description":"Oncology_ RNA_ gene expression by whole transcriptome sequencing_ formalin-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cell cryopreserve/storage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88240","description":"Cell cryopreserve/storage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWC0","description":"ICD-OJWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25500","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Coronary artery graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33503","description":"Coronary artery graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXF1","description":"ICD-ODXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Air injection into abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49400","description":"Air injection into abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELF1","description":"ICD-BELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRB0","description":"ICD-LFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brachytherapy needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1715","description":"Brachytherapy needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKE1","description":"ICD-FCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endoscope_ single-use (i.e. disposable)_ upper GI_ imaging/illumination device (insertable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1748","description":"Endoscope_ single-use (i.e. disposable)_ upper GI_ imaging/illumination device (insertable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQF0","description":"ICD-GBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUB1","description":"ICD-BHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJD0","description":"ICD-JHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB235","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGD0","description":"ICD-FHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2048","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2048","description":"HCPCS-A2048","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEF1","description":"ICD-CAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Aphakia prosth service temp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92358","description":"Aphakia prosth service temp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Caffeine citrate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0706","description":"Caffeine citrate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair amputee w/o leg r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1171","description":"Wheelchair amputee w/o leg r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMC0","description":"ICD-FDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAME1","description":"ICD-JAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Add ue prost a/e ultlite mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7401","description":"Add ue prost a/e ultlite mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rho d immune globulin inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2790","description":"Rho d immune globulin inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53410","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDD1","description":"ICD-NBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q0155","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","description":"HCPCS-Q0155","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCB0","description":"ICD-MGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOE0","description":"ICD-CGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amobarbital 125 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0300","description":"Amobarbital 125 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWF0","description":"ICD-HAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of scapula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23190","description":"Partial removal of scapula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dx laryngoscopy excl nb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31525","description":"Dx laryngoscopy excl nb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlso 3mod sacro-scap pre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0462","description":"Tlso 3mod sacro-scap pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWF0","description":"ICD-DBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUD0","description":"ICD-ABUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc Uveal MLNMA MRNA gen xprs prfl 15 gene alg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0081U","description":"Onc Uveal MLNMA MRNA gen xprs prfl 15 gene alg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVC0","description":"ICD-NJVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLE1","description":"ICD-OLLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA260","description":"Reduced Physical Function _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt reason for no beta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9191","description":"Pt reason for no beta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Back Pain As Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 3.0 Or Back Pain Measured By The Visual Analog Sc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2138","description":"Back Pain As Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 3.0 Or Back Pain Measured By The Visual Analog Sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDB1","description":"ICD-IHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrst x-ray urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74420","description":"Contrst x-ray urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66020","description":"Injection treatment of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB51","description":"Medium Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOA1","description":"ICD-OBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0677","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0677","description":"HCPCS-G0677","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBE0","description":"ICD-CEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar or lumbar rib pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1040","description":"Lumbar or lumbar rib pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"P32 na phosphate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9563","description":"P32 na phosphate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDF0","description":"ICD-NJDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACB0","description":"ICD-IACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLC1","description":"ICD-JHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg 2.1-3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11603","description":"Exc tr-ext mal+marg 2.1-3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOD1","description":"ICD-GDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00140","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00140","description":"CPT-00140","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIA1","description":"ICD-IAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE14D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Belt/vest elec/combo vad rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0499","description":"Belt/vest elec/combo vad rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB12C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoplasty; for laryngeal stenosis_ with graft_ with indwelling stent placement_ age 12 years or older","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31554","description":"Laryngoplasty; for laryngeal stenosis_ with graft_ with indwelling stent placement_ age 12 years or older","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHA1","description":"ICD-JIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVE0","description":"ICD-KCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal kidney open radical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50230","description":"Removal kidney open radical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVF0","description":"ICD-OCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nerve palsy microsurg graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15842","description":"Nerve palsy microsurg graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYE1","description":"ICD-OBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incid ct liver/kid/adre fdg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9547","description":"Incid ct liver/kid/adre fdg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid check both ears","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92593","description":"Hearing aid check both ears","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99281","description":"Emergency dept visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Evacuation Of Meibomian Glands_ Using Heat Delivered Through Wearable_ Open-Eye Eyelid Treatment Devices And Manual Gland Expression_ Bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0563T","description":"Evacuation Of Meibomian Glands_ Using Heat Delivered Through Wearable_ Open-Eye Eyelid Treatment Devices And Manual Gland Expression_ Bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0142A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRF0","description":"ICD-LDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"InnovaMatrix PD_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2023","description":"InnovaMatrix PD_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAB1","description":"ICD-CBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92632","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","description":"CPT-92632","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQC1","description":"ICD-PBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Factor ix non-recombinant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7193","description":"Factor ix non-recombinant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDA0","description":"ICD-KCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCED0","description":"ICD-JCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77407","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMA0","description":"ICD-JCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay ass","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX17","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay ass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIME0","description":"ICD-EIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXC1","description":"ICD-KGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAA0","description":"ICD-OCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRD1","description":"ICD-DCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMC0","description":"ICD-MDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Abo rh blood typing docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3293F","description":"Abo rh blood typing docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHE1","description":"ICD-IHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient receiving first-time biologic disease modifying anti-rheumatic drug therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2182","description":"Patient receiving first-time biologic disease modifying anti-rheumatic drug therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Establish access to artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36120","description":"Establish access to artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGE0","description":"ICD-GHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fractionation ketosteroids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83593","description":"Fractionation ketosteroids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADED1","description":"ICD-ADED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection for hip x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27093","description":"Injection for hip x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4FB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FB21","description":"ICD-4FB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBF1","description":"ICD-CEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUE0","description":"ICD-NLUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNB0","description":"ICD-CFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Imuglucerase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1786","description":"Imuglucerase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Init pm e/m new pat infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99381","description":"Init pm e/m new pat infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA44","description":"Medium Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sphenoid sinus surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31051","description":"Sphenoid sinus surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMF0","description":"ICD-NBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWD0","description":"ICD-HIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAD0","description":"ICD-GFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTE0","description":"ICD-MFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCB0","description":"ICD-EBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urinary leg or abdomen bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4358","description":"Urinary leg or abdomen bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPA1","description":"ICD-OLPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD22B","description":"Special Care High _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcv >=10mg daily predniso","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4194F","description":"Pt rcv >=10mg daily predniso","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMC0","description":"ICD-KCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHE0","description":"ICD-FIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastrointestinal pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 22 targets (Campylobacter [C. jejuni/C. coli/C.","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0097U","description":"Gastrointestinal pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 22 targets (Campylobacter [C. jejuni/C. coli/C.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSF0","description":"ICD-GHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ low density flat foam sheet_ per 250 square centimeters_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6604","description":"Gradient compression bandaging supply_ low density flat foam sheet_ per 250 square centimeters_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDB0","description":"ICD-ECDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXC0","description":"ICD-BEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYA1","description":"ICD-DBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOD0","description":"ICD-GBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMB0","description":"ICD-MAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJB1","description":"ICD-CAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prosthesis modification","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5875","description":"Prosthesis modification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYF1","description":"ICD-GGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAF1","description":"ICD-OKAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ophthalmoscopy/dynamometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92260","description":"Ophthalmoscopy/dynamometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr ventral hern init block","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49561","description":"Rpr ventral hern init block","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETE0","description":"ICD-GETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGF1","description":"ICD-NBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00563","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00563","description":"CPT-00563","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder harness","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5699","description":"Shoulder harness","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWD1","description":"ICD-PBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient was not admitted to hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9856","description":"Patient was not admitted to hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBA0","description":"ICD-KEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFF1","description":"ICD-CGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Myelin Oligodendrocyte Glycoprotein (Mog-Igg1) Antibody; Flow Cytometry (Ie_ Fluorescence-Activated Cell Sorting [Facs])_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86363","description":"Myelin Oligodendrocyte Glycoprotein (Mog-Igg1) Antibody; Flow Cytometry (Ie_ Fluorescence-Activated Cell Sorting [Facs])_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMD1","description":"ICD-BAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMF0","description":"ICD-AGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBD0","description":"ICD-KIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA12A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD14D","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44020","description":"Explore small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of colon/ileostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44155","description":"Removal of colon/ileostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKF0","description":"ICD-BBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIB1","description":"ICD-JEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronch thermoplsty 1 lobe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31660","description":"Bronch thermoplsty 1 lobe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA3D","description":"Default_ /PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYF1","description":"ICD-OFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28630","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPA0","description":"ICD-BHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQC1","description":"ICD-CFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBA0","description":"ICD-OJBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLC0","description":"ICD-CFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNF0","description":"ICD-GCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUE0","description":"ICD-JGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath report nongyn spcmn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0550F","description":"Cytopath report nongyn spcmn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERA1","description":"ICD-DERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dias bp > or = 90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8755","description":"Dias bp > or = 90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD14A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rem endovas vena cava filter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37193","description":"Rem endovas vena cava filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endocrine nuclear procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78099","description":"Endocrine nuclear procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exploration femoral artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35721","description":"Exploration femoral artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCF0","description":"ICD-MCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAC1","description":"ICD-EFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIE0","description":"ICD-JCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD140","description":"Special Care High _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB24D","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic band & belt thigh fla","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2192","description":"Pelvic band & belt thigh fla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQF1","description":"ICD-PIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKB0","description":"ICD-BCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHA0","description":"ICD-KHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Positron emission tomography radiopharmaceutical_ diagnostic_ for non-tumor identification_ not otherwise classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9598","description":"Positron emission tomography radiopharmaceutical_ diagnostic_ for non-tumor identification_ not otherwise classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Room and Board Rate - A flat per diem rate before area wage adjustment for patients whose home is a nursing home.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0606","description":"Room and Board Rate - A flat per diem rate before area wage adjustment for patients whose home is a nursing home.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-49187","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","description":"CPT-49187","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Body muscle testing manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95834","description":"Body muscle testing manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4354","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","description":"HCPCS-Q4354","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCC0","description":"ICD-MHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUC1","description":"ICD-MFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enlarge breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19324","description":"Enlarge breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGF0","description":"ICD-OKGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQA0","description":"ICD-GAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB31","description":"Very High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Convert nephrostomy catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50434","description":"Convert nephrostomy catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rare constitutional and other heritable disorders_ whole genome and mitochondrial DNA sequence analysis_ blood_ frozen & formalin-fixed paraffin-embedded (FFPE) tissue_ saliva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0265U","description":"Rare constitutional and other heritable disorders_ whole genome and mitochondrial DNA sequence analysis_ blood_ frozen & formalin-fixed paraffin-embedded (FFPE) tissue_ saliva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIB0","description":"ICD-IIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYA1","description":"ICD-PDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJF0","description":"ICD-JIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMB1","description":"ICD-NDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion 1.1-2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11307","description":"Shave skin lesion 1.1-2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDF0","description":"ICD-FFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAD0","description":"ICD-NDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging_ breast_ without and/or with contrast material(s); unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77058","description":"Magnetic resonance imaging_ breast_ without and/or with contrast material(s); unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLE1","description":"ICD-ABLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ashkenazi jewish assoc dis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81412","description":"Ashkenazi jewish assoc dis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ olaratumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9485","description":"Injection_ olaratumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIA0","description":"ICD-MBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCE1","description":"ICD-CFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB256","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLA1","description":"ICD-OGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKF0","description":"ICD-NCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Probe nasolacrimal duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68811","description":"Probe nasolacrimal duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUC0","description":"ICD-AFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCE1","description":"ICD-NCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHC1","description":"ICD-MFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Dalbavancin_ 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9443","description":"Injection_ Dalbavancin_ 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEME1","description":"ICD-JEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2CC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CC11","description":"ICD-2CC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBB0","description":"ICD-GBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISC1","description":"ICD-DISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0105","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0105","description":"CDT-D0105","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKB0","description":"ICD-CHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Factor xiii recomb a-subunit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7181","description":"Factor xiii recomb a-subunit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBC0","description":"ICD-NKBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","description":"HCPCS-J2804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSE1","description":"ICD-GHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cabg arterial four or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33536","description":"Cabg arterial four or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSC0","description":"ICD-CBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9311","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9311","description":"HCPCS-C9311","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1066T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1066T","description":"CPT-1066T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPC0","description":"ICD-FDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBB0","description":"ICD-EIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSF0","description":"ICD-CCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC10C","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAD0","description":"ICD-MFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD151","description":"Special Care Low _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15952","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABC1","description":"ICD-MABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAD0","description":"ICD-AFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPD1","description":"ICD-CEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 std seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0822","description":"Pwc gp 2 std seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Right heart catheterization with implantation of wireless pressure sensor in the pulmonary artery_ including any type of measur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9741","description":"Right heart catheterization with implantation of wireless pressure sensor in the pulmonary artery_ including any type of measur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2GC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GC21","description":"ICD-2GC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFD1","description":"ICD-NKFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIB1","description":"ICD-FDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRE1","description":"ICD-HCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPA1","description":"ICD-CFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXC0","description":"ICD-KDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repl exhalation port for pap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7045","description":"Repl exhalation port for pap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ epoetin alfa_ biosimilar_ (Retacrit) (for ESRD on dialysis)_ 100 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5105","description":"Injection_ epoetin alfa_ biosimilar_ (Retacrit) (for ESRD on dialysis)_ 100 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFE1","description":"ICD-JHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTD1","description":"ICD-KCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUD1","description":"ICD-IGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYB0","description":"ICD-LEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXA0","description":"ICD-OJXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPC1","description":"ICD-NAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Genome sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81425","description":"Genome sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMA1","description":"ICD-MFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPE0","description":"ICD-OGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tib/per revasc stent & ather","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37231","description":"Tib/per revasc stent & ather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ctrl dose inh drug deliv sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0730","description":"Ctrl dose inh drug deliv sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFD0","description":"ICD-GHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64902","description":"Nerve graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neck spine fuse&remov bel c2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22551","description":"Neck spine fuse&remov bel c2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC111","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Manual breast pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0602","description":"Manual breast pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIND1","description":"ICD-NIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24126","description":"Remove/graft bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLF0","description":"ICD-FHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lsh uterus 250 g or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58541","description":"Lsh uterus 250 g or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPE1","description":"ICD-GAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML20","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYB0","description":"ICD-DIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUA1","description":"ICD-AAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICA1","description":"ICD-KICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITF1","description":"ICD-CITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE256","description":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMD1","description":"ICD-BCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML30","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hd inj >24h/gcs >15/no res","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9596","description":"Hd inj >24h/gcs >15/no res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth genitalia surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92051","description":"Anesth genitalia surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJE0","description":"ICD-JIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADA0","description":"ICD-KADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ phenylephrine hydrochloride (biorphen)_ 20 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2372","description":"Injection_ phenylephrine hydrochloride (biorphen)_ 20 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOC1","description":"ICD-GCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEND1","description":"ICD-CEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD21B","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUE1","description":"ICD-IBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFID0","description":"ICD-JFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLC0","description":"ICD-KDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUA1","description":"ICD-KFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98002","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","description":"CPT-98002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elevat proximal arm support","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2631","description":"Elevat proximal arm support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHC0","description":"ICD-FAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Scan proc cranial extra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61782","description":"Scan proc cranial extra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous laser 1st vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36478","description":"Endovenous laser 1st vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection Tocilizumab for COVID-19 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0249","description":"Injection Tocilizumab for COVID-19 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Complement fixation each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86171","description":"Complement fixation each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE15C","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQC1","description":"ICD-GHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amines vaginal fluid qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82120","description":"Amines vaginal fluid qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASD1","description":"ICD-OASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIB1","description":"ICD-OLIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMB1","description":"ICD-FDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ocular blood flow measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0198T","description":"Ocular blood flow measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSE1","description":"ICD-GBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNE1","description":"ICD-CCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEE0","description":"ICD-JCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWF0","description":"ICD-OIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRC1","description":"ICD-KCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAB0","description":"ICD-JGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACF0","description":"ICD-NACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISC0","description":"ICD-HISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCF0","description":"ICD-NFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25660","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA46","description":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory flow volume loop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94375","description":"Respiratory flow volume loop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDD1","description":"ICD-EDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap ileo/jejuno-stomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44187","description":"Lap ileo/jejuno-stomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE10C","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMB1","description":"ICD-BFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFE0","description":"ICD-NHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFD0","description":"ICD-NLFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBA1","description":"ICD-AGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHD0","description":"ICD-ICHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGE1","description":"ICD-GCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ olaratumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9285","description":"Injection_ olaratumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWD1","description":"ICD-KHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGD0","description":"ICD-NBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31086","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of inf vena cava","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37619","description":"Ligation of inf vena cava","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEB1","description":"ICD-NLEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ald fm/dm transmitter ald","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5288","description":"Ald fm/dm transmitter ald","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kidney imaging (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78710","description":"Kidney imaging (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1301","description":"HCPCS-C1301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAA1","description":"ICD-OCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAF0","description":"ICD-CCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAB1","description":"ICD-GBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bone replce graft each add","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4264","description":"Bone replce graft each add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0165","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","description":"HCPCS-J0165","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Renal function panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80069","description":"Renal function panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft head/neck >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64886","description":"Nerve graft head/neck >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHA0","description":"ICD-OKHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trnscrv uterin fibroid abltj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0404T","description":"Trnscrv uterin fibroid abltj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0802T","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXC0","description":"ICD-CGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARA1","description":"ICD-OARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Art byp ilio-celiac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35632","description":"Art byp ilio-celiac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDD1","description":"ICD-CFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g._ allergy_ intolerance_ infectious etiology_ pancrea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1184","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g._ allergy_ intolerance_ infectious etiology_ pancrea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCA0","description":"ICD-KFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPB0","description":"ICD-BIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD105","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSC0","description":"ICD-CDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fluorescent antibody titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86256","description":"Fluorescent antibody titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0524U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","description":"CPT-0524U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELE0","description":"ICD-FELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Adjacent tissue transfer or rearrangement_ any area; each additional 30.0 s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2025F","description":"Adjacent tissue transfer or rearrangement_ any area; each additional 30.0 s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVD1","description":"ICD-JIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of somatomedin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84305","description":"Assay of somatomedin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSD1","description":"ICD-KBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXD0","description":"ICD-FEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUA1","description":"ICD-IFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4346","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","description":"HCPCS-Q4346","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hep c therapy started","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9206","description":"Hep c therapy started","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low (or very low) risk of recurrence_ prostate cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9706","description":"Low (or very low) risk of recurrence_ prostate cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18I","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNC1","description":"ICD-JBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlso trnk sj-t9 pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0454","description":"Tlso trnk sj-t9 pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNC0","description":"ICD-OKNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCC0","description":"ICD-EGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of prostaglandin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84150","description":"Assay of prostaglandin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEA0","description":"ICD-AGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMC1","description":"ICD-KFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFD1","description":"ICD-BAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Health And Well-Being Coaching Face-To-Face; Individual_ Initial Assessment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0591T","description":"Health And Well-Being Coaching Face-To-Face; Individual_ Initial Assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens extended wear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2513","description":"Contact lens extended wear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"O shoe add felt w leath insl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3520","description":"O shoe add felt w leath insl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHD1","description":"ICD-AEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAE0","description":"ICD-ABAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBB0","description":"ICD-EFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Term dev_ sport/rec/work att","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6704","description":"Term dev_ sport/rec/work att","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogen_ semiquantitative identification_ DNA from 16 bacterial organisms and 1 fungal organism_ multip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0371U","description":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogen_ semiquantitative identification_ DNA from 16 bacterial organisms and 1 fungal organism_ multip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice respite care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2044","description":"Hospice respite care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"C-reactive protein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86140","description":"C-reactive protein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXA1","description":"ICD-OKXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBF0","description":"ICD-BIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWF1","description":"ICD-DEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) an","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX03","description":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEC0","description":"ICD-KBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUD1","description":"ICD-JHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cervical pneum trac equip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0849","description":"Cervical pneum trac equip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDD0","description":"ICD-KIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWC1","description":"ICD-KCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lap vent/abd hernia repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49652","description":"Lap vent/abd hernia repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFME0","description":"ICD-IFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fludeoxyglucose f18 up to 15 millicuries","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9609","description":"Fludeoxyglucose f18 up to 15 millicuries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXC0","description":"ICD-BHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIC0","description":"ICD-MFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIF1","description":"ICD-ODIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Specimen site not esophagus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8797","description":"Specimen site not esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEF0","description":"ICD-IIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVC0","description":"ICD-BFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDB0","description":"ICD-OCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCB0","description":"ICD-FDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWA1","description":"ICD-DCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavior identification assessment_ by the physician or other qualified health care professional_ face-to-face with patient and caregiver(s)_ includes administration of standa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0359T","description":"Behavior identification assessment_ by the physician or other qualified health care professional_ face-to-face with patient and caregiver(s)_ includes administration of standa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score shdl < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8664","description":"Fun stat score shdl < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAB1","description":"ICD-GGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE15C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immediate mandibular partial denture - flexible base (including any clasps_ rests and teeth)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5228","description":"Immediate mandibular partial denture - flexible base (including any clasps_ rests and teeth)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fentanyl citrate injeciton","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3010","description":"Fentanyl citrate injeciton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJND0","description":"ICD-OJND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc hip/pelvis les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27047","description":"Exc hip/pelvis les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 4 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP04","description":"Auto.test pane pricing code_ 4 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ct head/brain w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70460","description":"Ct head/brain w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYF0","description":"ICD-GAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96932","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hemophilus influenza antibdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86684","description":"Hemophilus influenza antibdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJC0","description":"ICD-BEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBB0","description":"ICD-MDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iliac art angio_cardiac cath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0278","description":"Iliac art angio_cardiac cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fix partial denture section","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9120","description":"Fix partial denture section","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA216","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHE0","description":"ICD-OIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx prostate w/rise psa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9080","description":"Onc dx prostate w/rise psa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWB0","description":"ICD-PJWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC0D","description":"Very High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFB1","description":"ICD-FDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWE0","description":"ICD-OKWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who died from cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9859","description":"Patients who died from cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Release encircling material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67115","description":"Release encircling material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr umbil hern block > 5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49587","description":"Rpr umbil hern block > 5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCC1","description":"ICD-MHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hbv assess&results intrp 1yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3517F","description":"Hbv assess&results intrp 1yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJD0","description":"ICD-JBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNB1","description":"ICD-NFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSF1","description":"ICD-CBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAID0","description":"ICD-OAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUA1","description":"ICD-FHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HTT (huntingtin) (eg_ Huntington disease) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81271","description":"HTT (huntingtin) (eg_ Huntington disease) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD10C","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of wrist prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25251","description":"Removal of wrist prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD25B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSA0","description":"ICD-OFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEC1","description":"ICD-MFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICB1","description":"ICD-GICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVA0","description":"ICD-NGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOF0","description":"ICD-DAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSD0","description":"ICD-OFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOE0","description":"ICD-DDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAA0","description":"ICD-MLAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pvb thoracic cont infusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64463","description":"Pvb thoracic cont infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOD0","description":"ICD-HCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Management of new patient-caregiver dyad with dementia_ high complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0521","description":"Management of new patient-caregiver dyad with dementia_ high complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lanreotide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1930","description":"Lanreotide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTF0","description":"ICD-NGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPD1","description":"ICD-NFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2090","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHE0","description":"ICD-FCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEF0","description":"ICD-JCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLA0","description":"ICD-KCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N block cont infuse b plex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64416","description":"N block cont infuse b plex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood gases w/o2 saturation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82805","description":"Blood gases w/o2 saturation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55881","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","description":"CPT-55881","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB4A","description":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Analysis of saliva sample","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0418","description":"Analysis of saliva sample","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVC1","description":"ICD-CFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVE0","description":"ICD-NJVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lysis + lavage w catheters","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7871","description":"Lysis + lavage w catheters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation handling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77790","description":"Radiation handling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of bowel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44605","description":"Repair of bowel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1022T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","description":"CPT-1022T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTB0","description":"ICD-MKTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Spirometry up to 2 yrs old","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94011","description":"Spirometry up to 2 yrs old","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB226","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0302","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0302","description":"HCPCS-B0302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD231","description":"Clinically Complex _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKE0","description":"ICD-OFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGB1","description":"ICD-OGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFA1","description":"ICD-NCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient pressure wrap with adjustable straps_ bra_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6589","description":"Gradient pressure wrap with adjustable straps_ bra_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vena cava filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1880","description":"Vena cava filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMF0","description":"ICD-NHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUE0","description":"ICD-AGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRE0","description":"ICD-PLRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHA1","description":"ICD-IHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRD0","description":"ICD-OGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOF0","description":"ICD-DFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC226","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tube_ pneumatic caster tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2385","description":"Tube_ pneumatic caster tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWC0","description":"ICD-DGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECID0","description":"ICD-ECID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy irrig cone/cath w brs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4399","description":"Ostomy irrig cone/cath w brs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPC1","description":"ICD-NLPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA241","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNA1","description":"ICD-OJNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAID1","description":"ICD-OAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHB1","description":"ICD-OAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPE1","description":"ICD-BHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1501","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1501","description":"CDT-D1501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHF0","description":"ICD-OJHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQF1","description":"ICD-GFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iop measurement not documented_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1226","description":"Iop measurement not documented_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBB1","description":"ICD-KGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEF0","description":"ICD-IFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYA1","description":"ICD-PKYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of throat abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42720","description":"Drainage of throat abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNE1","description":"ICD-KCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMB0","description":"ICD-IGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJE0","description":"ICD-CBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAF1","description":"ICD-CFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPB0","description":"ICD-FFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYB0","description":"ICD-GFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"H2o stat docd dehydrated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2031F","description":"H2o stat docd dehydrated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"NEURO ALZHEIMER QUAN IMAGING","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0207U","description":"NEURO ALZHEIMER QUAN IMAGING","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt w iv ab not given on time","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8917","description":"Pt w iv ab not given on time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCC1","description":"ICD-ECCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAD0","description":"ICD-ICAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5148","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","description":"HCPCS-Q5148","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Automated rbc count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85041","description":"Automated rbc count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIE0","description":"ICD-OAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt no elg phar ther osteo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8634","description":"Pt no elg phar ther osteo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart vessel fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33501","description":"Repair heart vessel fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amniotic membrane","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2790","description":"Amniotic membrane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDC1","description":"ICD-IHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"AI IBD MRNA XPRSN PRFL 17","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0203U","description":"AI IBD MRNA XPRSN PRFL 17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00567","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00567","description":"CPT-00567","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCF1","description":"ICD-NFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFB0","description":"ICD-OLFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pmkr_ dual_ rate-resp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1785","description":"Pmkr_ dual_ rate-resp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPD0","description":"ICD-BFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBC1","description":"ICD-FBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28X","description":"Special Care Low _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incompl donor egg case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4023","description":"Incompl donor egg case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAB0","description":"ICD-MCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIF0","description":"ICD-GAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hyperthermia treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77615","description":"Hyperthermia treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHC0","description":"ICD-MBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE201","description":"Special Care High _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRC1","description":"ICD-PIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1092T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1092T","description":"CPT-1092T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Test socket above knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5624","description":"Test socket above knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD221","description":"Clinically Complex _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUD0","description":"ICD-OJUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXA0","description":"ICD-OIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERE1","description":"ICD-OERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKB1","description":"ICD-GEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMC1","description":"ICD-JCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHD0","description":"ICD-KGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ vasopressin_ 1 unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2598","description":"Injection_ vasopressin_ 1 unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTB1","description":"ICD-JDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDB0","description":"ICD-IHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHC1","description":"ICD-NKHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBD0","description":"ICD-JCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDD0","description":"ICD-FEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICA1","description":"ICD-FICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA51","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Re-Cement Or Re-Bond Bilateral Space Maintainer - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1552","description":"Re-Cement Or Re-Bond Bilateral Space Maintainer - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr ing hern premie blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49492","description":"Rpr ing hern premie blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRF0","description":"ICD-PLRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB3A","description":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMD1","description":"ICD-MJMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0525","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","description":"HCPCS-J0525","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIC0","description":"ICD-IAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stereotactic biopsy_ aspiration_ or excision of lesion_ spinal cord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63615","description":"Stereotactic biopsy_ aspiration_ or excision of lesion_ spinal cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWA0","description":"ICD-LGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cefoxitin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0694","description":"Cefoxitin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIB1","description":"ICD-BCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSA1","description":"ICD-OHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBC1","description":"ICD-NHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00802","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00802","description":"CPT-00802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37200","description":"Transcatheter biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBE0","description":"ICD-JGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA2C","description":"Default_ /PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB5B","description":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Manual adult wc w tiltinspac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1161","description":"Manual adult wc w tiltinspac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYD1","description":"ICD-OEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB111","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPE0","description":"ICD-JHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWB1","description":"ICD-HEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRD0","description":"ICD-LHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Periacetabular osteotomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2115","description":"Periacetabular osteotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSF0","description":"ICD-KGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00770","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00770","description":"CPT-00770","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Periton dialysis plan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0507F","description":"Periton dialysis plan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTC1","description":"ICD-EFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKD1","description":"ICD-OGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB146","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKND0","description":"ICD-OKND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove cervix repair bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57556","description":"Remove cervix repair bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNE0","description":"ICD-JFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLF1","description":"ICD-MKLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCC1","description":"ICD-KBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Swallow goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8997","description":"Swallow goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Meniscal trnspl knee w/scpe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29868","description":"Meniscal trnspl knee w/scpe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKA0","description":"ICD-GGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tb test cell immun measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86480","description":"Tb test cell immun measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) a","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX03","description":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2AC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AC11","description":"ICD-2AC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBND0","description":"ICD-CBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGC1","description":"ICD-BGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBF1","description":"ICD-KFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUD0","description":"ICD-GHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLB0","description":"ICD-FGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco non-user","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1036F","description":"Tobacco non-user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove fix space maintainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1555","description":"Remove fix space maintainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBB1","description":"ICD-EBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient does not have a caregiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2184","description":"Patient does not have a caregiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30150","description":"Partial removal of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Creatine isoforms","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82554","description":"Creatine isoforms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC13","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA43","description":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair lung hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32800","description":"Repair lung hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIME0","description":"ICD-CIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHA0","description":"ICD-JFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFA0","description":"ICD-FGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASF0","description":"ICD-CASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILE1","description":"ICD-NILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Brief (20 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0081","description":"Brief (20 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"External ambulatory infus pu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0781","description":"External ambulatory infus pu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADB1","description":"ICD-IADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIME1","description":"ICD-MIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Odontics transosteal implnt","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6050","description":"Odontics transosteal implnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Asst oocyte fert case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4022","description":"Asst oocyte fert case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOE0","description":"ICD-PDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEE0","description":"ICD-AEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXC0","description":"ICD-FAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTD0","description":"ICD-ABTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAC1","description":"ICD-BHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVE0","description":"ICD-BEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXA0","description":"ICD-JEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUF0","description":"ICD-FEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHF1","description":"ICD-GEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Replacement diaphragm/fplate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7502","description":"Replacement diaphragm/fplate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reusable oral thermometer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4931","description":"Reusable oral thermometer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNE1","description":"ICD-KBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Myelography lumbar injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62305","description":"Myelography lumbar injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKD0","description":"ICD-FCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE226","description":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA40","description":"Default_ /60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBF1","description":"ICD-MKBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFE1","description":"ICD-GGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Self-adher band w>=3in <5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6454","description":"Self-adher band w>=3in <5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anesth correct heart rhythm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41051","description":"Anesth correct heart rhythm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB20B","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Evaluate swallowing function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92610","description":"Evaluate swallowing function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Med record copy admin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9981","description":"Med record copy admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILD1","description":"ICD-CILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ATN1 (atrophin 1) (eg_ dentatorubral-pallidoluysian atrophy) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81177","description":"ATN1 (atrophin 1) (eg_ dentatorubral-pallidoluysian atrophy) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABD1","description":"ICD-BABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVE1","description":"ICD-KIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pm device progr eval sngl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93279","description":"Pm device progr eval sngl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGD0","description":"ICD-KBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES30D","description":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m exametazime","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9521","description":"Tc99m exametazime","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMC1","description":"ICD-EEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBC1","description":"ICD-CIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOC0","description":"ICD-ODOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFA0","description":"ICD-NDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILA1","description":"ICD-EILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABE0","description":"ICD-CABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJB0","description":"ICD-JEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDF0","description":"ICD-CBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (hematolymphoid neoplasia)_ optical genome mapping for copy number alterations and gene rearrangements utilizing DNA from blood or bone marrow_ report of clinically s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0331U","description":"Oncology (hematolymphoid neoplasia)_ optical genome mapping for copy number alterations and gene rearrangements utilizing DNA from blood or bone marrow_ report of clinically s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrophys map 3d add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93613","description":"Electrophys map 3d add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Compressor air power source","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0565","description":"Compressor air power source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artery expos/graft artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33987","description":"Artery expos/graft artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Full sole/heel wedge btween","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3420","description":"Full sole/heel wedge btween","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYC0","description":"ICD-KHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISA0","description":"ICD-CISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVD0","description":"ICD-NHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQB0","description":"ICD-GIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGE0","description":"ICD-CDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX2C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKC1","description":"ICD-BCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD134","description":"Clinically Complex _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIA0","description":"ICD-NKIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remote Afterloading High Dose Rate Radionuclide Brachytherapy; 1 Channel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77785","description":"Remote Afterloading High Dose Rate Radionuclide Brachytherapy; 1 Channel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICC1","description":"ICD-EICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOF1","description":"ICD-LGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Intent pot remv time placemt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9539","description":"Intent pot remv time placemt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHA1","description":"ICD-MJHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excursion amplifier pulley t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6641","description":"Excursion amplifier pulley t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBD0","description":"ICD-MDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACA0","description":"ICD-FACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Innovamatrix FS_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2013","description":"Innovamatrix FS_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEE1","description":"ICD-MGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHC0","description":"ICD-KGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARB0","description":"ICD-HARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB151","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSF0","description":"ICD-HFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foam filled caster tire each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2217","description":"Foam filled caster tire each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57220","description":"Revision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIF0","description":"ICD-MAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNC1","description":"ICD-FFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrivalent (RIV4)_ derived from recombinant DNA_ hemagglutinin (HA) protein only_ preservative and antibiotic free_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90682","description":"Influenza virus vaccine_ quadrivalent (RIV4)_ derived from recombinant DNA_ hemagglutinin (HA) protein only_ preservative and antibiotic free_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETF0","description":"ICD-KETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46611","description":"Anoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYE1","description":"ICD-KHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEF0","description":"ICD-FDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEF1","description":"ICD-ECEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01940","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","description":"CPT-01940","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incis spine 3 column adl seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22208","description":"Incis spine 3 column adl seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFC0","description":"ICD-NJFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC22B","description":"Special Care Low _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0887T","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat shoulder blade fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23570","description":"Treat shoulder blade fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Influenza immunization was not administered_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1308","description":"Influenza immunization was not administered_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHA0","description":"ICD-NBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAF0","description":"ICD-NAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ non-duplicated gene when duplication/multip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0074U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ non-duplicated gene when duplication/multip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3268","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3268","description":"HCPCS-J3268","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAB0","description":"ICD-JIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYD0","description":"ICD-KIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thxp apheresis w/hdl delip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0342T","description":"Thxp apheresis w/hdl delip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCA0","description":"ICD-MFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCC0","description":"ICD-BFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJD0","description":"ICD-KFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nitrogen n-13 ammonia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9526","description":"Nitrogen n-13 ammonia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOE1","description":"ICD-LCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC254","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOF1","description":"ICD-CGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGB0","description":"ICD-OCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Narcosynthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90865","description":"Narcosynthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt instr nrml activities","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4245F","description":"Pt instr nrml activities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1173","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls daily mgmt-venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33948","description":"Ecmo/ecls daily mgmt-venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74290","description":"Contrast x-ray gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVE1","description":"ICD-NJVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKA0","description":"ICD-OLKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50570","description":"Kidney endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUA0","description":"ICD-OAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIF1","description":"ICD-CEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64473","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","description":"CPT-64473","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lumb artif diskectomy addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0163T","description":"Lumb artif diskectomy addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKF1","description":"ICD-OKKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"guided tissue regeneration_ edentulous area - resorbable barrier_ per site","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7956","description":"guided tissue regeneration_ edentulous area - resorbable barrier_ per site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRF1","description":"ICD-DIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIB0","description":"ICD-MAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAB0","description":"ICD-IHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE140","description":"Reduced Physical Function _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFA0","description":"ICD-BBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of sinuses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70220","description":"X-ray exam of sinuses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablation_ Malignant Breast Tumor(S)_ Percutaneous_ Cryotherapy_ Including Imaging Guidance When Performed_ Unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0581T","description":"Ablation_ Malignant Breast Tumor(S)_ Percutaneous_ Cryotherapy_ Including Imaging Guidance When Performed_ Unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPE1","description":"ICD-NEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTC0","description":"ICD-NHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0171A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Preparation of report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90889","description":"Preparation of report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3CA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CA31","description":"ICD-3CA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33030","description":"Partial removal of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Below knee acrylic socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5629","description":"Below knee acrylic socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"G compression stocking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6549","description":"G compression stocking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESF1","description":"ICD-CESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML23","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAE1","description":"ICD-CDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ intraoperative thoracic aorta (eg_ epiaortic)_ diagnostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76984","description":"Ultrasound_ intraoperative thoracic aorta (eg_ epiaortic)_ diagnostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRA0","description":"ICD-OJRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQA0","description":"ICD-OCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies); with intravascular lithotripsy_ and transluminal stent placement(s)_ includes angioplasty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9773","description":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies); with intravascular lithotripsy_ and transluminal stent placement(s)_ includes angioplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJF1","description":"ICD-OEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ped hospital bed semi/elect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0329","description":"Ped hospital bed semi/elect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove anal fist subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46270","description":"Remove anal fist subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3BB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BB21","description":"ICD-3BB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHID0","description":"ICD-NHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"MRI chest spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72146","description":"MRI chest spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1074T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1074T","description":"CPT-1074T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insitu hybridization (fish)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88365","description":"Insitu hybridization (fish)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove hip foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27086","description":"Remove hip foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc hep gene risk classifier","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0006M","description":"Onc hep gene risk classifier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Av dialysis shunt imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75791","description":"Av dialysis shunt imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBF1","description":"ICD-CBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUF0","description":"ICD-ABUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGE0","description":"ICD-OCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQE0","description":"ICD-LIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ldh enzymes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83625","description":"Assay of ldh enzymes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Walker_ battery powered_ wheeled_ folding_ adjustable or fixed height","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0152","description":"Walker_ battery powered_ wheeled_ folding_ adjustable or fixed height","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24101","description":"Explore/treat elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOB1","description":"ICD-CFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBD1","description":"ICD-OFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0479U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","description":"CPT-0479U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54385","description":"Repair penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0902T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","description":"CPT-0902T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHD1","description":"ICD-OBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55713","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","description":"CPT-55713","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQD0","description":"ICD-GCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc death in hosp aaa repair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9262","description":"Doc death in hosp aaa repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9760","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOA1","description":"ICD-OJOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inpt/ed teleconsult30","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0425","description":"Inpt/ed teleconsult30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHE1","description":"ICD-CDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Create tear duct drain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68745","description":"Create tear duct drain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Participant-Directed Goods and Services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1901","description":"Participant-Directed Goods and Services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB44","description":"Very High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27259","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Conditioning play audiometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92582","description":"Conditioning play audiometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special pump services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99191","description":"Special pump services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC256","description":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rbc pretreatment serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86978","description":"Rbc pretreatment serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3406","description":"HCPCS-J3406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive determination of absolute quantitation of myocardial blood flow (AQMBF)_ derived from augmentative algorithmic analysis of the dataset acquired via contrast cardia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0899T","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (AQMBF)_ derived from augmentative algorithmic analysis of the dataset acquired via contrast cardia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRA1","description":"ICD-OFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTD1","description":"ICD-JDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMB1","description":"ICD-KCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Afo ankle gauntlet pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1902","description":"Afo ankle gauntlet pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBC0","description":"ICD-EDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTE1","description":"ICD-JFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCA1","description":"ICD-FHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVE1","description":"ICD-BFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJC1","description":"ICD-FHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDC0","description":"ICD-FEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Opps/php;activity therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0176","description":"Opps/php;activity therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC14D","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHF1","description":"ICD-JAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22842","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNB1","description":"ICD-BFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMC0","description":"ICD-MIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRC1","description":"ICD-CDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6035","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","description":"HCPCS-L6035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENE0","description":"ICD-CENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSC0","description":"ICD-LDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v thin layer redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88143","description":"Cytopath c/v thin layer redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDD0","description":"ICD-ACDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory syncytial virus_ monoclonal antibody_ seasonal dose; 0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90380","description":"Respiratory syncytial virus_ monoclonal antibody_ seasonal dose; 0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIB1","description":"ICD-GHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient received combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperatively and/or intraoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9956","description":"Patient received combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperatively and/or intraoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAD0","description":"ICD-AEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMD0","description":"ICD-GAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ravulizumab-cwvz_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1303","description":"Injection_ ravulizumab-cwvz_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug interven","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0022","description":"Alcohol and/or drug interven","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOD0","description":"ICD-PJOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 11-20 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99422","description":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 11-20 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCD1","description":"ICD-FBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Colorectal cancer screening; blood-based biomarker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0327","description":"Colorectal cancer screening; blood-based biomarker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILD1","description":"ICD-IILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies)_ with intravascular lithotripsy_ includes angioplasty within the same vessel (s)_ when perfo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9772","description":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies)_ with intravascular lithotripsy_ includes angioplasty within the same vessel (s)_ when perfo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lamination collar w/ couplin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6629","description":"Lamination collar w/ couplin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD251","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIE1","description":"ICD-NCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Xenograft implantation into the articular surface","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0737T","description":"Xenograft implantation into the articular surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00812","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00812","description":"CPT-00812","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FC11","description":"ICD-1FC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Retainer - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6120","description":"Implant Supported Retainer - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00848","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00848","description":"CPT-00848","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOA1","description":"ICD-LCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8953","description":"Oncology mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWA1","description":"ICD-HAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Automated leukocyte count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85048","description":"Automated leukocyte count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBD0","description":"ICD-OJBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert pulse gen mult leads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33221","description":"Insert pulse gen mult leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVE1","description":"ICD-CFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDB1","description":"ICD-CGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11451","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADA1","description":"ICD-IADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHC0","description":"ICD-FFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCA0","description":"ICD-OKCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCA0","description":"ICD-GCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46080","description":"Incision of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apply bone fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20690","description":"Apply bone fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDA0","description":"ICD-BBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYF1","description":"ICD-KGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB21","description":"Low Rehab_ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA230","description":"Reduced Physical Function _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINE0","description":"ICD-CINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iodine I-131 iobenguane_ therapeutic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9408","description":"Iodine I-131 iobenguane_ therapeutic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAE0","description":"ICD-BBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWC1","description":"ICD-KEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC12A","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACD1","description":"ICD-JACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove vaginal foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57415","description":"Remove vaginal foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44144","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKA0","description":"ICD-NCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQE0","description":"ICD-CGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"PMS2 (PMS1 homolog 2_ mismatch repair system component) (eg_ hereditary non-polyposis colorectal cancer_ Lynch syndrome) mRNA sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0161U","description":"PMS2 (PMS1 homolog 2_ mismatch repair system component) (eg_ hereditary non-polyposis colorectal cancer_ Lynch syndrome) mRNA sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mlh1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81288","description":"Mlh1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBC0","description":"ICD-EEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCC0","description":"ICD-CBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJD0","description":"ICD-FGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCB1","description":"ICD-OHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shingrix vaccine was not administered for reasons documented by clinician (e.g._ patient administered vaccine other than Shingr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1065","description":"Shingrix vaccine was not administered for reasons documented by clinician (e.g._ patient administered vaccine other than Shingr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ trans atherectomy_ dir","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1714","description":"Cath_ trans atherectomy_ dir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAE0","description":"ICD-KGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJD1","description":"ICD-NBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fluoroguide for vein device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77001","description":"Fluoroguide for vein device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISB0","description":"ICD-PISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Autologous adipose-derived regenerative cell therapy for scleroderma in the hands; adipose tissue harvesting_ isolation and preparation of harvested cells including incubation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0489T","description":"Autologous adipose-derived regenerative cell therapy for scleroderma in the hands; adipose tissue harvesting_ isolation and preparation of harvested cells including incubation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXE0","description":"ICD-FCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIC1","description":"ICD-OAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Levonorgestrel implant sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7306","description":"Levonorgestrel implant sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Non-pneumatic sequential compression garment_ full arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0682","description":"Non-pneumatic sequential compression garment_ full arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pt ed write/oral pts w/ hf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4003F","description":"Pt ed write/oral pts w/ hf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1485","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","description":"HCPCS-M1485","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIF0","description":"ICD-IFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHE0","description":"ICD-CHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection for shoulder x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23350","description":"Injection for shoulder x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Iodine i-123 sod iodide mic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9516","description":"Iodine i-123 sod iodide mic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Custom abutment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6057","description":"Custom abutment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTC0","description":"ICD-NGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of proinsulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84206","description":"Assay of proinsulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sugars multiple qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84377","description":"Sugars multiple qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDF0","description":"ICD-JDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ 14 or more classes of drugs and substances_ definitive tandem mass spectrometry with chromatography_ capillary blood_ quantitative report with th","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0054U","description":"Prescription drug monitoring_ 14 or more classes of drugs and substances_ definitive tandem mass spectrometry with chromatography_ capillary blood_ quantitative report with th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laser inc for pkp/lkp recip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0290T","description":"Laser inc for pkp/lkp recip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFED1","description":"ICD-BFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg_ carrier testing)_ includes SMN2 (survival of motor neur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81329","description":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg_ carrier testing)_ includes SMN2 (survival of motor neur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVF1","description":"ICD-NGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHD0","description":"ICD-NAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRE0","description":"ICD-CCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWC1","description":"ICD-HHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28B","description":"Clinically Complex _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPA0","description":"ICD-NHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26725","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXD0","description":"ICD-CEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Annual gynecological examina","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0612","description":"Annual gynecological examina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8A","description":"Medium Rehab _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of skin wrinkles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15829","description":"Removal of skin wrinkles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Positional change of finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26555","description":"Positional change of finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOE1","description":"ICD-GBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXF0","description":"ICD-GGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA4B","description":"Low Rehab_ ADL Index 0-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIF0","description":"ICD-IGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ necitumumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9295","description":"Injection_ necitumumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICF1","description":"ICD-IICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMB1","description":"ICD-JIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tlso flex trnk sj-t9 pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0455","description":"Tlso flex trnk sj-t9 pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLA0","description":"ICD-BHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3BA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BA11","description":"ICD-3BA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Shoe heel pad removable for","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3485","description":"Shoe heel pad removable for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rpr s/n/a/gen/trk20.1-30.0cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12006","description":"Rpr s/n/a/gen/trk20.1-30.0cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sheath below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8400","description":"Sheath below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0998T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","description":"CPT-0998T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair & adjust spectacles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92371","description":"Repair & adjust spectacles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60270","description":"Removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE14B","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Change g-tube to g-j perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49446","description":"Change g-tube to g-j perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATF0","description":"ICD-KATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAA0","description":"ICD-EIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPA1","description":"ICD-OCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKD0","description":"ICD-BDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trabeculotomy by laser_ including optical coherence tomography (OCT) guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0730T","description":"Trabeculotomy by laser_ including optical coherence tomography (OCT) guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAA0","description":"ICD-KBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28D","description":"Special Care High _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMF0","description":"ICD-OKMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQD1","description":"ICD-OEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lateral trochanteric pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1290","description":"Lateral trochanteric pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMA1","description":"ICD-EDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERC0","description":"ICD-HERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADA0","description":"ICD-MADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDA0","description":"ICD-OKDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXF1","description":"ICD-NGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAED1","description":"ICD-IAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOA0","description":"ICD-OAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNE1","description":"ICD-NCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEF1","description":"ICD-BAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWA0","description":"ICD-GCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWF1","description":"ICD-KAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C7567","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7567","description":"HCPCS-C7567","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42182","description":"Repair palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUB0","description":"ICD-EDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of rectal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46045","description":"Incision of rectal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEF1","description":"ICD-NHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPE0","description":"ICD-NAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJF0","description":"ICD-NLJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPB0","description":"ICD-FGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLD1","description":"ICD-OHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYA0","description":"ICD-LGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc death after cea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9260","description":"Doc death after cea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICB0","description":"ICD-CICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXE0","description":"ICD-BAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0506","description":"Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTC0","description":"ICD-CDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Major vessel shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33750","description":"Major vessel shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX10","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOF1","description":"ICD-KCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Echo transesophageal intraop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93318","description":"Echo transesophageal intraop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4368","description":"Ostomy filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No eval activity clin symp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3119F","description":"No eval activity clin symp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHE1","description":"ICD-FAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDE1","description":"ICD-NKDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fluorine-18 fluorodeoxygluco","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8085","description":"Fluorine-18 fluorodeoxygluco","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score hip < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8652","description":"Fun stat score hip < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchial valve init insert","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31647","description":"Bronchial valve init insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSE0","description":"ICD-PDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLE1","description":"ICD-JDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILC1","description":"ICD-FILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC144","description":"Clinically Complex _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hightop w/ supp/pronator chi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3206","description":"Hightop w/ supp/pronator chi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRB1","description":"ICD-DFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0406","description":"HCPCS-C0406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Group audiometric testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92559","description":"Group audiometric testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of temporary anchorage device [screw retained plate]_ requiring flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7298","description":"Removal of temporary anchorage device [screw retained plate]_ requiring flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Cutaneous Melanoma)_ Mrna_ Gene Expression Profiling By Real-Time Rt-Pcr Of 31 Genes (28 Content And 3 Housekeeping)_ Utilizing Formalin-Fixed Paraffin-Embedded Tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81529","description":"Oncology (Cutaneous Melanoma)_ Mrna_ Gene Expression Profiling By Real-Time Rt-Pcr Of 31 Genes (28 Content And 3 Housekeeping)_ Utilizing Formalin-Fixed Paraffin-Embedded Tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No ster wd ifx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8572","description":"No ster wd ifx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 9","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA56","description":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 9","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRF0","description":"ICD-DDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laboratory processing of microbial specimen to include culture and sensitivity studies_ preparation and transmission of written report","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0414","description":"Laboratory processing of microbial specimen to include culture and sensitivity studies_ preparation and transmission of written report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBF0","description":"ICD-MJBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJD1","description":"ICD-NLJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Testosterone response","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80414","description":"Testosterone response","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADD0","description":"ICD-JADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ptfalls assess-docd ge2>/yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1100F","description":"Ptfalls assess-docd ge2>/yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPF1","description":"ICD-NGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LB21","description":"ICD-3LB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD24B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Computer-aided detection_ including computer algorithm analysis of MRI image data for lesion detection/characterization_ pharmacokinetic analysis_ with further physician revie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0159T","description":"Computer-aided detection_ including computer algorithm analysis of MRI image data for lesion detection/characterization_ pharmacokinetic analysis_ with further physician revie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excision of tongue lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41114","description":"Excision of tongue lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Safety concerns screening not provided_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9925","description":"Safety concerns screening not provided_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIE1","description":"ICD-MGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sec art thrombectomy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37186","description":"Sec art thrombectomy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD216","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ phenylephrine hydrochloride_ 20 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2371","description":"Injection_ phenylephrine hydrochloride_ 20 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31750","description":"Repair of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYC0","description":"ICD-CIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endodontic endosseous implan","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3460","description":"Endodontic endosseous implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGC0","description":"ICD-JFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGE0","description":"ICD-OAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGED1","description":"ICD-FGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27429","description":"Reconstruction knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2FA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FA21","description":"ICD-2FA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCD0","description":"ICD-IFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIB1","description":"ICD-IIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16072","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16072","description":"CPT-16072","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5166","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5166","description":"HCPCS-Q5166","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of histamine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83088","description":"Assay of histamine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASD0","description":"ICD-PASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ below knee_ 18-30 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6610","description":"Gradient compression stocking_ below knee_ 18-30 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJE0","description":"ICD-OJJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYA1","description":"ICD-CCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNE1","description":"ICD-OLNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQE0","description":"ICD-LDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"2high risk no ord","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9368","description":"2high risk no ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Activate matrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4301","description":"Activate matrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUF0","description":"ICD-IEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elec med comp dev_ noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1505","description":"Elec med comp dev_ noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovas aaa repr w/sm tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34800","description":"Endovas aaa repr w/sm tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB104","description":"Clinically Complex _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of stomach partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43632","description":"Removal of stomach partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNE1","description":"ICD-JFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft finger lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26215","description":"Remove/graft finger lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCC0","description":"ICD-ABCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove lung foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32151","description":"Remove lung foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNE0","description":"ICD-CFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LA11","description":"ICD-2LA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVC1","description":"ICD-CGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDC0","description":"ICD-KGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTF0","description":"ICD-FFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No mrs score in 90d followup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9647","description":"No mrs score in 90d followup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incis w/discectomy cervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22220","description":"Incis w/discectomy cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1413","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","description":"HCPCS-M1413","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNF1","description":"ICD-CFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Radiation therapy planning","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77263","description":"Radiation therapy planning","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ftl cgen abnor 3 proteins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81509","description":"Ftl cgen abnor 3 proteins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTD0","description":"ICD-OCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVD1","description":"ICD-OLVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of urethra defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53520","description":"Repair of urethra defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1703","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1703","description":"HCPCS-A1703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy lower leg soft tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27613","description":"Biopsy lower leg soft tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEC1","description":"ICD-OGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Data Preparation And Transmission","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0711T","description":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Data Preparation And Transmission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of a total replacement heart system (artificial heart) for heart transplantation (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33929","description":"Removal of a total replacement heart system (artificial heart) for heart transplantation (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Explore sinus remove polyps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31032","description":"Explore sinus remove polyps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXA0","description":"ICD-ODXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARF1","description":"ICD-GARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ single dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90480","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ single dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of jaw bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21044","description":"Removal of jaw bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIA1","description":"ICD-KDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMC0","description":"ICD-OFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYF0","description":"ICD-PDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray bile duct dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74363","description":"X-ray bile duct dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPD1","description":"ICD-KHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ granisetron_ extended-release_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1627","description":"Injection_ granisetron_ extended-release_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA130","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRE0","description":"ICD-KBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCC1","description":"ICD-JCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open ablate liver tumor rf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47380","description":"Open ablate liver tumor rf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0202","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0202","description":"CDT-D0202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of skin abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10061","description":"Drainage of skin abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOA1","description":"ICD-DFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMF0","description":"ICD-IEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENC1","description":"ICD-NENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC23D","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Afo_ walk boot type_ cus fab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4631","description":"Afo_ walk boot type_ cus fab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Portable oxygen concentrator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1392","description":"Portable oxygen concentrator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Destroy cerv/thor facet jnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64633","description":"Destroy cerv/thor facet jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES34B","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gallium nitrate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1457","description":"Gallium nitrate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLB1","description":"ICD-GDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed xtra hvy dty x wide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0304","description":"Hosp bed xtra hvy dty x wide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96133","description":"Neuropsychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRD0","description":"ICD-DBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Elliotts b solution per ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9175","description":"Elliotts b solution per ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychological testing (eg_ Halstead-Reitan Neuropsychological Battery_ Wechsler Memory Scales and Wisconsin Card Sorting Test)_ per hour of the psychologist_s or physicia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96118","description":"Neuropsychological testing (eg_ Halstead-Reitan Neuropsychological Battery_ Wechsler Memory Scales and Wisconsin Card Sorting Test)_ per hour of the psychologist_s or physicia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBD0","description":"ICD-EDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of estriol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82677","description":"Assay of estriol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVD0","description":"ICD-OJVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15999","description":"Removal of pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNE1","description":"ICD-FGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0108","description":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUC1","description":"ICD-MLUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daxibotulinumtoxina-lanm_ 1 unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0589","description":"Injection_ daxibotulinumtoxina-lanm_ 1 unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx pancreatic unresectab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9107","description":"Onc dx pancreatic unresectab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Indwelling trach insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8511","description":"Indwelling trach insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0603","description":"HCPCS-C0603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ketorolac tromethamine inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1885","description":"Ketorolac tromethamine inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA5D","description":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transfer of abdominal muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27100","description":"Transfer of abdominal muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD155","description":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"TAG_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4261","description":"TAG_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUB0","description":"ICD-IGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES335","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHD1","description":"ICD-IHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy vent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4366","description":"Ostomy vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18B","description":"Clinically Complex _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gjb6 gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81254","description":"Gjb6 gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD15B","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC24A","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular Repair Of Iliac Artery At The Time Of Aorto-Iliac Artery Endograft Placement By Deployment Of An Iliac Branched Endograft Including Pre-Procedure Sizing And Devic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34717","description":"Endovascular Repair Of Iliac Artery At The Time Of Aorto-Iliac Artery Endograft Placement By Deployment Of An Iliac Branched Endograft Including Pre-Procedure Sizing And Devic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXF0","description":"ICD-KAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKD1","description":"ICD-BIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of thigh/knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27498","description":"Decompression of thigh/knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home visit est pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99334","description":"Domicil/r-home visit est pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cephapirin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0710","description":"Cephapirin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insulin suppression panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80432","description":"Insulin suppression panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA24","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXE1","description":"ICD-GEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40844","description":"Reconstruction of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEF0","description":"ICD-GFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEB0","description":"ICD-EAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLF1","description":"ICD-NLLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sirolimus protein-bound particles_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9091","description":"Injection_ sirolimus protein-bound particles_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of knees","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73565","description":"X-ray exam of knees","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGC0","description":"ICD-KDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHD1","description":"ICD-NHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIC0","description":"ICD-OIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEA0","description":"ICD-EEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tongue removal neck surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41145","description":"Tongue removal neck surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Implt nrostm pls gen sng non","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8686","description":"Implt nrostm pls gen sng non","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYC0","description":"ICD-DAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1421","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","description":"HCPCS-M1421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Debridement of premalignant hyperkeratotic lesion(s) (ie_ targeted curettage_ abrasion) followed with photodynamic therapy by external application of light to destroy premalig","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96574","description":"Debridement of premalignant hyperkeratotic lesion(s) (ie_ targeted curettage_ abrasion) followed with photodynamic therapy by external application of light to destroy premalig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMD0","description":"ICD-KHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMF0","description":"ICD-BGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHD1","description":"ICD-MGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWB0","description":"ICD-HCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB02","description":"High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28106","description":"Remove/graft foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTE0","description":"ICD-CFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services for patient provided any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1067","description":"Hospice services for patient provided any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNB0","description":"ICD-CGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Caster wheel excludes tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2395","description":"Caster wheel excludes tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nasopharyngoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92511","description":"Nasopharyngoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Multiple_ including serial trended analysis and limited reprogramming of device parameter - AV or VV delays only_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0224T","description":"Multiple_ including serial trended analysis and limited reprogramming of device parameter - AV or VV delays only_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVF1","description":"ICD-JIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIB0","description":"ICD-GGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJE0","description":"ICD-NKJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBA1","description":"ICD-OGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Balance lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2700","description":"Balance lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revision of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28737","description":"Revision of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMB0","description":"ICD-OFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA60","description":"Low Rehab_ ADL Index 0-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFB0","description":"ICD-KIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1LB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LB21","description":"ICD-1LB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bile acids cholylglycine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82240","description":"Bile acids cholylglycine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Idecabtagene vicleucel_ up to 460 million autologous anti-BCMA CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9081","description":"Idecabtagene vicleucel_ up to 460 million autologous anti-BCMA CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC22A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOB0","description":"ICD-PAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQA1","description":"ICD-GAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eye exam establish patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92012","description":"Eye exam establish patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXA1","description":"ICD-CGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLF1","description":"ICD-KBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPB0","description":"ICD-GIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Asthma kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8097","description":"Asthma kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPE0","description":"ICD-NJPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSE1","description":"ICD-CBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXC0","description":"ICD-GGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAF0","description":"ICD-CEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove tear gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68540","description":"Remove tear gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES311","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXD0","description":"ICD-KAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oxford w/ supinator/pronator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3203","description":"Oxford w/ supinator/pronator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAE1","description":"ICD-CFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Seg pneum int legs/trunk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0670","description":"Seg pneum int legs/trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Plastic mold recipro hip & c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2627","description":"Plastic mold recipro hip & c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYC1","description":"ICD-OLYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEB1","description":"ICD-AAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYC0","description":"ICD-OKYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTA1","description":"ICD-NDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home phototherapy visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9098","description":"Home phototherapy visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOD1","description":"ICD-HDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMA1","description":"ICD-OEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCD0","description":"ICD-NDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES15B","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fluoroestradiol f18_ diagnostic_ 1 mci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9060","description":"Fluoroestradiol f18_ diagnostic_ 1 mci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHA1","description":"ICD-CCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBB0","description":"ICD-GGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foam dressing wound filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6215","description":"Foam dressing wound filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEND0","description":"ICD-CEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27506","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bk waist belt padded and lin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5690","description":"Bk waist belt padded and lin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC07","description":"Very High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBD1","description":"ICD-MIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21461","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","description":"HCPCS-J3404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE226","description":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVB1","description":"ICD-FFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Trach/laryn tube plug/stop","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7527","description":"Trach/laryn tube plug/stop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc rehab svcs considered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4079F","description":"Doc rehab svcs considered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tinzaparin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1655","description":"Tinzaparin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy ablate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45320","description":"Proctosigmoidoscopy ablate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUB1","description":"ICD-JHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDA0","description":"ICD-GCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63268","description":"Excise intrspinl lesion scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFB1","description":"ICD-KGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXD1","description":"ICD-NDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGB0","description":"ICD-JAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEC0","description":"ICD-EBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9224","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9224","description":"CDT-D9224","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTA0","description":"ICD-JFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ PEGylated-aucl_ (Jivi)_ 1U","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7208","description":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ PEGylated-aucl_ (Jivi)_ 1U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fev<60% pred & no copd sym","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8925","description":"Fev<60% pred & no copd sym","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPC0","description":"ICD-NDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSD1","description":"ICD-ODSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSF0","description":"ICD-PBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOD0","description":"ICD-OFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA12B","description":"Reduced Physical Function _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOC1","description":"ICD-DEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLD1","description":"ICD-NDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB0A","description":"Very High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHC1","description":"ICD-ADHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEF1","description":"ICD-ABEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Creation of arteriovenous fistula_ percutaneous using magnetic-guided arterial and venous catheters and radiofrequency energy_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9755","description":"Creation of arteriovenous fistula_ percutaneous using magnetic-guided arterial and venous catheters and radiofrequency energy_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFB1","description":"ICD-OJFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of external ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69120","description":"Removal of external ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB140","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA110","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0552U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","description":"CPT-0552U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fc receptor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86243","description":"Fc receptor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWF0","description":"ICD-CFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDC1","description":"ICD-BIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE155","description":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCE0","description":"ICD-KHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Inj for sacroiliac jt anesth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0260","description":"Inj for sacroiliac jt anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dysphag test done b/4 eating","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6010F","description":"Dysphag test done b/4 eating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQE1","description":"ICD-CDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHE0","description":"ICD-ODHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Linezolid injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2020","description":"Linezolid injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Water distilled w/nebulizer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7018","description":"Water distilled w/nebulizer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIB1","description":"ICD-JBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFF0","description":"ICD-CCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFE0","description":"ICD-NLFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hospice in inpatient psych","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5008","description":"Hospice in inpatient psych","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRA1","description":"ICD-OIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHE0","description":"ICD-BAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA121","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUE1","description":"ICD-BBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Symes type ptb brim design s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5632","description":"Symes type ptb brim design s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Withdrawal of arterial blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36600","description":"Withdrawal of arterial blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIA1","description":"ICD-NFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esophageal motility study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78258","description":"Esophageal motility study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair & adjust spectacles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92370","description":"Repair & adjust spectacles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incise inner eye adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65880","description":"Incise inner eye adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt w cath maint dia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9240","description":"Doc pt w cath maint dia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ko elas w/ condyle pads & jo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1820","description":"Ko elas w/ condyle pads & jo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01935","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01935","description":"CPT-01935","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL2B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7514","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7514","description":"HCPCS-J7514","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ algorithm reported as a probabilit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0366U","description":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ algorithm reported as a probabilit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFC0","description":"ICD-OJFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0584T","description":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWB1","description":"ICD-KAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Optx post ankle fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27769","description":"Optx post ankle fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTF0","description":"ICD-IBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGC1","description":"ICD-GHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insrt drug device for iop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0356T","description":"Insrt drug device for iop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Srs cran les simple addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61797","description":"Srs cran les simple addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGD0","description":"ICD-FEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRE1","description":"ICD-CBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIB1","description":"ICD-AIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDA1","description":"ICD-NIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKA1","description":"ICD-OCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHE0","description":"ICD-GDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVB0","description":"ICD-BCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWE0","description":"ICD-PGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTD0","description":"ICD-FCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVD1","description":"ICD-JDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHED1","description":"ICD-BHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKC1","description":"ICD-KCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAA0","description":"ICD-BIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAB0","description":"ICD-MHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stent_ non-cor_ tem w/o del","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2617","description":"Stent_ non-cor_ tem w/o del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rectal catheter for use with the manual pump-operated enema","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4453","description":"Rectal catheter for use with the manual pump-operated enema","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53025","description":"Incision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJB1","description":"ICD-NEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBE1","description":"ICD-MEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDD0","description":"ICD-BHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVA1","description":"ICD-JAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESA1","description":"ICD-CESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPA1","description":"ICD-JFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1809","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","description":"HCPCS-J1809","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Test socket hemipelvectomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5628","description":"Test socket hemipelvectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLF1","description":"ICD-MFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYD0","description":"ICD-OIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGF1","description":"ICD-FGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD22A","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1062T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1062T","description":"CPT-1062T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKC0","description":"ICD-FGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXC0","description":"ICD-JIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Set radiation therapy field","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77290","description":"Set radiation therapy field","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILD1","description":"ICD-MILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSE1","description":"ICD-LBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSC0","description":"ICD-OGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFD0","description":"ICD-BHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEB0","description":"ICD-MGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; read by instrument assisted direct optical observation (eg_ utilizing immunoassay [","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80306","description":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; read by instrument assisted direct optical observation (eg_ utilizing immunoassay [","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE211","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1303","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1303","description":"CDT-D1303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparo cholecystectomy/explr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47564","description":"Laparo cholecystectomy/explr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43122","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hysteroscopy remove myoma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58561","description":"Hysteroscopy remove myoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKE0","description":"ICD-JHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEE1","description":"ICD-NBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended-release (brixadi)_ less than or equal to 7 days of therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0577","description":"Injection_ buprenorphine extended-release (brixadi)_ less than or equal to 7 days of therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHD1","description":"ICD-OCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEE0","description":"ICD-FIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYE0","description":"ICD-PFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADF1","description":"ICD-AADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGF1","description":"ICD-NHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v automated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88147","description":"Cytopath c/v automated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"X-ray guide gu dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74485","description":"X-ray guide gu dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Athletic train eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97005","description":"Athletic train eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKB0","description":"ICD-BAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAA0","description":"ICD-KAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol amino acid &","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4189","description":"Parenteral sol amino acid &","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOB1","description":"ICD-CHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIB1","description":"ICD-EDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVE1","description":"ICD-JBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing care not medically possible because the patient was discharged early due to specific medical events_ documented in the medical record_ such as the patient became hosp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1147","description":"Ongoing care not medically possible because the patient was discharged early due to specific medical events_ documented in the medical record_ such as the patient became hosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patients who died from cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9849","description":"Patients who died from cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWE1","description":"ICD-KDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBB1","description":"ICD-FIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dermabind sl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4284","description":"Dermabind sl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEE1","description":"ICD-AFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Allergy immunology services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95199","description":"Allergy immunology services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory surgical boot eac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3260","description":"Ambulatory surgical boot eac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score le >= 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8655","description":"Fun stat score le >= 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx orbit fx transantral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21385","description":"Opn tx orbit fx transantral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHF0","description":"ICD-JHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELD1","description":"ICD-NELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Air ambulanc nonemerg fixed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9960","description":"Air ambulanc nonemerg fixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWF1","description":"ICD-LHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Esrd home pt srv p day 12-19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90969","description":"Esrd home pt srv p day 12-19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHC0","description":"ICD-NCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB230","description":"Special Care High _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKB1","description":"ICD-BIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEF1","description":"ICD-CBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBF0","description":"ICD-OHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAF1","description":"ICD-JGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Home environment assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1028","description":"Home environment assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVE0","description":"ICD-NLVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct lip with flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40527","description":"Reconstruct lip with flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXB1","description":"ICD-NHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYF0","description":"ICD-LEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eyelid lining surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68399","description":"Eyelid lining surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIE1","description":"ICD-BHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBD0","description":"ICD-MIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPA1","description":"ICD-OJPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert self-contd prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54401","description":"Insert self-contd prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Pathology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4023","description":"Pathology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foot fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28062","description":"Removal of foot fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGC0","description":"ICD-GEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Copper cu-64_ dotatate_ diagnostic_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9592","description":"Copper cu-64_ dotatate_ diagnostic_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC217","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Nebulizer water collec devic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7012","description":"Nebulizer water collec devic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive preoperative assessment performed for cataract surgery with i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0122U","description":"Comprehensive preoperative assessment performed for cataract surgery with i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOB0","description":"ICD-KBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX21","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESC1","description":"ICD-OESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Exc forearm les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25071","description":"Exc forearm les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC10B","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMA1","description":"ICD-KAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLC0","description":"ICD-MKLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAED0","description":"ICD-JAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Eye Imaging Validated To Match Diagnosis From Seven Standard Field Stereoscopic Photos Results Documented And Reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2104","description":"Eye Imaging Validated To Match Diagnosis From Seven Standard Field Stereoscopic Photos Results Documented And Reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA11","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTB0","description":"ICD-ACTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBC0","description":"ICD-CHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AB11","description":"ICD-3AB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANE0","description":"ICD-GANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Resect heart sac lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33050","description":"Resect heart sac lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKME1","description":"ICD-NKME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWB0","description":"ICD-OHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJA0","description":"ICD-NHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPD0","description":"ICD-BIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHF0","description":"ICD-NJHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tcd vasoreactivity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93890","description":"Tcd vasoreactivity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB221","description":"Special Care Low _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXA0","description":"ICD-GFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal surg cong cyst malf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2402","description":"Fetal surg cong cyst malf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Female condom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4268","description":"Female condom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOA0","description":"ICD-CFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB21C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLF1","description":"ICD-IGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGME1","description":"ICD-EGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC24C","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18A","description":"Special Care Low _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gastric emptying imag study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78265","description":"Gastric emptying imag study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBD0","description":"ICD-KHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTF1","description":"ICD-KBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8H","description":"Medium Rehab _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bk molded supracondylar susp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5670","description":"Bk molded supracondylar susp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gated heart planar single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78472","description":"Gated heart planar single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISC0","description":"ICD-PISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCID0","description":"ICD-JCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gr27 non-sealed leadacid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2372","description":"Gr27 non-sealed leadacid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOA0","description":"ICD-OKOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01360","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01360","description":"CPT-01360","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00754","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00754","description":"CPT-00754","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCC0","description":"ICD-KBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEB0","description":"ICD-CIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGA1","description":"ICD-KIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies)_ including lesion detection_ characterization_ an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0866T","description":"Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies)_ including lesion detection_ characterization_ an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWA0","description":"ICD-OCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCE1","description":"ICD-ABCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAF0","description":"ICD-EDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim-apgf_ biosimilar_ (nyvepria)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5122","description":"Injection_ pegfilgrastim-apgf_ biosimilar_ (nyvepria)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mrcp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8037","description":"Mrcp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDC1","description":"ICD-MLDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Anterior asis pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1250","description":"Anterior asis pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUB1","description":"ICD-NFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB11A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Storage/year sperm/semen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89343","description":"Storage/year sperm/semen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPB0","description":"ICD-KDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVF1","description":"ICD-GFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB24B","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCB0","description":"ICD-JCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTC1","description":"ICD-FHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38I","description":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWE1","description":"ICD-HEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXF1","description":"ICD-JIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98984","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","description":"CPT-98984","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C7564","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7564","description":"HCPCS-C7564","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHD0","description":"ICD-AHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALE1","description":"ICD-IALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise palsy hand tendon(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25316","description":"Revise palsy hand tendon(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic duct procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38380","description":"Thoracic duct procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Excise excess skin arm/hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15837","description":"Excise excess skin arm/hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Secondary urethral surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54340","description":"Secondary urethral surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEA1","description":"ICD-AIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFA0","description":"ICD-CFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICE1","description":"ICD-CICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYD0","description":"ICD-GFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD141","description":"Special Care High _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antithromb thx presc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8696","description":"Antithromb thx presc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cd4+cell cnt/% docd as done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3500F","description":"Cd4+cell cnt/% docd as done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA140","description":"Clinically Complex _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVE0","description":"ICD-CEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"PROTON THERAPY","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77524","description":"PROTON THERAPY","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Apply interstit radiat compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77778","description":"Apply interstit radiat compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0104","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0104","description":"HCPCS-A0104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES344","description":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTA1","description":"ICD-BDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ ITE/BTE","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5213","description":"Hearing aid_ contralateral routing system_ binaural_ ITE/BTE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLC0","description":"ICD-MGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIC0","description":"ICD-MKIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB156","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hepatology (nonalcoholic fatty liver disease [NAFLD])_ semiquantitative evaluation of 28 lipid markers by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0344U","description":"Hepatology (nonalcoholic fatty liver disease [NAFLD])_ semiquantitative evaluation of 28 lipid markers by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQC1","description":"ICD-KGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Other immunoelectrophoresis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86325","description":"Other immunoelectrophoresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJB1","description":"ICD-NAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE24C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries_ including right heart catheterization_ pulmonary artery angiography_ and all imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0793T","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries_ including right heart catheterization_ pulmonary artery angiography_ and all imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHF1","description":"ICD-GFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lo sag ri an/pos pnl pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0627","description":"Lo sag ri an/pos pnl pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAD1","description":"ICD-FGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCB1","description":"ICD-OKCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJD0","description":"ICD-OJJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Lso sag rigid frame cust","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0632","description":"Lso sag rigid frame cust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOE0","description":"ICD-OAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score neck/ts >=0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8671","description":"Fun stat score neck/ts >=0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rbc sed rate nonautomated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85651","description":"Rbc sed rate nonautomated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMF0","description":"ICD-MLMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAD1","description":"ICD-FFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB56","description":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFB1","description":"ICD-ODFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Foot drop splint pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4398","description":"Foot drop splint pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWB0","description":"ICD-PFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Corneal transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65750","description":"Corneal transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rx cntact lens aphakia 1 eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92315","description":"Rx cntact lens aphakia 1 eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputate leg at thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27590","description":"Amputate leg at thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDB0","description":"ICD-NBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ak univ multiplex sys frict","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5616","description":"Ak univ multiplex sys frict","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8C","description":"Low Rehab_ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Minimally invasive direct co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2205","description":"Minimally invasive direct co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sperm evaluation test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89329","description":"Sperm evaluation test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01420","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01420","description":"CPT-01420","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELC0","description":"ICD-KELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOF1","description":"ICD-PCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4417","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","description":"HCPCS-Q4417","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65800","description":"Drainage of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSA0","description":"ICD-PDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENE0","description":"ICD-FENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA236","description":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJE0","description":"ICD-KFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Methyl aminolevulinate_ top","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7309","description":"Methyl aminolevulinate_ top","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAC1","description":"ICD-MLAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8005","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8005","description":"HCPCS-C8005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAME0","description":"ICD-CAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEA1","description":"ICD-JHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL13","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stainless steel any wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6630","description":"Stainless steel any wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFF1","description":"ICD-NAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65285","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJME0","description":"ICD-MJME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHF0","description":"ICD-JFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCA0","description":"ICD-OHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"N-et; stretcher van_ mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2049","description":"N-et; stretcher van_ mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFC0","description":"ICD-CEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAB0","description":"ICD-IDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDF1","description":"ICD-CCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBB1","description":"ICD-KDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEF1","description":"ICD-CFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Duplex Scan Of Arterial Inflow And Venous Outflow For Preoperative Vessel Assessment Prior To Creation Of Hemodialysis Access; Complete Bilateral Study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93985","description":"Duplex Scan Of Arterial Inflow And Venous Outflow For Preoperative Vessel Assessment Prior To Creation Of Hemodialysis Access; Complete Bilateral Study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQA0","description":"ICD-KGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic mammography_ including computer-aided detection (CAD) when performed; unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77065","description":"Diagnostic mammography_ including computer-aided detection (CAD) when performed; unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29887","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ext ecg complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0295T","description":"Ext ecg complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWB1","description":"ICD-KBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB205","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Antidepressant rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4064F","description":"Antidepressant rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENE0","description":"ICD-GENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ophth us quant a only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76511","description":"Ophth us quant a only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGB1","description":"ICD-CHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIA0","description":"ICD-EHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAD1","description":"ICD-NBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIF1","description":"ICD-BEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac event recorder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0616","description":"Cardiac event recorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Sympathectomy cervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64802","description":"Sympathectomy cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIB1","description":"ICD-MGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJD1","description":"ICD-OCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of fibula fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27781","description":"Treatment of fibula fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAB1","description":"ICD-CCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of heel fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28400","description":"Treatment of heel fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCD0","description":"ICD-GDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Professional services_ initial visit_ for the administration of intravenous chemotherapy or other highly complex infusion drug or biological for each infusion drug administrat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0090","description":"Professional services_ initial visit_ for the administration of intravenous chemotherapy or other highly complex infusion drug or biological for each infusion drug administrat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAE0","description":"ICD-NCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Catheter w/bag 3-way","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4313","description":"Catheter w/bag 3-way","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DB31","description":"ICD-3DB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVB0","description":"ICD-BFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Monitor cable elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0485","description":"Monitor cable elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJB0","description":"ICD-GIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE130","description":"Special Care High _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKA0","description":"ICD-GCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBE1","description":"ICD-IHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOF1","description":"ICD-DCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Day habil waiver per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2021","description":"Day habil waiver per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct interprete man","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0365","description":"Cone beam ct interprete man","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHF0","description":"ICD-ECHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50060","description":"Removal of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWF1","description":"ICD-OHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMD0","description":"ICD-NLMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUC0","description":"ICD-FIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gjb2 gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81252","description":"Gjb2 gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fulvestrant (teva) not therapeutically equivalent to j9395_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9393","description":"Injection_ fulvestrant (teva) not therapeutically equivalent to j9395_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35121","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Assay of selenium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84255","description":"Assay of selenium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ pegylated-aucl (Jivi)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9141","description":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ pegylated-aucl (Jivi)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Space maintainer_ fixed_ bilateral_ mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1517","description":"Space maintainer_ fixed_ bilateral_ mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPA1","description":"ICD-FFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGA0","description":"ICD-JGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFB1","description":"ICD-NHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBE1","description":"ICD-OEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPA1","description":"ICD-KIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Body-worn binaur hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5120","description":"Body-worn binaur hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1HB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HB21","description":"ICD-1HB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXD1","description":"ICD-JCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFA0","description":"ICD-FBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-38227","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","description":"CPT-38227","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRA0","description":"ICD-KDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCE1","description":"ICD-GHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of forearm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25900","description":"Amputation of forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB17","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUE0","description":"ICD-ECUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGD1","description":"ICD-KCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLE1","description":"ICD-IHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFE1","description":"ICD-OCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRF1","description":"ICD-HCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUA0","description":"ICD-NDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dental prophylaxis child","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1120","description":"Dental prophylaxis child","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drain lower leg bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27604","description":"Drain lower leg bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Enlarge breast with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19325","description":"Enlarge breast with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESF1","description":"ICD-KESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPB1","description":"ICD-FCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKC1","description":"ICD-NBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPE0","description":"ICD-BEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHME0","description":"ICD-OHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOD0","description":"ICD-PKOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Medcurrent_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1002","description":"Clinical Decision Support Mechanism Medcurrent_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQD0","description":"ICD-OAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Surgical stent","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5982","description":"Surgical stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1GC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GC31","description":"ICD-1GC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27596","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUE0","description":"ICD-AFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1DA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DA31","description":"ICD-1DA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXC0","description":"ICD-BAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJF0","description":"ICD-NEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ anifrolumab-fnia_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0491","description":"Injection_ anifrolumab-fnia_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2209","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMA1","description":"ICD-OJMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc stom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43659","description":"Laparoscope proc stom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Not all data norsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9324","description":"Not all data norsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous Transluminal Angioplasty Of Native Or Recurrent Coarctation Of The Aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33897","description":"Percutaneous Transluminal Angioplasty Of Native Or Recurrent Coarctation Of The Aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAF0","description":"ICD-JDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCD0","description":"ICD-ACCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRB0","description":"ICD-HCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Stent_ coated/cov w/o del sy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1875","description":"Stent_ coated/cov w/o del sy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of hemorrhoid clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46320","description":"Removal of hemorrhoid clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMC1","description":"ICD-ODMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRF1","description":"ICD-PDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Open tx septal fx w/wo stabj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21336","description":"Open tx septal fx w/wo stabj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCD1","description":"ICD-FFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Urinary pouch w/barrier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5071","description":"Urinary pouch w/barrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"L/s ratio fetal lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83661","description":"L/s ratio fetal lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 85 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0147U","description":"Drug assay_ definitive_ 85 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPC1","description":"ICD-KGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Perq abltj lvr cryoablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47383","description":"Perq abltj lvr cryoablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Work hardening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97545","description":"Work hardening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD24C","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVC0","description":"ICD-NAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDE1","description":"ICD-GEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKC1","description":"ICD-OJKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPC1","description":"ICD-NBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDC0","description":"ICD-BFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8E","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat kneecap dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27562","description":"Treat kneecap dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLD1","description":"ICD-GDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Mastectomy bra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8000","description":"Mastectomy bra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vital signs recorded","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2010F","description":"Vital signs recorded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD234","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAED1","description":"ICD-BAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5099","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","description":"HCPCS-Q5099","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXB1","description":"ICD-NFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGC1","description":"ICD-CIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAE1","description":"ICD-BDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKF1","description":"ICD-NIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEB0","description":"ICD-IIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDE0","description":"ICD-MEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEE0","description":"ICD-JGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLE0","description":"ICD-BCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ naloxone hydrochloride (zimhi)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2311","description":"Injection_ naloxone hydrochloride (zimhi)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73040","description":"Contrast x-ray of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0604","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0604","description":"HCPCS-B0604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX26","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAC1","description":"ICD-AGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49429","description":"Removal of shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEF1","description":"ICD-MDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOD1","description":"ICD-OHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERA1","description":"ICD-CERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Single visn sphere 4.12-7.00","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2101","description":"Single visn sphere 4.12-7.00","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Middle ear surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69799","description":"Middle ear surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ open or percutaneous_ incl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37247","description":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ open or percutaneous_ incl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRD1","description":"ICD-CDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJE1","description":"ICD-GAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of finger tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26474","description":"Fusion of finger tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81259","description":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFA1","description":"ICD-KHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Wound pouch each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6154","description":"Wound pouch each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAD1","description":"ICD-ADAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (inherited thrombocytopenia)_ genomic sequence analysis of 23 genes_ blood_ buccal swab_ or amniotic fluid (Versitiā„¢ Inherited Thrombocytopenia Panel)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0276U","description":"Hematology (inherited thrombocytopenia)_ genomic sequence analysis of 23 genes_ blood_ buccal swab_ or amniotic fluid (Versitiā„¢ Inherited Thrombocytopenia Panel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Blood sulfhemoglobin assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83060","description":"Blood sulfhemoglobin assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEF1","description":"ICD-FCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEC1","description":"ICD-FFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUB1","description":"ICD-ODUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEB1","description":"ICD-IAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMD0","description":"ICD-ABMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTD0","description":"ICD-MJTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQB0","description":"ICD-GEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Swivel adaptor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8186","description":"Swivel adaptor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGB1","description":"ICD-JDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCB0","description":"ICD-CGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Als1-emergency","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0427","description":"Als1-emergency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPB1","description":"ICD-BAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDE1","description":"ICD-IGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDD1","description":"ICD-KHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Remove epididymis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54840","description":"Remove epididymis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGA0","description":"ICD-FCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWA1","description":"ICD-LAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMA1","description":"ICD-NFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXE1","description":"ICD-OLXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYD0","description":"ICD-HBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAA1","description":"ICD-NGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHB0","description":"ICD-BEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATC1","description":"ICD-OATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat shoulder dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23650","description":"Treat shoulder dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHD0","description":"ICD-CAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 60 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0149U","description":"Drug assay_ definitive_ 60 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves_ including fluoroscopic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0782T","description":"Bronchoscopy_ rigid or flexible_ with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves_ including fluoroscopic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg_ DiGeorge syndrome_ Cri-du-chat syndrome)_ circulating cell-free fetal DNA in maternal blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81422","description":"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg_ DiGeorge syndrome_ Cri-du-chat syndrome)_ circulating cell-free fetal DNA in maternal blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAB1","description":"ICD-NDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insertion Of Ventricular Assist Device_ Percutaneous_ Including Radiological Supervision And Interpretation; Right Heart_ Venous Access Only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33995","description":"Insertion Of Ventricular Assist Device_ Percutaneous_ Including Radiological Supervision And Interpretation; Right Heart_ Venous Access Only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Neuromuscular reeducation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97112","description":"Neuromuscular reeducation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYC1","description":"ICD-KBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ureter stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51060","description":"Removal of ureter stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIC1","description":"ICD-FHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHE1","description":"ICD-JCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62327","description":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDE0","description":"ICD-ODDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKB0","description":"ICD-FCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Unplnd hosp readm in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9310","description":"Unplnd hosp readm in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPD1","description":"ICD-KEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAB1","description":"ICD-FGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEE1","description":"ICD-ABEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0589U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","description":"CPT-0589U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDE1","description":"ICD-KGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4GB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GB31","description":"ICD-4GB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEF1","description":"ICD-ICEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB13A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatric service/therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90899","description":"Psychiatric service/therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCC1","description":"ICD-JGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 BIVALENT 50 MCG/0.5 ML ADDL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0134A","description":"IMM ADMN SARSCOV2 BIVALENT 50 MCG/0.5 ML ADDL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e._ patient has an abnormal neurological exa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9536","description":"Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e._ patient has an abnormal neurological exa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATB0","description":"ICD-MATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC2C","description":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDA1","description":"ICD-MIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICC0","description":"ICD-JICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat vagina infection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57150","description":"Treat vagina infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUA1","description":"ICD-BHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGA0","description":"ICD-FEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELE0","description":"ICD-AELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAD1","description":"ICD-CGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXD1","description":"ICD-CIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ablate atria lmtd add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33257","description":"Ablate atria lmtd add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJF1","description":"ICD-JCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLC0","description":"ICD-BBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBD1","description":"ICD-GEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIF0","description":"ICD-NLIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC11","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKD1","description":"ICD-FFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSB0","description":"ICD-GCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSE1","description":"ICD-LGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWB0","description":"ICD-DCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g._ spirometry equipment not available at the time of the encounter)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1217","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g._ spirometry equipment not available at the time of the encounter)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies_ other t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0017","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies_ other t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55712","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","description":"CPT-55712","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL44","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD244","description":"Special Care High _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Gardner vag dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87511","description":"Gardner vag dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD260","description":"Special Care Low _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBF1","description":"ICD-OKBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Part removal of ankle/heel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28120","description":"Part removal of ankle/heel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEB0","description":"ICD-ABEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m sulfur colloid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9541","description":"Tc99m sulfur colloid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Rear whl compl pneum tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0070","description":"Rear whl compl pneum tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQE1","description":"ICD-LHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQF1","description":"ICD-PLQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAB0","description":"ICD-NEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOF1","description":"ICD-DDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWF1","description":"ICD-KEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ eflapegrastim-xnst_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1449","description":"Injection_ eflapegrastim-xnst_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Revise urethra stage 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53400","description":"Revise urethra stage 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX50","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARF0","description":"ICD-OARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCA1","description":"ICD-MJCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Artacent AC_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4189","description":"Artacent AC_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB40","description":"Ultra High Rehab _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDA1","description":"ICD-BFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Automatic ext defibrillator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0617","description":"Automatic ext defibrillator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOA1","description":"ICD-DCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Dx bronchoscope/wash","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31622","description":"Dx bronchoscope/wash","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCB1","description":"ICD-GFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Insert aqueous drain device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0253T","description":"Insert aqueous drain device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXE1","description":"ICD-OBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Recon_ cta for surg plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0288","description":"Recon_ cta for surg plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKD0","description":"ICD-BHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWF1","description":"ICD-GCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Incision of tendon & muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23405","description":"Incision of tendon & muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQD0","description":"ICD-PDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITA0","description":"ICD-GITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Bat clps elec/comb vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0497","description":"Bat clps elec/comb vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFE0","description":"ICD-JEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLC0","description":"ICD-MHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITB1","description":"ICD-KITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of ureter & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50810","description":"Fusion of ureter & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBC1","description":"ICD-BIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARE1","description":"ICD-GARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCA1","description":"ICD-MBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAD1","description":"ICD-JIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLF0","description":"ICD-FGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Vol reduction of blood/prod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86960","description":"Vol reduction of blood/prod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient receives hcv antibody test with nonreactive result","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1231","description":"Patient receives hcv antibody test with nonreactive result","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAD0","description":"ICD-NLAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiological Evaluation Of Implantable Cardioverter-Defibrillator System With Substernal Electrode (Includes Defibrillation Threshold Evaluation_ Induction Of Arrhythm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0577T","description":"Electrophysiological Evaluation Of Implantable Cardioverter-Defibrillator System With Substernal Electrode (Includes Defibrillation Threshold Evaluation_ Induction Of Arrhythm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Services of skilled nurse in home health setting_ each 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0154","description":"Services of skilled nurse in home health setting_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGF0","description":"ICD-JIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCC0","description":"ICD-ODCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFF0","description":"ICD-GFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24516","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAC0","description":"ICD-CAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Patient not screened for tobacco use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1312","description":"Patient not screened for tobacco use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAD0","description":"ICD-BEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-da","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB26","description":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"Laiv vacc pandemic intranasl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90664","description":"Laiv vacc pandemic intranasl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"No wet-dry drssings rx recmd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4266F","description":"No wet-dry drssings rx recmd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXE0","description":"ICD-KIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":64.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2102536176]}]}]}